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Engaging the unengaged – the future of health engagement

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A Chief Medical Officer recently described Type 2 Diabetes as a ‘disease of the unengaged’. While maybe a sweeping pronouncement and certainly one with exceptions, his basic point was clear. There are millions of ill people in the U.S., and around the world, who have diseases like Type 2 Diabetes because they just didn’t engage in living a healthy life.

Of course, there are genetic issues and predispositions when it comes to chronic diseases. However, if you eat well and exercise, mostly you can keep Type 2 at bay, reduce its impact or even avoid it all together. The same can be said about COPD, CHF, Hypertension and all sorts of other diseases. According to the Milken Institute, in 2016, the total costs in the U.S. for direct health care treatment for chronic health conditions totaled $1.1 trillion—equivalent to nearly 6% of the nation’s GDP. The most expensive chronic health condition is Type 2 Diabetes. 

The Challange

So, if the problem is a lack of engagement, the solution should be easy: get suffers of Type 2 engaged and following their care plans. But the American Diabetes Association reports that around 50% of people don’t follow their prescribed care plans. 

Why? 

There seem to be four main reasons.

  1. They don’t understand them - A 2006 study by the U.S. Department of Education found that only about 12% of the population were deemed proficient because they could search a complex document and find the information necessary to define a medical term. 
  2. They forgot what they were told to do – The Journal of the Royal Society of Medicine reports that between 40% and 80% of medical information provided by healthcare practitioners is forgotten immediately after being told to a patient.
  3. They don’t believe it will help - MotivIndex in a study of 5,000 patients discovered that 55% of them don’t believe in their doctor.
  4. They can’t afford it – In a Consumer Reports survey, 1 in 7 people don't fill their prescriptions because it costs too much.

So, given all of this: What can be done?

A Solution

If the problem is a lack of engagement, then old approaches won’t work. 

At Wellsmith we have reimagined engagement from the consumer’s perspective. That means a Care Plan is not a confusing directive from your healthcare professional, but instead becomes a simple, memorable and actionable health guide. In other words, it should be as intuitive to follow as directions from a GPS on your phone or in your car. 

So how does this help?

  • When a consumer doesn’t understand their Care Plan we break it down to simple, easy to follow steps
  • When they can’t remember what needs to be done, we present in real-time the next action they need to take
  • If they don’t believe it will help, we provide direct feedback and actionable steps to take to see the impact their choices have on their health

The reality of making a Care Plan simple, memorable and actionable has a big impact on if and how people follow it. At Wellsmith we assess this by asking: are people engaged in their Care plan? Or in other words, of the things the Care Plan asks them to do, what percentage of these things are they doing? 

Engaging the unengaged

So how well do we engage the population on Wellsmith? Well, as of a couple of weeks ago, in our current population of Type 2 diabetics:

  • 94% are engaged and 6% disengaged
  • 65% are highly engaged (completing over 50% of all tasks)
  • 38% are very highly engaged (completing over 70% of tasks)
  • Of the highly engaged (>50%)
    • 65% of the time they log in-range glucose readings
    • 75% medication adherence
    • Walk an average of 5,400 steps (double the steps of the disengaged)
    • 1lb/week weight loss

Clearly, Wellsmith has created a way to compel some of the unengaged. 

Yet, for people with Type 2 there is still the issue of cost. Often, out-of-pocket expenses from medications and supplies (test strips for their glucometers) can cost up to $100 or more per month if they follow their Care Plans correctly.