Telehealth for Chronic Disease Management in the United States

In the management of chronic diseases, telehealth can help bridge gaps in delivery and improve efficiencies of the system and can benefit both physicians and patients. Different applications of telehealth technologies can be leveraged to improve quality of services and reduce cost of the provision of such services to chronically ill people.

For instance, telehealth at home uses remote monitoring systems in patients’ homes to track vital sign readings and generate daily reports on their condition; such information is then relayed to care managers. Currently, an important aspect of remote health monitoring systems is the cooperation of the patient. The system is designed such that the patient can be engaged in a daily session of interactive content that tracks the health of the patient. However, we are in the early phases of learning how to use this technology and over time we will want these systems to operate in the background with minimal patient engagement.

This daily tracking by the patient promotes an awareness of one's health and encourages self-management among patients. The constant monitoring of health indicators also allows for a more accurate assessment of real-time conditions leading to early detection of possible exacerbations, and gives way for a more appropriate preventive measure. This close tracking and subsequent preventive measures offered by a clinician and followed by the patient can reduce the occurrence of hospitalizations and emergency room visits. In addition, when patients do need to consult a professional, they can often do so remotely, thereby reducing loss time waiting in the clinics or hospitals. Benefits of this alternative means of patient management will be noted throughout this report, and particularly in the focus on telehealthcare interventions with patients living with congestive heart failure (CHF).

Despite the huge potential for telehealth, the technology and ways to deploy it are still in their infancy as noted by Richard Kimball. The Pew Internet and American Life survey found in 2013 that a majority (59 percent) of U.S. adults surveyed have looked online for health information in the past year. When asked what they did the last time they were sick, 70 percent of individuals responded that they sought treatment or information from a health care provider; however, only a small fraction of those individuals used telehealth services. Only 1 percent of all respondents reported exclusively receiving care or information from a physician or other health care provider online; 8 percent reported receiving care from a health care professional [both online and offline].

A shift to a technology-based approach is imminent, however. The growing ICT infrastructure is introducing ways to reduce the cost of healthcare delivery through telehealth by increasing its use. [Referencing surveys ] conducted by HIT consultancy, the American Hospital Association (AHA) January 2015 report discussed this development, in which it is noted:

Telehealth has moved into the mainstream. In 2013, 52 percent of hospitals utilized telehealth, and another 10 percent were beginning the process of implementing telehealth services. Consumer interest, acceptance and confidence in telehealth are growing as well. Recent studies on the use of telehealth services have shown that:

• 74 percent of U.S. consumers would use telehealth services;
• 76 percent of patients prioritize access to care over the need for human interactions with their healthcare providers;
• 70 percent of patients are comfortable communicating with their healthcare providers via text, email or video, in lieu of seeing them in person; and
• 30 percent of patients already use computers or mobile devices to check for medical or diagnostic information.

One example of companies offering telehealth distribution methods for the management of chronic care is HExL. Richard (Rick) Kimball Jr. is CEO and Founder of HExL. HExL enables independent primary physicians to transform their practices financially and clinically to drive better health outcomes, lower costs and improve accessibility. We offer a turnkey technology enabled service enabling primary care physicians to enter into value based reimbursement programs and to be paid for keeping patients healthy.