Monday, December 23, 2013

Expert patients as health coaches for population health management


20% of patients consume about 80% of healthcare resources . These are typically patients with chronic illnesses,  such as diabetes , asthma or heart disease . Since patient behavior plays a large role in the successful management of these illnesses , lots of companies have tried different methods in order to motivate and incentivize these patients so that they can take better care of themselves.

Most population health management tools today use a combination of technology and nurses ( or physician extenders ) as health coaches, in order to teach patients with chronic illness what they need to do to manage their disease . Typically, they use data analytics to identify patients who are at high risk for complication and poor outcomes ( for example, those whose blood sugar levels are out of control; or those who fail to keep their medical appointments ).  The nurses then reach out to these patients, and use behavioural modification techniques, so that they regain control of their illness. However, nurses are an expensive resource, because they are in short supply.

I think a far cleverer way of doing this would be to use expert patients as health coaches. For example, for diabetes, an expert patient would be one who has managed his diabetes well for the last 3 years. He would be trained; and would then serve as a health coach on the population health management system, which would serve as a platform where he could connect with patients who needed help with managing their diabetes. He would then be able to guide and help patients who are having difficulty with their disease, as to what they can do to help themselves .

The platform could be created as a marketplace, where expert patients could offer to sell their services as health  coaches. Patients could then search for a coach who matches them closely ( for example, with regards to age and location). Interested patients could then select the coach they feel who would best meet their needs . Over time, the coaches would be ranked, so that the best coaches could become more visible ( much like fiverr.com does).

Not only is this going to be a far less expensive method as compared to using healthcare professionals, it’s also likely to be far more effective . Patients are likely to be more effective as health coaches once they’ve been trained, because they’ve “been there and done that”. They know first-hand what it's like to live with a chronic illness , which means they are going to be far more empathetic . They are also more like to provide “real-world advise” which patients can put to immediate practical use. Patients are much more likely to bond and respond to someone who understands their problems and provides them with actionable solutions . Peer to peer counseling can have a long lasting impact, because the advise is likely to be unbiased and impartial.

What about quality control ? Calls can be recorded and transcribed, so there is documentation of what is being said. This can help to weed out ineffective health coaches. Also, patients are smart enough to understand that what another patient suggests is not medical advise, so they will use their own common sense and filter this advise.

We can thus use the collective wisdom of patients to help other patients to get better !

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