By Dr Jitesh Bhat
Healthcare is no longer only about how many people are covered under the service umbrella. Everyone from health policy makers and patient support groups have moved the conversation in healthcare to quality. Quality of care includes many aspects like safety, effectiveness, patient-centeredness, timeliness of care, efficiency and whether healthcare is distributed equitably or not.
A wide range of factors influence the delivery of quality healthcare services. The prerequisite for a high quality healthcare service delivery system is a robust structure, concrete processes and the ability to produce outcomes that are meaningful to patients as well as healthcare professionals (HCPs).
Patient-centeredness is a critical component of quality healthcare. It takes into account the individual’s specific health needs and the desired health outcomes of the individual are the driving force behind all health care decisions and quality measurements.
How is quality and patient-centeredness measured?
Measuring quality of healthcare and patient-centeredness can be tricky. It requires collecting and analysis of data on indicators that are able to capture the perspectives of patients, as well as the HCPs. Measuring quality of health services requires systems to set goals and standards of care and match the status quo with the set standards. Real-time data is very valuable to measure quality and patient-centeredness. For example, a patient who has hypertension and is at risk for a hemorrhagic stroke would benefit greatly if his/her hypertension was maintained in the safe target zone. This would require regular monitoring of blood pressure levels.
When do we say quality healthcare has been established?
Quality of care is a journey and not a destination. It is a mindset that needs to be followed iteratively to maintain the said standards. An example of high-quality care is when the patient is satisfied with the care (subjective, difficult to measure), the patient medical outcomes are as per the personalized targets set (objective/ easily measurable aspects) and the HCPs are able to provide services without being burnt out (subjective, difficult to measure). One of the ways these can be captured real-time is through digital technology.
Why is quality vital in healthcare?
In a country like India where the population is humongous, achieving quality and patient-centeredness may seem like a herculean task. Lack of training, lack of time and high patient ‘load’ is cited as reasons for low quality in healthcare service delivery. About 35% of patients in low and middle-income countries report a poor user experience. It was estimated in 2016 that an additional 5 million people lost their lives due to poor quality of healthcare. Hence poor quality is not just leaving users dissatisfied, it is also costing us millions of lives.
How is Digital Therapeutics (DTx) driving quality of care?
Let us examine how DTx can drive quality with a few examples.
- A patient with asthma lives in a polluted city in India. His exacerbations increase in winter when the smog is thick and heavy. The exacerbations reduce his quality of life considerably. Now, if his physician prescribes a DTx like Wellthy CARE TM, where the patient gets real-time information on air-quality levels in his area, he could prevent his exacerbations either by working from home or requesting a change in work-times. The DTx was able to provide the patient with the necessary knowledge and information to improve his health, this not only reduced the disease burden but also saved the patient’s time and money. The DTx could also be vital in suggesting use of short-acting bronchodilator use based on the digital entry of the peak expiratory flow rates of the patient.
- Patients with diabetes need to maintain their blood glucose in the personalized age-appropriate target zone. Their blood glucose levels depend on various factors like timings of meals, what they eat, exercise levels and type of exercise etc. Wellthy CARE TM has features like meal logging, digital diary for logging blood glucose levels and advice from trained diabetic educators that help in improving outcomes, patient satisfaction and driving quality of services.
How is DTx enabling patient centric care?
A service is patient-centric when the patient’s concerns are given priority and care is tailored to fit the patient’s needs. Every patient has different habits, practices, socio-cultural environment and eating preferences and these affect the health of the patient. Working around these factors to achieve the desired health outcomes can be difficult, but tools like DTx can help in the process. One of the users of the Wellthy CARE TM DTx app shares feedback that he felt like the program was made for him and that the instant feedback on the app was very helpful in controlling his diabetes. This a classic example of how DTx can act as a patient-centric driver of healthcare services.
In conclusion, the complex issues of quality and patient-centeredness in healthcare can be approached with DTx tools as a part of the solution to the larger problem.
(The author is Vice President, Clinical Product, Wellthy Therapeutics. The article is for informational purposes only. Please consult health experts and medical professionals before starting any therapy or medication. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)