High costs and lack of payer coverage are two leading barriers to widespread mHealth and patient engagement technology adoption, despite their potential to support chronic disease management, shows a recent survey from the New England Journal of Medicine Catalyst.
Fifty-one percent of respondents, which included practice and hospital executives, clinical leaders, and clinicians, said that lack of payer coverage was the biggest barrier to adopting patient engagement technology. Sixty-one percent of respondents said that payers should be responsible for covering the cost of these technologies.
Forty-five percent of respondents noted that net costs to individual patients were also a significant barrier to technology adoption. This was an especially pressing issue for clinicians, with 49 percent reporting patient cost concerns compared to 38 percent of executives. Twenty-nine percent of clinicians said they hesitated suggesting these tools to patients because of cost considerations.
The survey also revealed that providers have doubts about the effectiveness of patient engagement technology, and are concerned about incorporating these tools into their workflows.
About half of respondents said patient engagement technology would be more attractive if it incorporated more patient engagement strategies, seamlessly integrated into their clinical workflows, or was more usable.
“Telling me that some technology will automatically send me [a diabetic patient’s] numbers is not helpful; I need to see them in an easily readable way at the time I see the patient in the office,” a respondent said.
Additionally, providers need more clinical evidence to convince them of the usefulness of patient engagement technologies. Sixty-seven percent say they don’t always recommend technology to patients because they don’t know which tools are useful, and 42 percent say there isn’t enough evidence that these tools even work.
Respondents said that in most cases, patient engagement technologies and mHealth were primarily helpful for the extremely sick and for those managing a chronic illness.
Eighty-one percent of providers said patient engagement technology is best suited for chronic disease management, and 66 percent found it useful for supporting medication adherence, an important component to chronic disease management.
Patient engagement technology is best for extremely ill patients, one respondent said. “I don’t think ‘improving’ the health of healthy people is a high value use of medical training,” the provider asserted.
“There is great potential [for these tools] in those patients with chronic diseases to better track and interact with the provider as to how they are doing or if they have any concerns,” another clinician noted.
Sixty-seven percent of respondents said patient engagement technology was useful for supporting healthy behaviors between office visits, and 60 percent said they provide information to clinicians about patient progress. These tools can be used as motivators and accountability tools, the respondents suggested.
“The technology needs to provide motivation to the patient to continue with the desired behavior. If the technology can show to a patient that a desired metric correlates with their improved symptoms, then the patient will be more likely to adhere to a given regimen,” one respondent explained.
Ultimately, these findings show that there is potential for patient engagement technology to improve chronic disease management.
“Patient engagement technology tools encourage patients to be accountable for their own health and to identify and curb the behaviors that result in poor health,” the report’s authors wrote. “They form a link between the provider, patient, and third-party information, creating feedback loops, offering insights about disease and disease management, and building support systems.”
However, in order for patient engagement technology to have its fullest effects, providers will need to target the patient populations who stand to benefit the most – chronically ill patients.
Additionally, other members of the healthcare industry workforce, such as payers and technology developers, will need to make cost-effective solutions so to offer more widespread access to a financially diverse patient group.