discussion #7 disease

Technology Applications
in Chronic Illness
Management

Health
Information
Technology
(Health IT)

§ Chronic diseases are among the most prevalent and costly of all
health problems in the United States

§ Chronic disease management requires daily oversight and
treatment adjustment.

§ Patients coping with chronic medical conditions oftentimes see a
variety of specialists that need to communicate effectively and
coordinate services in to ensure optimal care

§ Many providers and health care organizations are looking toward
health information technology (health IT) as a tool to support
improved continuity of care.

Health IT
Applications

§ Health IT involves the use of electronic information
applications. These include:

§ Electronic health record (EHR)
§ Contain integrated decision support and chronic care management

tools help providers manage patient information and monitor health
outcomes for patients who are undergoing treatment for chronic
diseases. Clinical-decision support (CDS) systems

§ CDS capture, store, and manage clinical information

§ Health information exchanges (HIE)
§ Allow organizations to share information across organizational

boundaries. Such systems enable all participating providers in a
community to access patient information, thereby helping them to
provide better patient care.

§ Disease Registries
§ Capture and track key patient information to assist care team members

in proactively managing patients.

Health IT
Applications
(continued)

§ Patient-centered applications
§ Patient portals, personal health records (PHRs), and integrated voice response

(IVR) systems are designed to educate patients about their disease, their
medications, and how they can self-manage chronic conditions.

§ Telehealth applications
§ Remotely connect providers and patients in co-management of chronic diseases.

Remote monitoring devices and electronic health records are components that
extend traditional Telehealth networks to provide enhanced CDM functions for
patients and providers.

§ Health IT applications have the potential to transform the quality
and safety of care for chronically-ill patients despite the challenges
associated with developing and implementing them in ‘real-life’
settings.

§ Research shows that technology can facilitate better knowledge
sharing and support improved communication and coordination
across care settings.

Conditions for
Overcoming
Barriers in
CDM App

Implementation

§ The widespread use of chronic disease management apps has faced
multiple barriers over the years

§ They need to be ‘appealing enough’ for patients to want to purchase them
independently and/or offer services that are relevant to health care system
needs

§ Both organizations and individual patients need to be able to see the
value proposition of paying for an app and need to be motivated to use it
for a particular purpose.

§ Apps need to be diffused and adopted so that their benefits can be
documented and established

§ Apps should support multiple medical conditions and integrate
smoothly with a provider’s workflow and electronic medical record
system.

§ It is only with expanded use that developers will have the change to
improve CDM products, a critical part of the development process.

Sample
Mobile

Applications

v Medisafe

v An app that helps patients manage medications. It helps with dosage and
reminds patients to take their medications, increasing adherence rates. The
information can also be shared with the health care team and pharmacy.

v Pain Diary

v Allows patients to chart and score pain as well as record and track other
symptoms of the disease such as fatigue and mood swings. This app also has a
feature where patients can connect with others living with the same chronic
illness and swap best practices.

v ZocDoc

v Allows patients to search for local specialist doctors who are approved by their
insurance

v My Medical Info

v An app that stores relevant health history and insurance details and allows
patients to program in doctors’ appointments and medication reminders.

v Fooducate

v Helps patients keep track of their diet and make healthy choices. It also works in
conjunction with many fitness apps.

v Sleep Cycle

v Analyzes how much sleep and the quality of sleep patients get each night.

Sample
Mobile

Applications

v Medisafe

v An app that helps patients manage medications. It helps with dosage and reminds patients to
take their medications, increasing adherence rates. The information can also be shared with
the health care team and pharmacy.

v Pain Diary

v Allows patients to chart and score pain as well as record and track other symptoms of the
disease such as fatigue and mood swings. This app also has a feature where patients can
connect with others living with the same chronic illness and swap best practices.

v Curable

v Online patient education and pain management program

v ZocDoc

v Allows patients to search for local specialist doctors who are approved by their insurance

v My Medical Info

v An app that stores relevant health history and insurance details and allows patients to
program in doctors’ appointments and medication reminders.

v Fooducate

v Helps patients keep track of their diet and make healthy choices. It also works in conjunction
with many fitness apps.

v Sleep Cycle

v Analyzes how much sleep and the quality of sleep patients get each night.

v Headspace

v Mindfulness mediation app currently being studied in multiple clinical trials

Biofeedback

§ Biofeedback is a mind–body technique in which
individuals learn how to modify their physiology for the
purpose of improving physical, mental, emotional and

§ It requires active participation on the part of patients and
often regular practice between training sessions.

§ Clinical biofeedback may be used to manage chronic
disease symptoms as well as to improve overall health and
wellness through stress management training.

§ Research has shown that biofeedback interventions are
efficacious in treating a variety of medical and mental
health conditions.

Biofeedback
Described

v Biofeedback requires special equipment to convert physiological signals into
meaningful visual and auditory cues, as well as a trained biofeedback
practitioner to guide the therapy.

v Using a screen such as a computer monitor, patients get feedback that
helps them develop control over their physiology.

v Just as looking into a mirror allows one to see and change positions,
expressions, etc., biofeedback allows patients to see inside their bodies,
with a trained practitioner serving as a guide directing them to use the
feedback to regulate their physiology in a healthy direction.

v Common types include: heart-rate variability (HRV) biofeedback which looks
at the interval between heartbeats; electroencephalograph (EEG)
biofeedback, also called neurofeedback, which focuses on brain wave
activity; and electromyography biofeedback, which concentrates on muscle
activity.

v The physiological information monitored with biofeedback is thought to
help patients self-regulate processes that are normally not thought about at
‘conscious’.

v Patients can eventually learn to use self-management techniques learned
with the assistance of biofeedback tools without being connected to the
biofeedback equipment.

Biofeedback
Evidence for

Chronic Illness
Management

§ Biofeedback is recognized by the National Institute
of Complementary and Alternative Medicine
(CAM) as one of the mind–body therapies.

§ As more and more Americans seek out such
complementary and alternative therapies for their
healthcare and as research continues to reveal the
efficacy of biofeedback for more and more medical
dis s, it is likely that it will become an
accepted therapy for more disease conditions.

§ Current studies indicate that Biofeedback is
efficacious for treating a variety of conditions.

Biofeedback
Resources

v Association for Applied Psychophysiology and Biofeedback

v https://www.aapb.org

v Biofeedback – Patient Information Resource Sheet

v https://www.mayoclinic.org/tests-
procedures/biofeedback/about/pac-20384664

v International Certification

v https://www.bcia.org/i4a/pages/index.cfm?pageid=3698

https://www.aapb.org/