Chronic care is one of the most challenging issues faced by healthcare systems across the world. According to WHO report, 60 percent of all deaths occur due to chronic conditions worldwide. The percentage of deaths due to chronic diseases varies from one country to another, depending upon the country’s healthcare infrastructure and practices of addressing those challenges. Chronic diseases also have a deep impact on the healthcare costs of the country and add to the economic burden of the healthcare system. One of the main factors causing an ongoing rise in chronic conditions is the aging population. Technological advancement in healthcare sector has improved life expectancy of people. Lesser people are dying from infectious diseases and more people are living longer lives, and therefore in many cases, living long enough to develop chronic conditions. Chronic diseases not only affect the lifestyle of the patient but also the quality of life of people who provide care to the chronically ill family member. As the population ages and more people are affected by chronic disease, there is a steep escalation in demands for healthcare resources. These demands bring some challenging implications for governments as they try to achieve a sustainable growth in the healthcare system. Thus, providing care to patients with chronic care is not only a case of clinical precedence but also a financial one. Chronic diseases will continue to rise in the coming years in the US and worldwide. The objective for both healthcare providers and patients using home health solutions is to achieve optimal level of health via regular monitoring and self tracking. It will require patients to participate more in the wellbeing than just following compliances and medications prescribed by the provider. Patients will have to actively engage and take charge of their overall health management in order to enhance the quality of their health and life. On the care providers’ side, patient engagement via home health solutions will allow physicians to timely access patient information, therefore helping them more efficiently manage their patients through enhanced best practices and improving patient outcomes. Successful chronic care management through patient engagement will require support from patients and healthcare professionals, patient education on chronic diseases, financial contributions from social, support from governments, innovation from technology companies and better coordination between developers and health providers. All these, put together, will have the potential to transform the healthcare system.

1. Managing Chronic Care
Through Patient Engagement

2. Managing Chronic Care Through Patient Engagement 2
Executive Summary
Chronic care is one of the most challenging issues faced by healthcare systems across the world.
According to WHO report, 60 percent of all deaths occur due to chronic conditions worldwide. The
percentage of deaths due to chronic diseases varies from one country to another, depending upon
the country’s healthcare infrastructure and practices of addressing those challenges.
Chronic diseases also have a deep impact on the healthcare costs of the country and add to the
economic burden of the healthcare system. One of the main factors causing an ongoing rise in
chronic conditions is the aging population. Technological advancement in healthcare sector has
improved life expectancy of people. Lesser people are dying from infectious diseases and more
people are living longer lives, and therefore in many cases, living long enough to develop chronic
conditions. Chronic diseases not only affect the lifestyle of the patient but also the quality of life of
people who provide care to the chronically ill family member.
As the population ages and more people are affected by chronic disease, there is a steep escalation
in demands for healthcare resources. These demands bring some challenging implications for
governments as they try to achieve a sustainable growth in the healthcare system. Thus, providing
care to patients with chronic care is not only a case of clinical precedence but also a financial one.
Chronic Disease: The Current Scenario
Healthcare systems across the world are under tremendous pressure to address critical barriers in
providing better health outcomes, such as providing quality care to the aging population, addressing
the needs of the growing number of people with chronic illness, improving access to EHR,
inadequate amount of clinics/ clinicians etc. Also, patients suffering from chronic illness are required
to face lengthy wait times in order to obtain adequate senior housing or Long Term Care (LTC) beds
in health institutes. As such, providers are looking to adopt new care models that allows the patient
to stay at home and still receive quality and continuous care.
Figure 01: The world population is growing and getting older

