I

magine being given the keys to a complex, high-tech car and told to drive it across the country with minimal instruction and no manual. That’s what it can feel like to be told you have diabetes, asthma, kidney disease, or some other complex chronic condition.

Take diabetes as an example. People diagnosed with this lifelong condition have to do a lot more to manage it than take medication. It’s a day in and day out process of monitoring blood sugar levels along with every bit of food consumed. Months can go by between doctor visits, with many people floundering in their attempts at self-management and falling off course with their care plans. Others, feeling overwhelmed, forget to follow up with providers, miss medication doses, and don’t eat healthily or exercise.

Chronic disease is a thorn in our nation’s side. About half of US adults have at least one chronic disease, while one-quarter of us have two or more of them. Chronic diseases are costly to treat, accounting for a staggering 86 percent of our national health care costs. Perhaps most perplexing is that chronic diseases such as heart disease, stroke, cancer, type 2 diabetes, obesity, and arthritis happen to be the most preventable — yet chronic disease is still the nation’s leading cause of death and disability.

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Health coaching is a useful tool for managing chronic diseases. It isn’t new. But it is increasingly being seen as an effective way to influence and support long-lasting behavior changes in patients with chronic disease, especially complex ones like diabetes or addiction. A health coach can be the advocate that patients and providers need to help empower individuals to take control of their health through disease education and consistent support.

Research shows that the extra human touch from health coaches can have an extraordinary impact. Individuals who can offer health education to patients as well as build relationships based on trust and unequivocal support can be game changers in the management of chronic disease.

As powerful as the patient-coach connection can be, technology can extend it and further individualize care. Many companies, including my own, Welkin Health, are now using technology to widen the reach of health coaching and deliver its benefits to more people living with chronic conditions.

Say a person living with diabetes has questions that come up on a daily basis — can I eat this piece of cake or enjoy a burger at a friend’s barbecue? Or perhaps someone managing addiction is having a rough day and just needs a few words of encouragement to stay on track. These individuals can contact their personal health coach via phone, email, text, or video conference — whatever means they prefer. Today’s technology puts this support a fingertip away.

Taking it a step further, many of the platforms that help connect health coaches to patients also capture essential data that can be analyzed and used to further personalize their care. Every person is unique — what works for one may not work for another — so the ability to personalize care increases the odds that health goals will be met.

This more personalized approach to care for people with chronic illness will be increasingly important as the health care industry undergoes broad changes. The transition to value-based care will require treatments that meet patient needs and improve health with reporting of real-world outcomes. Health coaching with a technology platform makes it easier to track results over time, and can help identify the long-term improvements in health outcomes that everyone in the health care industry is striving to achieve.

The benefits of technology-assisted health coaching for improving health outcomes and lowering overall health care costs are clear. However, uncertainty around changes in health care policies and incentives make it challenging to get the support necessary for widespread adoption of this approach for chronic disease care.

At the end of the day, healthier people cost less to care for. And preventive health, especially for chronic diseases, is the best kind of health care.

Chase Hensel is the CEO and cofounder of Welkin Health, which makes a software platform for life science companies that work with health coaches.

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  • whoa! Someone woke up on the wrong side of the bed. I wrote “I am pleased to see the disease management model evolving.” Not sure how that translates into “bashing.”

    If you want to see the wellness industry “bashed,” I’d suggest you look at any article in any lay or high-end academic publication — including STATNews — and basically any comment to those articles. People (other than you, apparently) don’t need me to tell them they’re being snookered.

    I didn’t quote myself — I quoted the HCUP database. All you need to do is find a smart person to explain this database to you, and you’ll see that “86% of cost being due to chronic disease” (inexplicably raised from their previous mantra of 75% — which means spending on acute and preventive care was almost cut in half, and somehow no one noticed) simply doesn’t remotely pass the sniff test for employers, very little of whose cost is avoidable wellness-sensitive medical events.

    Either your employer is hiring very unhealthy people or else you should ask that smart person to explain to you how the only events that can be avoided through screening the stuffing out of your employees are heart attacks and diabetes events, and combined they account for about 2% of spending.

    And if you’re so sure you’re right, why aren’t you and your cronies in the wellness industry claiming the $2-millon reward? I’m just askin’… http://insurancethoughtleadership.com/2-million-reward-if-wellness-works/

  • As the person who is credited by search engines with inventing disease management, I am pleased to see it evolving beyond the old call center model, which was quite ineffective. The jury is still out on this new model, but at least it is lower in cost, and has the advantage of offering greater responsiveness.

    We know this model does not work for wellness, though, since most people don’t want to share information on their health with their employer or an agent of their employer. However, if someone already has a chronic disease, they might find that the usefulness outweighs the privacy impact.

    By the way, that “staggering” 86%-of-cost-due-to-chronic disease figure is a total urban legend. http://www.ajmc.com/contributor/al-lewis-jd/2016/02/chronic-disease-in-the-workplace-are-we-fighting-the-wrong-battle

    • Al

      The author is citing the CDC’s data on chronic conditions and includes Medicare data. You cite yourself, which as anyone in a debate would tell you is not factual.

      Take us for example. Among our 14,500 covered lives, one-third had at least one chronic condition, and those 4800 people accounted for 68.2% of costs, but that number includes a lot of children. Take them out and just look at adults, and chronic conditions account for 82% of adult costs, not far off from that number.

      You also never miss an opportunity to bash wellness efforts, and in this case keep up the notion that “most” people won’t “share” information with their employer, even though said employer doesn’t see individual data. How would you explain our results of getting 93% of our covered employees and 78% of covered spouses to participate in our wellness efforts alone, and really without complaints?

      Personally, I take the position that coaching is just one of many parts of a multifaceted approach to successfully addressing health care costs and trend, plus attendant health related metrics like productivity, sick leave, overtime expenses, disability, presenteeism, etc. I particularly like, and we have been successful with, the high tech, high touch model of Livongo for our population with diabetes. A connected glucometer that is also a communication device, big data engines and 24/7 human support by certified diabetes counselors. See their white paper on our experience with them.

  • Health coaches are a critical part of helping our healthcare system better serve patients with chronic disease. As a family care doc I know that my patients sometimes struggle to comply with the treatment plan we agreed upon together—whether that’s increased physical activity, changes in diet, or adding stress reduction exercises to their daily routine.

    Health coaches can fill in the gap between visits to my office and offer patients advice and encouragement as they integrate self-care into their treatment regimen. They are key change agents to help shift our healthcare system from one that is focused on reacting to disease and injury into one that also supports prevention and fosters health and wellbeing.

    This is the core of what integrative health is all about. An approach to healthcare in which healing is as important as curing. Where the focus is not just on countering illness but also on supporting health—fully integrating preventative care with the treatment of disease, illness and injury.

    An efficient, integrated, well-operating, patient-centered team system needs to be the focus of any healthcare delivery. Then we will be able to provide healing to all people.

    Wayne Jonas, MD
    @DrWayneJonas

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