Ochsner researchers offer new care model for chronically ill _lowres

Photo provided by Fitbit-- The Fitbit Surge tracks the steps you take, calories you burn and other measurements of activity. It also displays your heart rate, which can be helpful for those who want to monitor their exertion level.

Apps and wearables could play a key role in treating the rapidly increasing number of people with chronic conditions, such as diabetes, high blood pressure, and heart and kidney disease, according to two Ochsner Clinical School researchers.

The current delivery model is poorly constructed to manage the epidemic of chronic disease, which now accounts for 75 percent of U.S. health costs, according to Drs. Richard V. Milani and Carl J. Lavie. Modifying treatment to include team-based care and patient-centered technologies offers great promise for managing these conditions.

Their article, “Healthcare 2020: Re-engineering Healthcare Delivery to Combat Chronic Disease,” has been published in The American Journal of Medicine.

“What does tend to influence our behavior in general — just forget the apps and the devices and all that stuff for now — is the social network, the people that we come in contact with,” Milani said.

So if a person starts hanging around people who exercise regularly, it’s more likely he also will begin exercising.

Milani and Lavie believe the power of the social network can help patients with chronic conditions.

Some of the devices and apps out now engage social networks.

So two people who have FitBits, for example, can track each other’s progress, encourage each other and even compete, all of which tend to change behavior, Milani said. Some patients will like one app, some will like another. They may like automated feedback, competition, networking or attaboys.

The important thing is that patients find an option that is attractive.

The researchers say another key to improving patients’ health is the use of what are called specialized integrated practice units, dedicated to a specific disease condition.

The care teams may include pharmacists, advanced practice clinicians, health educators, dietitians, social workers, counselors and therapists.

The teams and the apps allow patients to connect and communicate more frequently and effectively to the health care system.

One of the oldest forms of these care teams is the Coumadin clinic, where a full-time clinical pharmacy team manages patients’ warfarin, or blood thinner, levels.

These clinics have proven highly cost-effective with outcomes far superior to the previous traditional method of having a physician regulate the patient directly or having a physician manage a nurse who regulates the patient, Milani said.

Follow Ted Griggs on Twitter, @tedgriggsbr.