Digital Health: Connected Care for Chronic Conditions

Mar 12, 2019
Through innovative partnerships, Express Scripts is leading the trend to help patients manage conditions like diabetes and hypertension with digital health tools.
Data Analytics

According to a recent survey conducted by Rock Health, digital health is on the rise, with a 9% increase in the adoption rate of emerging technologies over the past three years. Moreover, the priorities of digital health consumers are shifting away from general fitness and well-being to integrated care management.

At Express Scripts, we continue to innovate within the digital healthcare space through strategic relationships with our tech partners, like Propeller and Mango, providing constant care to patients with chronic conditions.

(Not) Playing Games with Diabetes Management

Currently, more than 77% of adults own a smartphone and users check them around 80 times a day. America’s cultural obsession with digital connectivity lends itself to the pairing of condition management strategy with a mobile health component. Mobile platforms can deliver statistically and clinically significant benefits in members with chronic conditions, like diabetes, which leads to better health outcomes for patients and decreased costs for health plan sponsors.

While a number of mobile apps have been developed to assist people with diabetes in managing their condition, Mango Health leverages a unique “gamified” approach to condition management. Through the app, users receive medication reminders, clinical messaging and refill capabilities via a user-friendly dashboard. Users earn points as they respond to daily reminders. As more points are earned, the user moves up from level 1 to 8. This “leveling up” provides a sense of progression and mastery toward goals for users. Moreover, elements of peer comparison, such as showcasing a user’s medication adherence data compared with others in the Mango community, are shown to further increase engagement.

In a recent study of Mango Heath users, adherence rates rose by nearly 6% after the first 30 days compared to non-users, with an average of more than two daily user sessions and 60% read rates for clinical messaging. In this way, members benefit through increased adherence, improved health literacy and closed gaps in care, while plan sponsors reduce the cost of drug spend and improve health outcomes for member populations.

Breathing Easier with Digital Medicine

While diabetes represents the costliest therapy class for plan sponsors and patients alike, asthma sufferers stand alone in terms of medication nonadherence, as nearly 55% of patients self-report as nonadherent to their prescribed dosage. One in 12 Americans has been diagnosed with asthma, totaling 25 million people. Despite the affordability and availability of asthma medications, the biggest barrier to better control is nonadherence to prescribed controller medications.

While most mobile applications for asthma control focus on medication reminders, Propeller Health, a digital therapeutics company, has developed a platform that brings together trigger tracking, clinical messaging and dosage documentation. Patients use Propeller’s digital platform by attaching a sensor to their existing inhaler. The sensor then collects data on the amount, frequency and location of each dose and delivers insights to the patient via their smart phone, mobile phone or desktop portal, including medication adherence reminders, daily asthma forecasts, symptom triggers and tips to help them self-manage their disease. The mobile app also allows for the user’s data to be shared wirelessly with family members, physicians and pharmacists, with the patient’s consent. The inhaler activity trends are reviewed by clinicians who receive alerts or on-demand reports notifying them of patients who are using their rescue inhaler more often than usual or are nonadherent with their controller medication.

As of 2018, the asthma-control technology has been tested in more than 16 clinical studies, totaling 2,500 patients, and has been deployed in more than 65 commercial programs across 16 countries. According to these studies, more than 50% of patients with uncontrolled asthma achieve controlled status within one year of starting on the app, with rescue inhaler use declining by 75%. With this data, clinicians can perform patient-specific counseling to improve health outcomes, allowing their patients to breathe easier through better control over their condition.

Health Connections Across the Care Continuum

Technology and innovation affect all areas of our lives, and health care is no different. When we see people with a smartphone or tablet in hand, we often assume they’re texting a friend, posting a tweet, or scrolling through their newsfeed. However, they may also be using their mobile devices to monitor their health, mitigating the risk of nonadherence while promoting innovative care through digital convenience. Through the smart use of technology and data analytics, physicians and pharmacists are able to better align the right patient with the right drug, and the right adherence solution.

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