Chronic diseases, which affect six in 10 adults in the United States, are a leading driver of the nation’s spiraling healthcare costs. Medical providers often struggle with the barriers to effective chronic disease management. The crux of the issue: Finding cost-effective ways to reach out to patients and provide them with sufficient support to do what they need to do to stay well as they work to manage conditions such as heart disease, cancer, and diabetes.
The good news? Telehealth is now a proven tool for helping healthcare providers provide effective health management. The Community Preventive Services Task Force (CPSTF), an independent panel of experts, has concluded that telehealth strategies can reduce chronic disease risk factors and help with managing common chronic conditions.
Telehealth for Chronic Disease Management
When it comes to chronic disease management, telehealth can take many different forms:
- Virtual visits with providers
- Electronic reminders of upcoming appointments and when to take medications
- Remote patient monitoring (such as patients monitoring their own blood pressure, then sending that information to their provider)
- Educational outreach
After reviewing a wide range of telehealth interventions, the CPSTF concluded that telehealth can effectively help patients with chronic diseases do better at properly taking their medications and sticking to their healthcare goals.
The CPSTF now recommends using telehealth for chronic disease management. These strategies can help patients manage a wide range of conditions, including cardiovascular disease, high blood pressure, diabetes, HIV infection, end-stage renal disease, asthma, and obesity.
Telemedicine Methods to Manage Chronic Disease
Telemedicine applications continue to become more reliable and more sophisticated.Live videoconferencing makes it easy for providers to examine patients from afar — which is particularly valuable in this age of COVID-19 and for patients with mobility and transportation barriers. It also allows specialists, in stroke cases, for instance, to examine and oversee the treatment of patients at home, in nursing homes, and in critical access hospitals.
There is also store-and-forward videoconferencing, which allows providers to quickly share lab results, imaging studies, and other reports with patients and/or specialists.
Remote patient monitoring allows patients to use electronic devices to check their own health benchmarks, including weight, blood pressure and blood sugar, and send the results directly to their providers. And mHealth helps patients use mobile devices to set up reminders for themselves and/or monitor progress toward their health goals.
And, of course, patients and providers can also stay in touch from afar the old-fashioned way: over the telephone.
The Evidence that Telemedicine Works
The annual cost of cardiovascular disease is estimated at between $273 and $444 billion, according to studies surveyed by the CPSTF.
We know that managing blood pressure and cholesterol and quitting smoking substantially reduce the risk of heart attack and stroke. And the studies the CPSTF reviewed showed that telemedicine interventions are helping cardiac patients adhere to medication protocols, more reliably follow up with their providers, set goals, and successfully manage their risk factors. The panel found that interactive digital devices have proven effective at helping patients manage their own blood pressure — and even found that patients who use telemedicine are more likely to stay in cardiac rehabilitation programs.
The CPSTF also found strong evidence that text messaging interventions help patients with asthma, diabetes, HIV infection, and cardiovascular disease better adhere to their medications. Sent through mobile phones, these messages vary — from weekly reminders, to texts that actually remind patients at the time they are supposed to take their medicines. Some messages are personalized and some even involve the possibility of two-way communication, with patients being able to text their providers. One meta-analysis found that text message interventions doubled the odds of medication adherence among patients with chronic disease.
There is also evidence that telehealth interventions helped patients with cardiovascular disease, end-stage renal disease, and diabetes improve their diets by lowering their sodium intake and upping their intake of fruits and vegetables, the panel found. Benefits of these chronic care management interventions through telehealth included weight loss and better blood pressure control.
Why Telehealth Works for Chronic Disease Management
When patients have complex, long-term medical conditions, proper management is a marathon. Telehealth can help provide better access to specialists and improve communication, not only between patients and their providers, but among all of the members of a patient’s health care team.
Telemedicine just makes it a lot easier to communicate. It makes it easier for healthcare providers to keep close tabs on patients with complex illnesses and to convey information those patients need. And it makes it easier for patients to stay in more frequent contact with their providers and even manage their own conditions, without the hassle and expense (and the deterrent effect) of traveling to appointments and waiting in consulting rooms. The result of using telehealth for chronic disease management: improved health and better quality of life for patients, and significant financial savings for patients and the healthcare system, through reduced emergency room visits and hospital utilization.