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Reaching Beyond the Exam Room: How Technology-backed Lifestyle Intervention Is Improving Health Outcomes for Diabetes and Hypertension Management

Andreas Michaelides, PhD, and Ed Pienkosz, MS

In 2003, Susan L. Norris, MD, MPH, a researcher at McMaster University, Ohio State University, and the CDC Center for Diabetes Translation, and her colleagues sought an operational definition of chronic disease management. Based on their review of programs in clinical settings, they defined chronic disease management as:

An organized, proactive, multi-component, patient-centered approach to healthcare delivery that involves all members of a defined population who have a specific disease entity (or a subpopulation with specific risk factors). Care is focused on, and integrated across, the entire spectrum of the disease and its complications, the prevention of comorbid conditions, and relevant aspects of the delivery system.1

This definition certainly describes the approach to addressing chronic disease at that time and in many cases today. For decades, the medical community has designed chronic disease management programs to fit within the clinical patient care setting, whether or not it was convenient for the patient. For individuals who do not need care in a clinical setting, there are numerous chronic disease self-management education programs (CDSMPs). These programs extend beyond the traditional educational, knowledge-centered approach to include knowledge application in real-world situations, self-monitoring, problem solving, utilization of external resources, and application to behavior change in real world situations.2 They are typically provided in a community setting to minimize the clinical feel. However, CDSMPs require participants to show up at a specific time and location and adjust their life to the provider rather than meeting them where they are.

What if a lifestyle intervention and management program was designed to address the risk factors associated with the condition, enhance knowledge, and lead to sustainable behavior change in a way that allowed participants to attend when and where it was convenient for them? More importantly, what if the program allowed participants to engage when they were truly “present” and not merely in a state of presenteeism? Now, with the proliferation of mobile technology, such programs exist.

Bringing together innovative technologies and clinically validated curricula expands reach outside of the physician exam room and/or community-based setting into the daily lives of patients. This powerful combination can significantly enhance the prevention of lifestyle-related chronic conditions to improve health outcomes further upstream. The potential of this approach is extensive, with benefits related to prevention of the condition and/or symptom improvement, as well as a reduction in healthcare costs.

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