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Wisconsin Health System Puts mHealth to Work for Chronic Care Management

The Froedtert & The Medical College of Wisconsin health system is using an mHealth platform to help care providers and patients with chronic conditions improve medicine management at home.

Source: ThinkStock

By Eric Wicklund

- A Wisconsin health system is using an mHealth platform to give patients with chronic conditions a better idea of how medication management should work. The connected care platform will also give doctors an opportunity to boost outcomes through better care management.

The Froedtert & the Medical College of Wisconsin regional health network, a five-hospital system based in Milwaukee, is prescribing Proteus Digital Medicine’s technology, which includes ingestible sensors, an accompanying mHealth patch and app and a provider-facing dashboard, to selected patients living with diabetes, hypertension and Hepatitis C.

The platform enables Froedtert & MCW’s care providers to remotely monitor medication adherence through the sensors, which chart when prescribed drugs are taken and how they interact with the patient, and the app, which relays that data to both patient and provider.

Bradley Crotty MD, MPH, an internist with the Froedtert & MCW health network and an Assistant Professor of Medicine at MCW, says the remote monitoring platform gives both patient and doctor a better understanding of what goes on outside the doctor’s office. This, in turn, allows doctors to modify care plans when needed, rather than only during a weekly or monthly office visit.

“We now have better data to overcome that clinical inertia of saying, ‘Let’s keep doing what we’re doing,’” he says.

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The health system is one of a growing number across the country using digital therapeutics to get a better handle on chronic care management. These platforms use digital health technology to track medication use and effectiveness, offering opportunities to providers to create care plans that use fewer medications, reduce waste and boost outcomes.

A critical component to that platform, Crotty says, is the patient.

“We want the patient to be the primary recipient of the data, to be empowered,” he says. “Ultimately this is an intervention that is able to help them manage their medications” and to craft care plans that work for them.

Roughly 130 patients are currently enrolled in the program, with some 20,000 medication ingestions recorded.

Another element to this program is integration with the electronic health record. Froedtert & MCW is facilitating that through technology provided by Xealth, a developer of digital health prescribing and monitoring platforms. Through that integration, patients who qualify for the program are presented to the doctor in his or her EHR workflow, and the data produced by the Proteus platform is funneled to both patient and provider.

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“The ability to include Proteus in a medical record not only improves care coordination but it individualizes and broadens our view of the person,” Crotty said in a recent press release highlighting the new program. “We can better partner with patients by understanding how they’re doing between appointments and increasingly help personalize and optimize their regimen more quickly.”

That capability also plays a part in care team coordination. Aside from the patient and provider, the platform can be accessed by the pharmacist, enabling him or her to weigh in from that end of the spectrum.

The integration enables Froedtert & MCW to better manage the program from the start, selecting patients who have a better chance of adapting to the mHealth-based treatment rather than enrolling everyone with certain chronic conditions and expecting a certain number of dropouts.

“It’s a tool, and we want to make sure we’re using it for the right patients and under the right circumstances,” Crotty says. “There are many different use cases for this technology, but that doesn’t always mean that someone is going to benefit from it.”

According to Froedtert & MCW officials, in the 13 months that the platform has been in use, patients living with Hepatitis C have achieved 98 percent medication adherence, and all have achieved a sustained viral response. Those living with type 2 diabetes, hypertension and high cholesterol, meanwhile, have achieved 91 percent medication adherence, as well as a reduction in average glucose levels and lower LDL cholesterol levels.

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Going forward, Crotty wants to see how more data – such as activity – can be factored into the platform and used by doctors to improve care management. He’d also like to see the platform evolve to become less obtrusive to patients, some of whom aren’t comfortable with adhesive patches.

“There’s a lot that we can do with this,” he says. “We have to make sure we’re doing it right.”

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