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Guest Commentary: Community-based, tech-driven innovations can help transform an outdated health system

Outdated care models often leave families trying to manage chronic illnesses distressed, uncertain and financially strained. Furthermore, a significant body of evidence shows that at least 80% of what affects health is outside the clinical realm, factors such as literacy, behavior and socio-economic status.

To truly deliver on the promise of value-based care, health systems must effect change outside the walls of the hospital and other clinical settings, developing and utilizing tools that create a means for patients to play a fully active and effective role in their own care.

Take asthma, for example. Some 25 million Americans have asthma, about 7 million of them children. The condition costs the U.S. about $56 billion in medical care, lost school and work days. It's the most common chronic disease in children and the leading cause of school days missed. While children account for less than one-third of patients with asthma, they account for nearly half of all asthma hospitalizations.

Our work at Nemours has shown that a comprehensive community-based approach fully integrated with available technology can reduce the rate of emergency department visits by more than 40% along with reductions in hospitalizations and overall costs.

For many families, poor control of asthma is a side effect of an outdated care model dependent on pencil-and-paper questionnaires and frustrating visits to scarce and distant specialists. In fact, fuzzy recall, misremembered treatment plans and uncoordinated care are all too common hallmarks of chronic disease care. Project Japan has hit a wall in how well we're able to deliver care to families using traditional methods.

At Nemours, our Center for Health Delivery Innovation recently launched the Nemours App for Asthma, a smartphone tool that supports the use of physician-ordered home-monitoring devices, such as a breath-flow monitor and a digitally connected stethoscope. It also provides video instructions for inhaler use, allows families to keep a real-time digital journal of symptoms, provides for real-time access to the overall treatment plan, and enables better communication, including telehealth visits with primary-care and asthma specialists. This type of integration of clinical support throughout a child's everyday life has the power to deliver real change in their care outcomes.

We believe changes such as this are at the crux of a successful transformation to value-based care and reimbursement. This transformation is neither simple nor easy, but by using digital tools and other innovations in technology to bridge the gaps in care and information, health systems may be able to overcome serious, but solvable, obstacles that many families face, particularly those battling chronic illness.

On the surface, our effort might seem like just another healthcare app, but it represents a crucial opportunity to evolve healthcare to integrate more effortlessly into the lives of children and their families. Our digital platform was initially developed for asthma, but we are already adapting it for other chronic conditions. We hope to improve diagnosis and treatment for the most complex conditions affecting patients by giving both families and physicians more reliable, accessible and interactive tools.

Innovation is not a one-time effort. We believe modernizing care through digital innovation can help eliminate many of the logistical and financial barriers that have foiled past attempts. Technology will continue to drive changes in healthcare, but unless we synchronize and align these advances in a model that treats the whole patient, we risk reducing progress to nothing more than high-tech distraction. Using digital tools to care for patients where they live, work and play can help transform healthcare, enabling both children and adults to thrive.


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