Automate 'hovering' to improve patient health, engagement

Monitoring patients within and outside healthcare encounters, whether through telehealth services, home-based programs or transitional care interventions, not only costs healthcare organizations a lot of money but also makes it difficult to keep patients engaged.

Hospitals looking to improve patient care and protect their wallets, however, may find solace in "automated hovering," according to a recent article in the New England Journal of Medicine.

The authors note that automated initiatives reduce the cost of "hovering over people in their daily lives" and, more importantly, do so in ways that are convenient and even welcomed by patients.

"Even patients with chronic diseases might spend no more than a few hours a year in front of a doctor or a nurse. But they spend over 5,000 waking hours a year doing everything else--and that 'everything else' often has a big impact on their health," lead author David A. Asch, M.D., director of University of Pennsylvania's Leonard Davis Institute of Health Economics, said in a June 20 statement. "If we are to help patients improve their health, we need to find a way to engage them during those 5,000 hours."

The automated hovering approach mixes new principles of behavioral economics, new technologies such as wireless devices and new reimbursement strategies that encourage provider accountability for health outcomes to motivate patients to improve their own health, according to the article. Such improvements include adhering to medication, medical advice and dietary regimens.

To show the success of automated hovering, the article points to previous University of Pennsylvania research, in which people prescribed warfarin could win $10 or $100 each day they take the drug. Thanks to the home-based pill dispenser electronically linked to the lottery system, the rate of incorrect doses fell from 22 percent to roughly 3 percent.

The automated system also provided daily engagement, the chance of a prize and a sense of anticipated regret as it hovered over patients.

But the authors note that healthcare organizations should target automated hovering at specific patient populations. Diabetic patients who can manage their disease at home with medication and dietary compliance and chronic heart failure patients are well-suited for such approaches.

For more:
- read the NEJM article
- here's the research announcement

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