Adherence is one of the biggest challenges physicians face in diabetes management. The reasons for noncompliance are multiple, including time-consuming and complicated care plans that require regular glucose monitoring, insulin injections, food-intake monitoring, multiple logs and diaries, and, if not controlled, the addition of new therapies.
For physicians and clinical care teams, the commitment to keep their patients engaged with their care is significant and frustrating. Additionally, the types of care protocols physicians need to think through have increased due to innovations in diabetes management and advances in classes of treatments. The mixture of disease escalation and progression coupled with reduced clinical time, increased demand on physicians, and ongoing adherence challenges have created the perfect storm for personalization and digital health solutions.
As scientific and care breakthroughs have advanced, so have new digital solutions, which offer a wider range of targeted and personalized support to physicians and people with diabetes. Such digital solutions, like mobile apps, are rapidly changing the management and care of patients with diabetes — from simple blood glucose tracking to more sophisticated clinical decision tools that enable behavioral changes, better adherence, and proactive diabetes management. Furthermore, the capacity to collect and analyze real-world data has moved the real-time management of diabetes even further forward.
Unfortunately, data alone cannot solve the compliance and adherence issues. Nor has access to better real-time data helped address the significant time required to treat people with diabetes. What focused digital healthcare solutions have done is reduce the time to resolve noncompliance complications and broader disease progression for those who actively adhere to their care plans.
Game-changing, personalized digital solutions are on the cusp of reducing the physical and financial impact of diabetes management. Mobile apps powered by cloud-based technology, and wearables, coupled with meal trackers, are creating algorithms of calories, movement, and weight. These seemingly simple devices have Nudge transformative impacts.
A small research study, published in 2013 in the Journal of Medical Internet Research, found that in combination with traditional physician care, support tools such as digital adherence programs combined with weekly text-message support from a healthcare professional can significantly improve glycemic control in adults with diabetes.
Treating diabetes will only get easier with new glucose monitors on the market that make it easy to see glucose data in real time, including pushing physicians to use EHRs to track progression.
Growing platforms of care for people with type 2 diabetes are clearly starting to improve disease outcomes, whether that’s better adherence or compliance to treatment. New technologies such as gamification or multi-layered apps designed to share, analyze, and visualize real-time health data across different platforms and populations are changing personalized medicine and individualized care. “Health 3.0” is revolutionizing the way people take control of their own health and promises to transform healthcare systems by giving doctors valuable new insights and researchers clues to the prevention and management of chronic illness.
Care within diabetes has slowly been progressing through telemedicine and remote care monitoring. Part of the slow progression has been the result of many physicians’ low engagement with remote consultation, due in part to the lack of training and limited reimbursement. However, hospital and payer pressure (particularly due to outcomes-based models) is opening new remote care channels and business opportunities for physicians and the broader care community.
The biggest barrier to digital adoption by people with diabetes (and physicians) rests largely in the user experience and the design of current apps, trackers, and websites. Many of the current digital tools have been developed for mass consumption, requiring significant time to input health data and daily activities. For physicians, the lack of integrated networks that allow for real-time review of a patient’s progression has been a challenge. Currently, physicians need multiple dashboards or multiple sign-in web applications to review a patient’s condition.
Managing diabetes means an entire lifestyle adjustment for patients, which is a massive undertaking, for those with a deadly progressive disease. But clinical outcomes depend on both the patients’ adherence and their willingness to change behavior and lifestyle. This will continue to push digital health innovators and pharmaceutical companies to develop solutions for diabetes management.
Even with new advancements such as subcutaneous insulin, which releases when blood glucose is too high and then turn off when glucose returns to a safe level, will require consistent personalized content to patients to support healthy lifestyles. Medication alone does not solve for control, and physicians still require support in prompting and promoting people with type 2 diabetes to exercise, eat right, sleep well, and avoid certain negative behaviors. It is the ecosystem and interconnected platforms designed for the patient, for the physician, and for the whole care community that will genuinely change the care continuum and quality outcomes of people with diabetes.
Cassandra Sinclair is the EMEA lead at Wunderman Health.