3 Benefits of Telemedicine to Chronic Disease Management: Telemedicine Can Change How We Manage Chronic Health Conditions

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What could we have done better?

How could we have saved her?

What did we leave undone?

Where did we go wrong?

These and many more questions ran through my aching heart the moment my sister Idara was pronounced dead after battling colorectal cancer for four years.

Colorectal cancer is the third most common cancer in Nigerian men and the fourth most common cancer in Nigerian women; it is approximated that 49,190 colorectal deaths occurred in Nigeria in 2016. The number of new occurrences is predicted to increase to 77% by 2030. A larger part of that growth (62%) will occur in low/middle-income countries like Nigeria and other sub-Saharan countries while the numbers have declined remarkably over the years in many high-income countries.

Colorectal cancer is one in several chronic diseases that claim lives yearly in these parts and with inefficient healthcare to manage these conditions, the numbers keep rising. Other chronic diseases include heart disease, stroke, lung cancer, type 2 diabetes, HIV/AIDS, arthritis, asthma, etc.

Chronic health conditions pose several challenges, you need to learn how to

• Live with the physical effects of the illness which could be for the rest of one’s life.
• Deal with the treatments.
• Be in constant communication with your doctors.
• Keep an emotionally balanced countenance.
• Stay positive.

Our traditional healthcare system have exhausted their means and the results haven’t improved; one would say it is about time we adopted more effective methods of managing these health conditions to improve treatment outcomes and quality of life.

Chronic Disease Management in The Sub-Sahara

Chronic disease management continues to raise concerns for healthcare providers and patients alike. Africa bears a significant portion of the global burden of chronic disease followed by the poor regions in Asia and Latin America.

Chronic diseases such as heart disease, cancer, chronic obstructive pulmonary disease (COPD), stroke, Alzheimer’s, diabetes, and kidney disease accounts for roughly three-quarters of all physician visits, as well as 80% of hospital admissions and 81% of readmissions in the U.S.

Nine out of ten prescriptions are related to the management of chronic diseases according to Amwell and a staggering one-third of the world’s adult population suffer from multiple chronic diseases.

These chronic diseases make up 33.5% (3.1 million deaths) of all deaths in the sub-Saharan region yearly. In Nigeria alone, chronic diseases account for 24% of all deaths every year and these numbers will increase by 2025.

My sister was in that number.

After Idara’s passing, I did a quick survey on other patients who were receiving care at the cancer treatment centre in our city and they all shared similar challenges

• Difficulty travelling a long distance to keep up with doctor’s appointments.
• Shortage of healthcare providers and specialists.
• Unavailability of close monitoring especially in lockdown during the pandemic.
• Overcrowded waiting rooms.

Why do patients still face these challenges in an era where technology is improving healthcare?

What kind of technology in health can solve these problems for patients and doctors alike?

Telemedicine.

Telemedicine sometimes called telehealth refers to virtual or remote healthcare or the use of remote clinical services. Examples include video conferencing for consultations with specialists or transmission of patient or medical information between health care providers.

Telemedicine has proven to be very effective in remote care. Healthcare providers see it as a means to deliver timely and top-quality healthcare to chronic disease patients despite their location.

Wondering how? Let’s dive right in

3 Benefits of Telemedicine to Chronic Disease Management

1. Monitoring Medication Adherence and Poor Outcomes

The Covid-19 pandemic exposed one very prominent lapse in the management of chronic health conditions; only 50% of chronic disease patients take their medications as prescribed.

There is also the issue of poor healthcare literacy, non-involvement in decision making and even confusion for both the patients and healthcare providers as to what medications have worked for them in the past and what is best for them to continue with. These all result in poor outcomes.

Medication reconciliations can be done over virtual clinical sessions by showing and confirming pill dispensers or bottles. More so, the patient’s relatives can join in during the visit from any location and hear what is being said. This is turn will improve their literacy and understanding of their relative’s condition and treatment.

