Health IT, Patient Engagement

Beyond the reminder: Patients need virtual assistants to help with meds

Chronic disease in the U.S. is at an all-time high, with half of all adults […]

Chronic disease in the U.S. is at an all-time high, with half of all adults managing at least one chronic condition, such as diabetes, heart disease or obesity. Though the majority of these conditions could be prevented through patient adherence to care plans that address controllable factors, chronic diseases are still responsible for seven out of 10 deaths in the U.S., killing nearly 1.7 million people each year.

Not only are chronic diseases deadly, but the country as a whole spends $317 billion per year on medical costs to treat avoidable health complications. Even with pharmaceutical advancements, costs will not stop climbing unless we advance patient adherence.

Patients continue to express the desire for the medical industry to find a solution that meaningfully improves care. However, patients are picky. They don’t just want any solution – they want one that requires minimal effort on their part while providing quick resolution to any health concerns (and preferably giving answers via the internet or their smartphones rather than having to call or email a physician). At the same time, 88 percent of physicians want patients to monitor their health at home.

We’re our own worst enemy

Ultimately, the issue lies with the patient. Human error is the underpinning of most chronic disease complications. For patients taking prescription medications to manage their conditions, behavioral issues such as simple procrastination and forgetfulness are 69 percent of the problem. If patients would only stick to their prescribed care plans, their health will improve. But they don’t.

Although they continue to gain popularity, health and fitness trackers are not the solution. Devices like the Samsung Simband or the Jawbone Up wristband don’t create change, they just create more data. Out of more than 43,000 health or medical apps on iTunes, less than 50 actually relate to condition management. The rest just tell you how far you run, how many calories you burn… you get the idea. And even if data collection was the answer, 90 percent of these apps score 40/100 or less for functionality according to an IMS study.

Pill reminder apps might seem like the solution, but in fact they only provide a patient with a list of tasks to complete. Apps like the Drugs.com Pill Reminder and MedCoach Medication Reminder only do part of the job. Yes, they can remind you when to take your medicine, and they can even remind you when you need a refill your prescription. But how does that help a patient who can’t remember what they’re actually supposed to do when it’s time to take their medication? Siri can’t tell someone what their dosage should be, or provide answers to their questions about proper administration and side effects. When you can’t get the answer you need, Siri suddenly seems less helpful.

From nagging to coaching

To solve non-adherence, we need to go beyond the pill reminder. We can’t just nag patients by telling them it’s time to take their medication. Especially for chronic conditions, patients need help knowing not just when, but how to take their medication. Physicians today rely on the fine print of pill bottle labels, and paper pamphlets that are easily lost, to direct patients regarding how to take their prescriptions. But knowing how to properly administer medication for diseases such as diabetes and MS is much more complex than taking a pill with a glass of water.

Virtual assistant technology provides the key to unlocking patient adherence, enhancing patient care and ultimately improving outcomes. We need to give patients highly personalized intelligence and support to go along with their medication. According to Timothy Bickmore, PhD, Associate Professor at Northeastern University, College of Computer and Information Science, “. . . relational agents can play a major role in chronic disease management.”

In his study, Bickmore found that not only would 74 percent of hospital participants rather interact with an intelligent virtual assistant than an actual human being, but adherence for anti-psychotic medication increased 39 percent using virtual assistant technology.

Virtual health assistants go the last mile for patients. Once a patient walks out the doors of a hospital or clinic, aside from calling or emailing their physician, a virtual health assistant is the only solution that can provide easily accessible, accurate information on health conditions, symptoms and management. And, through frequent interaction, VHAs can facilitate real behavior change by motivating and coaching patients, proactively engaging them to adhere to their care plans and guiding them through the process of taking their medication.

The technology is available, we just need to finetune it for healthcare. The investment in virtual health assistants is certainly worthwhile — remember the $317 billion the U.S. spends each year? If we solved non-adherence, those funds could be used to cover the cost of healthcare for 44 million Americans.

Thomas Morrow, MD

Dr. Morrow is chief medical officer for Next IT. He has more than 30 years of experience in healthcare, including 14 years of clinical practice and 10 years as an NCQA Surveyor. He also served as a physician executive for Genentech, Inc. and is a prolific writer, including the medical technology column Tomorrow’s Medicine, in Managed Care Magazine.

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