Empowering people to live with chronic conditions

Submitted by Jerry Halberstadt on Sun, 10/26/2008 - 17:47

What are the prospects today for enabling people living with a chronic health problem (like sleep apnea, COPD, or diabetes) to be empowered to manage their own health? What is the role of technology in enabling "connected health" using the internet, smart phones, and testing devices to connect the patient living his or her life with the doctor?

Because I believe that information, education, and support are vital elements in enabling people to achieve effective adherence to treatment (patient-centered "compliance"), I published patient handbooks for people living with sleep apnea and COPD. I came to see that such publications, while effective, were not sufficient to change the delivery of health care except for the individual reader. Because chronic care is so costly, in both human and financial terms, I searched for better methods.

A better system would address several issues:

Primary care physicians need to recognize a chronic disease and to be aware of the best methods for preventive and routine care that will prevent the need for expensive acute intervention.
Physicians need to adopt a collaborative mode of working with patients who must be responsible for their own daily care.
New forms of interaction and communication are needed: connecting medical experts to patients not only in the office, but wherever and whenever the patient needs expert support. Technologies are becoming available and some institutions are expanding the use of communication technology beyond the physicians office or the hospital.
Professionals and laypeople alike will need to adopt new patterns of relationship.
Payment systems need to reward prevention and health maintenance, not just acute interventions.
Needed: a context for connecting patients and their families to others like themselves.
The barriers are many. The health care system and the political system need to work to introduce change.
Mobilizing patients and their families to help inform and educate the medical community and the public.

For insight into the state of the art, I report on a seminar presented by the Center for Connected Health. Based in the Partners system in Boston, they state that "We are engaging patients, providers and the connected health community to deliver quality care outside of traditional medical settings."

Presenters and exhibitors at the seminar represent people and institutions that have been working to advance new models of patient care. I expect to have a new set of criteria and goals after attending the seminar.

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