This is an archived article that was published on sltrib.com in 2012, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
In just four months, Michael Blankenstein, a 48-year-old father of two, achieved the equivalent of an Olympic gold medal in health: He brought his dangerously high blood sugar under control and dropped 50 pounds, thereby slashing his risk of heart disease, stroke, and ultimately death.
The most remarkable part of Michael's story is that his secret weapon was not a new drug, but rather his cell phone.
Earlier this year, Michael made a decision to take control of his health. He selected a mobile phone program, Care4Life, to help him track and manage his blood sugar and a second program, MyFitnessPal, to lose weight. He heard about Care4Life from his physician, Dr. Chris Gay, who practices in a clinic participating in the Utah Beacon Community Program. This federally-funded demonstration program is finding ways to improve care and lower costs through technology.
Care4Life is a computer-driven program that encourages patients to track their blood sugar, take their medications, and achieve exercise and weight loss goals through daily text reminders and personalized coaching messages, all of which are based upon guidelines from organizations like the American Diabetes Association. Patients respond to requests for their most recent blood sugar readings, and Care4Life responds with feedback and support. In essence, it's a low-cost "pocket health coach."
"To see my progress in these tools was a motivator. To submit my information to Care4life and have it reply back and say, 'Keep up the good work!' — that was a motivator too," says Michael.
Programs like Care4life won't work for everyone. Some patients don't text; others aren't motivated to change; still others don't like being nagged by a person, or a computer. But in our experience, many patients do connect with the program, and likely for the same reasons that so many people hire personal trainers. Behavior change is difficult, day-to-day management is hard to maintain, and encouragement from someone who's paying attention seems to make a difference.
Such interventions are not a panacea for our escalating health care woes, nor are they a replacement for the services of a medical provider. But they do offer a promising new strategy for how we might begin to address the alarming epidemic in diabetes in this country, which, according to some projections, will affect one in three Americans by 2050.
"We need different approaches for different patients," says Gay. "It's helpful for patients to know that someone is following them, that they have a connection to the health care system even when they're on their own."
Treatment adherence, fundamental lifestyle change, and assiduous tracking are the hallmarks of optimal diabetes self-care. Yet, too often, these aspects are overlooked, in part because health coaching and diabetes education aren't always services that insurance plans will cover.
But there are signs that mobile phone solutions are gaining traction even among penny-pinching insurers: Two recently agreed to pay the monthly costs for WellDoc, a mobile phone tool for diabetes, when and if a doctor prescribes it.
Our experience with providers and patients in our Beacon Community suggests adoption of such innovations will accelerate as new payment models take root, providers seek ways to serve more patients, and individuals become more comfortable with alternative support tools.
Indeed, this shift toward payment models that reward medical providers for improving patient outcomes could usher in an exciting era of experimentation with patient-centered technologies. This is a positive sign that we are moving toward a system where patients are the principal players in their own quest for health improvement.
Korey Capozza is consumer engagement director at HealthInsight, a Utah-based nonprofit that leads the Utah Beacon Program.