Treating chronic disease with better-informed and coordinated care

For this blog post I’m reviewing a white paper, “Addressing the cost of chronic disease withbetter-informed and coordinated care” by Lorraine Fernandes, global health ambassador at IBM and Susan J. Hyatt, an advisor to governments and global technology companies for the past 30 years. The paper seeks to outline the type of information systems architecture that governments can invest in and implement to reduce costs and improve care for chronic disease patients.

The authors observe that chronic diseases are responsible for more deaths globally than all other diseases combined. As populations age so will chronic illness, and costs associated with caring for chronically ill patients.

They believe IT technology solutions can help with care of chronically ill patients while reducing costs.
To achieve this goal they urge governments to create programs that are well-managed and coordinate care close to patient’s home or community. Such community based care can be coordinated effectively with greater access to patient and provider information and reduce the use of expensive acute care facilities.

Community based care faces obstacles due to the complexity of coordinating care. It requires “integrated and timely communication between health and community services,” where up-to-date patient information is available and readily accessible by care providers. Care coordination is often fragmented due to little interoperability between healthcare systems. This appears to be case even where EHRs have been implements – they have often replaced paper silos for electronic ones.

The authors argue that to overcome these challenges government investment is required to provide the infrastructure needed to provide complete, real-time patient and provider information to coordinate care for chronically ill patients in community care settings. The current, more costly government investments in acute care can be reduced by investing in technology solutions that end up saving money in the long run.

With interoperable systems of coordinating care we can make available complete patient and provider information. This will result in better care management, increase accuracy of treatment and reduce duplicate treatment or tests, allow for better medication management and reducing risks of drug interactions or overdose, using mobile technology to deliver reminders of medications or care, telemedicine to reduce need for travel and wait times for care, and coordinate ePrescriptions and transportation for patients.

The requirements for such IT solutions includes providing systems that are interoperable, scalable to the growing data needs, provide accurate patient data with daily or weekly snapshots of near real-time information and must be easy to implement.