Furthermore, the fear of sitting alone in a doctor’s office and being told what to do sometimes without any family or friend is eliminated. During telemedicine sessions, the patient is in the comfort of their home and would feel at ease to have a conversation and ask questions at any point with the doctor rather than a one-sided seemingly authoritative discussion. With frequent telehealth visits, patients and family members’ education is reinforced and focused on improving a positive lifestyle.

For instance, a patient who has a colostomy bag can be directed on how to properly dress and care for the stoma and the stoma bag. The stoma can also be examined by the doctor during a telemedicine appointment in case of any infections.

2. Telemedicine Will Reduce Hospital Readmissions

The patient is seen in an office visit — Follow up appointments are set up oftentimes at inconsistent intervals.

This is the traditional healthcare model our hospitals operate with at the moment.

Between these follow-up appointments, four in five patients would end up in an emergency room, hospital or care centre as a result of acute relapse. These readmissions drive a huge percentage of healthcare spending.

Telemedicine can reduce patient readmission rates drastically as seen in a report by HiMSS where the Department of Veteran affairs showed a reduction in readmissions by 20% with the use of telehealth services to manage patients with chronic diseases.

With telemedicine, there can be continuity of care in chronic disease management cases. Patients can see their doctors every other day unlike they would have if they tried to keep up with follow-up appointments, which creates gaps in monitoring their progress.

Patients with chronic diseases account for over 80% of hospital readmissions in the US. However, when doctors can remotely monitor a patient’s condition, they can ensure that the patient keeps up with certain lifestyle changes and answer questions around medications.

After a patient is discharged from the hospital, telemedicine allows the healthcare provider to effectively and efficiently triage patients to the right level of care peradventure new symptoms arise. This will save both the patient and clinicians that sudden trip to the emergency room or hospital readmissions.

3. Virtual Care Will Improve Access to Healthcare and Save Time and Money

People who suffer from chronic diseases tend to require specialized care and may not get this care around them. In most cases, they may need to travel long distances to see their doctor or a specialist. For most patients, this may pose another challenge as they may find it difficult sitting or being in one position for a long time.

Virtual care or clinical visits will give them access to specialists from the comfort of their home thereby improving the quality of healthcare the patient will receive.

Doctors rush through in-office visits, spending a miserly fifteen minutes with each patient. This doesn’t give them enough time with the patient to understand the patient’s challenges and in turn, develop a better approach to managing the patient’s condition.

Reports show that the average hospital waiting time in the US is 103 minutes.

That is a very long time to have to wait to see a doctor, more so for a chronic disease patient who most likely travelled a thousand miles to keep to that appointment.

The time and cost of managing these in-office visits would be minimal with telemedicine.

It is often difficult to properly plan the duration of a session with the patient, which affects the duration of subsequent visits scheduled for that day. Also, the doctor is challenged with having time off as these sessions go from one to the next until the day is far gone.

Telemedicine will reduce or eliminate costs incurred from travel expenses if the patients had to travel long distances to see their doctor.

Therrie on The Benefits of Telemedicine to Chronic Disease Management

The chronic disease management market is valued at $346 billion and will grow to $440 billion by 2024. Barely three years from now.

We must tackle the problem and challenges of chronic disease management in our healthcare system as this would improve outcomes and reduce global healthcare spending.

One very effective way to do this is to adopt the use of telemedicine in the management of chronic health conditions.

By connecting digital health devices like wearables, BP monitors, Blood Sugar monitors, etc to smartphones, a patient’s vitals can be monitored remotely by a physician.

Patients will no longer feel alienated from their health management and decision making because telehealth will give them an avenue to discuss and interact closely with their doctor.

Time and money spent trying to locate and see a physician or specialist would be utilised and channelled into other aspects of healthcare like diet, therapy, exercise, and even spending time with family for patients and doctors alike.

In the long term, patient outcomes will improve and healthcare spending in regards to chronic disease management will reduce remarkably.