How Can Digital Tools Aid Long-Term Chronic Care Management? (Omada Health)
For over a decade, Omada Health, a US digital behavioral medicine company, has helped individuals living with prediabetes, diabetes, hypertension, and musculoskeletal issues manage their care better with the help of digital tools and personalized support. Their reflection on what works in chronic care? Motivation is malleable, and understanding specific health goals is essential.
Chronic diseases are the result of a combination of genetic, physiological, environmental, and behavioral factors. They require long-term management and often behavioral changes. Achieving long-lasting effects can be extremely difficult, and digital health solutions have since the beginning been seen as an important factor in assuring success, by providing patients with continuous monitoring and feedback. But that doesn’t suffice.
Technology plays a role in chronic care management, but human support and accountability are irreplaceable.
Sean Duffy, the CEO of Omada Health observes that lifestyle interventions are crucial alongside medications for long-term weight management. Lifestyle modifications have to include personalized strategies and incorporate small changes into a patient's lifestyle.
The quality of life and individual circumstances should be considered when measuring long-term impact. Omada Health aims to provide continuous support that adapts to patients' changing needs and situations. They have seen positive results in terms of cost management and reduction, with potential savings ranging from $800 to $3000 in year three per individual. This digitally supported intervention offers greater ROI compared to traditional healthcare services, which lack quantifiable savings opportunities.
A needed change: billing and financing of a-sync care
The tricky part in managing long-term conditions is that many challenges occur in-between medical check-ups. With the introduction of telemedicine, messaging, apps, and remote care, the insight into what happens to patients while they’re outside the doctor’s office, has significantly expanded. Asynchronous care improves the patient experience. However, incentives to support additional support and guidance in these “in-between” spaces, is not well supported yet, says Sean Duffy. “Most fee-for-service billing is set up for synchronous time. The CPT code infrastructure is set up for charging for units of time. And the challenge with that is the entire preference of the globe has shifted from synchronous to asynchronous. And so if you talk to the average primary care clinician right now in the US their job is really not fun. They're doing their visits during the day, either virtual or in person. And then in the nights or weekends, they're trying to burn down their MyCharts messages. Unpaid. I think a good step one without overthinking any health system is to just really lean into finding paths to asynchronous care and thinking through how do we do this? How do we incentivize our physicians? How do we carve the time? What are the expectations? What should be done?”
In essence, this is a to-do list for policymakers and insurers to consider:
1. Lean into asynchronous care and find paths to incentivize physicians, carve out time, and set expectations.
2. Explore creative ways to foster and embrace asynchronous care instead of fighting against it.
3. Evaluate how the payment system can support synchronous care billing for asynchronous care to encourage a shift towards value-based models.
4. Enable asynchronous billing even within fee-for-service models to promote more value in healthcare delivery.
Tune in to the full discussion on Spotify: