Chronic Disease Design Innovations Needed ASAP!
Monday, August 6th, 2012
Over 75% of the healthcare spending in the US goes to chronic conditions. One reason for the high cost is that they are not managed well. Recent studies show the ability to keep chronic disease in check is very difficult when patients have multiple conditions.
Keeping chronic conditions in check, and better avoiding them in the first place, requires a range of patient behaviors and choices. This point is dramatically illustrated in Living Not with One, But Six Chronic Conditions:
“It’s estimated that 80% of heart disease and stroke, 80% of type 2 diabetes, and 40% of cancers could be eliminated if Americans were able to do three things: stop smoking, eat a healthy diet, and get regular exercise. These same behaviors may also prevent exacerbations of existing chronic conditions.”
Fortunately, we don’t lack the science needed to manage these diseases well. What we do lack are programs that deliver the required evidence-based care in a cost effective and psychologically compelling way. We need programs that deliver a think-and-feel experience with enough power to shift smoking, eating and activity behaviors as well as support learning new condition specific self-care routines. Such programs must be based on understanding and meeting the cognitive needs of patients as they manage limited self-regulatory capacity and struggle to learn from experience which routines will fit-and-stick-with their personal circumstances.
In short we need a cognitive design initiative focused on managing multiple chronic conditions.
And the audience for such an effort is fairly well defined. One report emphasizes how concentrated healthcare costs are. The sickest 5% of citizens account for nearly 50% of all healthcare costs. More dramatically, just 1% (3-4 million people) account for 22% of the cost! Most suffer from multiple chronic conditions.
I am interested to hear from readers that have insights into deeply-felt and unmet psychological needs (cognitive, affective, motivational, volitional) of patients that are failing to manage multiple chronic conditions.