3. Managing Chronic Care Through Patient Engagement 3
Figure 02: Older Adults Are More Likely to Have Multiple Chronic Conditions in US
 The prevalence of multiple chronic conditions
increases with age
 One in 15 children has multiple chronic
conditions
 Almost three out of four people ages 65 and
older have multiple chronic conditions
Source: Medical Expenditure Panel Survey, 2006
Chronic illness continues to gain prevalence in all
countries (industrialized, middle income, low
income) and have even surpassed infections as a
disease burden. Due to increased burden on patients and their family members for chronic care
management, delivering care at home is a highly viable option for both patients and providers. There
is an urgent need for the healthcare systems to evolve Remote Patient Monitoring and Home Health
Solutions to deliver treatment in the home.
Remote Patient Monitoring is going to revolutionize the way healthcare is delivered. Remote Patient
Monitoring will enable this change by allowing both patients and providers to proactively engage
with each other, transforming current practices in areas such as chronic care management and
continual acute care sessions. In addition to enhancing the patient-provider engagement, it will allow
providers to empower patients and involve them in their own wellbeing. Patients, on the other hand,
will feel engaged and in charge of their own health and are more likely to instill lifestyle and
behavioral changes to achieve better outcomes.
RPM also ensures that vital clinical information is collected and securely transmitted, and then
shared with all the appropriate healthcare team members involved in the patient’s care. RPM is
efficient and highly cost-effective for managing chronic diseases and conditions that require daily
monitoring, such as Diabetes, Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary
Disease (COPD), and Hypertension.
Healthcare providers have been trying to drive value and success in ways, such as improving quality
via collaboration, building sustainable healthcare models improving health outcomes through
personalized care and ease consumer access. Today, the death rate from chronic disease is double
Cancer, diabetes, and heart diseases are no longer the diseases of the wealthy.
Today, they hamper the people and the economies of the poorest population
even more than infectious diseases. This represents a public health emergency in
slow motion.
– UN Secretary Ban Ki-Moon

4. Managing Chronic Care Through Patient Engagement 4
the death rate from the combination of all infectious diseases (including HIV/AIDS, tuberculosis, and
malaria), maternal and prenatal conditions and nutritional deficiencies. By 2020, chronic diseases are
expected to account for 7 of every 10 deaths in the world.
Countries are facing an urgent need to reduce healthcare costs, especially in the chronic care area.
According to World Health Organization, treating chronic diseases account to more than half of all
healthcare costs and are responsible for more deaths globally than all other diseases combined. The
continued rise on the percentage of chronic illnesses will result in an even greater impact on the
portion of governments - as well as patient’s – overall budgets going to manage chronic disease.
The Cost of Chronic Care
The World Economic Forum (WEF) predicts that by 2030, the global economic impact of the five
leading chronic diseases – cancer, diabetes, mental illness, heart disease, and respiratory disease –
could cost the world $47 trillion in healthcare costs. WEF found the costs of Non-communicable
Diseases (NCD) through its study published under the report entitled, “The Global Economic Burden
of Non-communicable Diseases”.
Figure 03: The Costs of Chronic Diseases in U.S.
Source: healthsciences.org
It’s startling to know that the estimated cumulative output loss caused by the five leading chronic
diseases over the next 20 years accounts for approximately 4% of annual global GDP. The top five
illnesses are already responsible for more than 36 million deaths every year and are predicted to kill
tens of millions more in future.
Among OECD Countries the Emerging Problem is People with Multiple Chronic Conditions
People with chronic conditions represent 80% of burden of disease in most OECD countries and
people with multiple chronic conditions represent over 50% of burden of disease in most OECD
countries. – World Economic Forum

5. Managing Chronic Care Through Patient Engagement 5
Figure 04: The cost of chronic diseases
With increase in age, people tend to develop chronic conditions. Many even develop Multiple
Chronic Conditions (MCC) and even though these conditions may not be immediately life
threatening, they considerably add to the suffering and expenses of the patient and reduce their life
expectancy. From the patient’s perspectives, it’s not the healthcare costs, but the overall health and
life quality, pain, suffering and emotional stress that poses the real burdens.
Figure 05: The Growing Problem of MCC in U.S.
Source: Analysis of 2010 Medical Expenditure Panel Survey Data

