We all know a healthy person when we see one, and we also know a sick person when we see one. In recent years, however, health care professionals have taken to address the group of folks who fall in the middle. This so-called "emergent risk" or "moderate risk" population is made up of those who aren’t in terrible health just yet, but, without proper attention, could see their health condition soon take a turn for the worse.
Typically those defined as moderate-risk have some medical condition but have not yet experienced significant organ damage. Their health care costs are somewhat higher than healthy folks, but their care is primarily done on an outpatient basis. Their condition is typically worsening due to lack of self-management and lifestyle behaviors. Most significant, about 15 percent of these folks will turn into "high-cost" patients every year and will progress to additional chronic diseases every three to five years.
What’s the difference between high-cost and moderate-risk? In 2010, under Medicare, 16.1 million people fell into the emergent-risk category, accounting for about $100 billion in costs, or just more than $6,000 per patient. By contrast, 7 million folks were high-cost, accounting for about $390 billion, averaging about $55,000 each. Translation: A high-cost patient is about 900 percent more costly than an emergent-risk patient.
How, then, do health care organizations help folks who fall into this emergent-risk category? It’s been well documented that regular interaction with health care professionals improves one’s health. Regular, periodic counseling helps people achieve their goals, whether such goals are increasing physical activity, eating healthier or other changes in behavior.
The challenge always has been getting the patients to the counselors (and vice versa) on a regular basis. For the most part, each patient needs to be addressed on an individual basis, a daunting undertaking. That’s where technology comes in. At this point in time, most folks are reasonably tech-savvy, especially those who fall into the age group of the emergent-risk population.
As such, adopting modern technologies in a structural fashion greatly increases the ability of patients, as well as health care providers, to adhere to a regular schedule. For example, communication can be done via email, and tracking of goals can be shared online between patient and provider. Mobile-based apps allow for even better real-time tracking of activities.
According to Adam Kaufman, president and CEO of DPS Health (dpshealth.com), a Los Angeles-based national provider of technology-based behavior change solutions, "we are only beginning to scratch the surface of improving the health of those in the emergent-risk population. By using advanced technologies to stem the tide of progression from emergent-risk to high-cost, we reduce overall costs, tangible and intangible, to individuals, employers, health care providers and the like. More importantly, we greatly increase the quality of life for those in the emergent-risk category."
John Agsalud is an IT expert with more than 20 years of information technology experience. Reach him at johnagsalud@yahoo.com.
