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Remote Monitoring: A Powerful Tool for Patient Adherence
Improving patient adherence is a great challenge for payers, providers and producers, education and monitoring solutions bringing together all stakeholders are fundamental to bringing about positive change, says Deepak Arora, Global Associate Brand Director at Novartis.
According to the World Health Organization, over half of all patients with chronic conditions do not take medications as prescribed, compromising treatment effectiveness, inflating costs and leading to poor health outcomes, and premature death.
Physicians, providers and producers are becoming increasingly aware that it's not enough to tell patients that they need their medication, more attention must now be paid to educating healthcare consumers about the nature of their treatment, and giving them a say in deciding what solutions to choose.
Support programs are being tailored to patients’ individual needs in order to provide information about their illness and the skills they need to manage it. How they feel and what they think about their condition and the treatment, will affect them and the overall success rate. Various stakeholders must be involved in this process to maximize efforts toward better patient outcomes.
“The conventional way of managing chronic conditions was contacting patients and making sure their fillings of the prescription were normal. Now there are blood tests … which give a complete long-term compliance report, and are programmed to text patients' phone to remind them about the dose,” Arora told us, illustrating how using a variety of technologies can support patient adherence.
“It costs a lot at the beginning, but it leads to a reduction of 'frequent flyers'.”
Integrated approaches were first introduced by medical device companies, which created surgically-implanted devices that allowed constant monitoring of organ function in recent transplant recipients. The information was collected and fed back to the physician in real time, allowing for any necessary intervention to be delivered immediately.
“It costs a lot at the beginning, but it leads to a reduction of 'frequent flyers', i.e. patients who keep coming back to the hospital. Ultimately, we see a reduction in hospital visits and an improvement in compliance, outcomes, even patient-physician interaction,” Arora said, adding that in the US and EU remote monitoring market is expected to reach approximately US$700M by 2015.
Remote monitoring is easy enough for transplant patients – where devices are implanted with organs– but other chronic conditions, e.g. diabetes, need to be followed-up on, too. Remote monitoring, which helps doctors, patients and scientists stay in touch for personalized health advice and education, was created with those individuals in mind.
Forgetting is the most frequent reason quoted by patients for giving up on doctors’ orders. Taking medication regularly requires considerable self-discipline, and there’s considerable interest in solutions that take the burden of tracking medication intake off patients’ minds, while allowing to avoid bad outcomes.
“The patients who take monitoring particularly seriously are patients who have failed, and who have to move from pills, diet and exercise, to injectable insulin. The closer patients get to the needle, the more help they welcome with their day-to-day diabetes monitoring system,” Arora explained.
Patients enrolled in monitoring have their information constantly streamed back to their physicians, who can provide tailored, non-stop feedback on their condition. Thanks to an infrastructure that relies on input from multiple sources, patients can be constantly advised, educated, and informed. This keeps them motivated to adhere to their treatment plan diligently.
While patients have the choice not to subscribe due to privacy concerns, Remote monitoring seems to offer the right balance between access to information and data protection. “To avoid misuse, third-party managers or hospitals take care of the data directly, the information is collected and monitored by the staff of those facilities and the physician is the owner of that data, without third-party interference,” Arora explained, showcasing the need for cooperation between various stakeholders this kind of solutions require.
“The buzz words now are reduction in re-hospitalization, shorter length of stay, lower in-hospital mortality and improved long term outcomes.”
Improving patient compliance is in everybody’s interest. It will improve health outcomes, leaving less patients dying prematurely and significantly improving their quality of life. All this while lowering healthcare costs by keeping people out of hospitals, and reducing time of hospitalizations of those already admitted. Costs for healthcare providers will be reduced and sales of pharmaceutical products will increase, making the market more receptive to innovation. But getting everybody to play their part might be more difficult than it seems, as both pharma and payers identify physicians as the main source of influence on patient adherence.
Indeed, patient-physician interaction is a vital element of compliance. After all, it's the physicians who monitor, advise, and counsel, but that interaction is changing. “In today’s world with social media things are coming to a possibility of patient-physician interaction in more partnering way,” Arora said.
How to engage other stakeholders? “The buzz words now are reduction in re-hospitalization, shorter length of stay, lower in-hospital mortality and improved long term outcomes – all those resonate with payers and healthcare providers. Innovation in patient access and support programs that improve compliance resonate with physicians and patient advocacy groups,” he added.
Example solutions include bonuses when departments run well, increasing payoff depending on the severity of a patient's state, and penalties for hospitals for readmissions within a certain timeframe.
“We should include healthcare providers and pharma in the social responsibility of supporting patient compliance, instead of blaming non-adherence on patients.”
The opinions expressed within this article are the opinions of the interviewee only and in no way represent the opinion of Novartis Healthcare Private Limited.
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