Redesigning Chronic Care Delivery Using Mobile Health Technology

Abstract

Typical management of chronic conditions is through sporadic office visits. But health indicators (such as blood pressure) can fluctuate significantly within a day. The infrequent office visits, however, offer the provider little information about the medical history of the patient between office visits resulting in delayed and sometimes inappropriate interventions. Providing the right product (making appropriate interventions) at the right place (patient's location) at the right time (before the worsening condition leads to a costlier intervention) is the objective of effective supply chain management. Use of mobile health (mHealth) technology in clinical care can help achieve all three objectives. mHealth enables continuous monitoring of measurements resulting in bidirectional information flow between providers and patients, thereby reducing information asymmetry. Our study examines redesigning of chronic care delivery using mHealth. It is important to make sure the redesigned delivery process is both efficient (reduces cost) and effective (improves patient health). In this paper we first present a big picture of the redesigned care delivery process. We then show how this delivery process can improve patient health by analyzing a panel dataset of 1627 patients. We examine the relationship between use of mobile health applications (to remotely upload measurements and receive physician intervention) and quality of care delivery (as measured by blood pressure readings) for hypertensive patients. We observe the blood pressure readings to decrease with frequency of app usage and time since adoption. With the use of mHealth apps increasing in the post COVID-19 era, our analysis indicates an efficient use of physician's time and an increased role for support-staff under the supervision of the physician. The chronic care delivery process can therefore be redesigned with the help of mHealth, improving patient health and reducing cost for both patients and providers.