Tech could improve care for medically complex, low-income patients

Focus groups concentrated on a key Medicaid population--medically and socially complex, low-income patients--revealed areas for which connected health initiatives could bring improvements, according to a blog post at Health Affairs.

The focus group participants were receiving services from case management/care coordination programs in New York state or Philadelphia.

These patients often have multiple conditions, including substance abuse and mental health issues, and have unstable living conditions. Many lack permanent housing, are homeless or live in shelters. 

Still, many own phones and were comfortable with technology. Half were comfortable with texting, two-thirds used voicemail and more than half used computers.

The meetings revealed some opportunities to use technology to overcome challenges in their care, including

  • Lack of consistent contact: These patients can be hard to reach, yet texting and call features provide ways for providers to communicate with them and monitor their conditions.
  • Fragmented care: Many receive care at multiple sites from multiple providers. Information-sharing tools can provide more coordinated care.
  • Difficulty managing complex medication regimensL Digital tools designed track medication adherence could make this easier.
  • Reactively, rather than proactively, managing health needs: These frequent emergency rooms. Remote tracking tools can let care teams know and act in real-time when a clinical issue is arising.

Several efforts are focused on these issues, including a partnership between the Robert Wood Johnson Foundation and StartUp Health to educate health care startups and entrepreneurs on the needs of low-income people and underserved communities.

The non-profit Center for Care Innovations has partnered with Blue Shield of California Foundation on an initiative supporting text messaging to increase access and improve care for underserved populations.

A professor from Stevens Institute of Technology in Hoboken, N.J., is working on a smartphone app that would monitor a patient's condition and alert health officials, potentially warding off expensive emergencies.

Meanwhile, Kentucky's Department for Medicaid Services is employing technology ranging from data analytics tools to geomapping software to help connect ER "super-users" to the right kind of medical care.

To learn more:
- find the blog post

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