According to the New England Healthcare Institute (NEHI)1, medication nonadherence costs the U.S. Healthcare system $290 billion dollars annually. According to Healthtransformation.net2, approximately 125,000 Americans die annually due to poor medical adherence and as many as 40 percent of patients still do not adhere to their treatment regimens3. This is consistent with NEHI’s results* noting “one-third to one-half of all patients do not take their medications properly.”
At mobileStorm, we view Mobility as the key to improving adherence. It’s about sending the right message, delivered at the right time, via the right channel. We believe in the three R’s of adherence: Relevant, Repetitive, and Rewardable.
Let me describe a use case the healthcare companies could execute today to improve adherence.
Use case: How can a healthcare company improve adherence towards insulin management for diabetics?
Step 1: Compile a target list of members who are currently managing their diabetes. Choose the Relevant channels of communication to reach these members. In this use case, immediacy is important so passive channels like email might not work best.
Step 2: Utilizing web-based sign-up forms, subscribe members to receive email, sms, and AppMail messages. Note that you can use all forms of media to brand the campaign and drive members to the sign-up form.
Step 3: Utilize an SMS text survey to remind the members that their medication is due to be taken. Use the same message to also receive back confirmation that the medication was taken. A simple message like: “It’s time to take your medication. Text “Rx YES” if you took the medication. “
Repeat this message several times a day depending on the member’s Rx profile. Repeat this program every day. Bonus points for integrations into your Rx systems to trigger out messages automatically.
Step 4: Re-enforce the SMS message with an AppMail message. As a PHI rated channel, you can be very explicit as to the type of medication, dosage, and frequency. For example, a sample message could be: “Dear John, You are now due to take your 5 mg dose of insulin. Don’t forget to also take your blood sugar reading. Please click on the Yes button once you have taken this dose.”
Step 5: Reward: It’s not enough to expect members to simply want to be better; an incentive-based reward system could and should be implemented. Think of the auto insurance industry. Your insurance premiums go down based on how long it’s been since you last got into an accident. Imagine a program that rewards people for taking their medications, almost like a perfect attendance program. Take your medication for 30 days in a row and get a discount on your co-pay. Feedback loops via secure mobile messaging could become the scorecard. These programs are especially valuable as they tie directly back to wellness and cost savings.
Step 6: Social/Viral Promotion. This will be controversial, but imagine allowing members to promote their adherence “wins” via social networking. Let them Tweet, Post, and Yammer their rewards. Clearly, PHI communication rules must be observed; however, this would be a great way to reward their hard work and if social networking has taught us anything, it’s that people love to promote themselves and their efforts to friends.
According to comScore4, 234 million Americans over the age of 13 use mobile phones and 69.5 percent used text messaging (162 million) on their devices. Roughly one-third of the mobile phone users (76.8 million) own smartphones and 39% (30 million) used downloadable apps.
Pew Research5 states that 45-58% of Americans between the ages of 25 and 34 now own a smartphone as do 49% of those ages 18-24 and 44% of those ages 35-44.
1. New England Healthcare Institute (2009). NEHI Research Shows Patient Medication Nonadherence Costs Health Care System $290 Billion Annually.
2. Center for Health Transformation (2010). The 21st Century Intelligent Pharmacy Project:
The Importance of Medication Adherence.
3. Atreja, A., Bellam, N., & Levy, S. (2005). Strategies to enhance patient adherence: Making it simple.
Medscape General Medicine, 7(1), 4.
4. comScore, Inc. (NASDAQ: SCOR) (2011). comScore Reports May 2011 U.S. Mobile Subscriber Market Share.
5. Pewinternet.org (2011). Pew Internet Smartphone Adoption and Usage.