- Health systems in Massachusetts and North Carolina are launching remote patient monitoring programs to determine whether a telehealth approach to medication adherence can improve health outcomes and reduce ER visits and hospitalizations in high-risk populations.
It’s estimated that half of those taking medications in the US aren’t following doctors’ orders, driving the nation’s healthcare bill upwards by about $310 billion in avoidable costs and $100 billion in avoidable hospitalizations. The problem is acute among those taking multiple medications: the top 1 percent of high-acuity chronic disease patients accounts for 23 percent of that healthcare bill, or about $107,000 per year per patient.
Healthcare officials are hoping a digital health platform that manages medication adherence at home and keeps care providers updated on those patients will reduce those costs and improve overall patient health.
In Massachusetts, Partners Healthcare’s Partners Connected Health and Lynn Community Health Center in Lynn, Mass., are leveraging the Philips Medication Adherence Solution for selected patients enrolled in MassHealth Primary Care Clinician (PCC) plans with a primary diagnosis of schizophrenia, bipolar disorder or major depression.
"Barriers to optimal health outcomes for our most vulnerable patients remain extensive and persistent," Emily Johnson, LCHC's Director of Community Outreach, said in a press release. "With this program and our partnership with Partners HealthCare and Philips, our goals are to improve medication adherence rates through connected technology, build a foundation of intensive and ongoing care coordination, and cut costs of unplanned hospital visits."
"Patients on complex medication regimens are at a high-risk for being unable to take their medication as prescribed,” added Dr. Kamal Jethwani, Senior Director at Partners Connected Health. “We have used technology successfully in the past to help such patients manage their medications. This would be our first trial in patients with mental illness, and if successful, would open an exciting opportunity to manage these patients in more effective ways."
The program is supported by an Innovation Investment Award from the Commonwealth of Massachusetts Health Policy Commission.
In North Carolina, meanwhile, the Greensboro-based Triad HealthCare Network will be using the Philips telehealth platform to measure medication adherence in Medicare Advantage members dealing with chronic conditions.
Triad’s program aims to analyze whether better medication adherence leads to improved outcomes among patients enrolled in one of three leading Medicare Advantage Part D health plans. Officials say these patients tend to have chronic conditions that require several medications and are some of the health system’s most frequent users.
"Medication non-adherence is a multibillion dollar problem," James Osborne, MD, FACP, Senior Medical Director for Population Health at Cone Health, part of the Triad network, said in the press release. "Through this program, we hope to discover an effective method to give our complex patients with a history of non-adherence the ability to stay on track easily. In turn, we aim to reduce unnecessary emergency transports and hospitalizations, and more effectively manage the cost of care."
The Philips platform, developed in a partnership with spencer Health Solutions, includes pre-packaged, multi-dose medications from mail-order and specialty pharmacies, a monitored in-home dispensing device, an mHealth app for caregivers and a clinician portal. The platform connects patients with care team members, including caregivers, clinicians and pharmacists, to make sure medication protocols are followed.
Due to the high cost of medication adherence, healthcare providers and entrepreneurs have attacked the medication management dilemma with a wide array of telehealth and telemedicine technologies. Some of the more notable and promising solutions include text messaging programs delivered to smartphones or wearable devices like the Apple Watch, mHealth patches and tattoos, ingestibles and sensor-embedded medication and smart devices in the home, including digital pillboxes and digital personal assistants.
Payers and the pharma industry are also taking notice. Last December, Humana unveiled a new mHealth app, RxMentor, that’s designed to help members keep track of their medications and deliver timely messages.
“Managing multiple daily medications is challenging especially when those medications might be prescribed for a member by multiple physicians,” William Fleming, PharmD, president of Humana’s Health Care Services, said in a press release. “Remembering all the names and when and how to take them can be a daunting task. The RxMentor tool can take some of those barriers away by giving our members an easier way to keep track of and communicate all their medication to their doctors and caregivers.”
Also last year, Harris County Public Health in Houston reported strong success with the emocha mobile health app, which records videos of the user taking her or her medications, in helping patients with tuberculosis maintain medication adherence during Hurricane Harvey.
“This tool proved to be very beneficial,” said Dana Wiltz-Beckham, the tuberculosis elimination program manager in Harris County Public Health’s Disease Control and Clinical Prevention Department. “There was no interruption of treatment here.”