6. Managing Chronic Care Through Patient Engagement 6
Figure 06: Percentage of people age 65 and over who reported having selected chronic conditions, by
sex, 2005‐2006.
Source: Federal Interagency Forum, Older Americans 2008
Patient Engagement via Home Health Solutions
So far patients have had limited involvement in their healthcare process. Healthcare services were
limited to treating patients for acute conditions rather than proactively engaging them in their
overall wellness and working towards achieving better health outcomes. This cannot continue to be
in practice anymore. As more people start developing single or multiple chronic conditions, it’s
become essential for care providers to reduce the number of unnecessary hospital admissions and
minimize readmissions in order to reduce pressure on the already overburdened healthcare system
from additional financial and clinical demands.
Providing care at home will unwind the next wave of technology in patient engagement that enables
them to become an integral part of their health. As many of the chronic illnesses require monitoring
and consultation on a daily basis, home health solutions will facilitate patients in tracking their vitals
and taking steps to improve their overall health.
For example, patients are given health goals that include medical compliances, exercise & diet
regimens, and asked to undergo regular lab tests among other things. The goals and the measures
depend on the perceived risk or conditions they suffer from. Home health solutions provide care
managers access to patient’s crucial health parameters such as past contacts, special notes and their
compliance record in addition complete health record of the patient. On the other end, patients can

7. Managing Chronic Care Through Patient Engagement 7
view & analyze their medical history, interact with care coordination team and update their health
stats manually or via home health devices.
Home health solutions are efficient at tackling chronic
conditions by making patients in charge of their own well-
being. It benefits patients by allowing them to monitor their
vitals such as BP, Heart Rate, Blood Glucose, BMI, Body Fat
etc and help them track their progress. Also, being
constantly connected means they can also get real time
health consultation tips from their care providers.
Concurrently, providers can get real time access to patient’s
vital signs & symptoms for early diagnosis & intervention. It
also helps providers in identifying the health issues
associated with the patient, give proper advice and
recommendations and take measures to reduce
readmissions.
Home health solutions will allow care providers to remotely
send additional educational materials that promote
behavioral changes and empowers the patient to achieve
better health outcomes. Previously, providers could procure
such detailed insights into patient’s vitals only through a
personal home visit or a phone call.
With patients becoming more involved in their health management via home health solutions,
physicians, nurses and other care providers can extend their reach and effectiveness.
Patient Empowerment
Patient engagement is a key aspect in achieving health and wellness in chronic care management.
The health outcome due to patient lifestyle and behavior has five times the influence as compared to
the various efforts and health plans recommended by providers. Educating patients to select
appropriate treatment options and encouraging them to follow ongoing self-management goes a
long way in attaining better health results.
Achieving better, more efficient health requires much more than just regular access to doctors.
Patients need to be educated and encouraged to follow treatment regimens or adopt a better
lifestyle, change their diets and make exercises a routine.
The Impact of Mobile Apps on Healthcare Costs
93 percent of physicians believe mHealth apps can be a key driver in improving patient health
outcomes. Out of those, 89 percent admitted to be willing to recommend a mobile health app to a
patient, a 2013 eClinicalWorks survey reveals. These figures are encouraging. It clearly indicates
physicians’ readiness to embrace mHealth and use them in day-to-day healthcare delivery.
emrAnyWhere (Screenshot) - a mobile app
that allows patients to view their medical
records and check keep their vitals in check

8. Managing Chronic Care Through Patient Engagement 8
However, there is a holdup. The IMS Institute’s 2013 mHealth report suggests that most of the
43,000+ health and wellness apps currently available for download (on the US iTunes store alone!)
do not meet expectations in terms of scope, functionality and efficiency. There is paucity between
the interests of the hospitals/ providers and that of the developers. Most of the times, mobile app
developers are unable to cover the functionalities and services required by the doctors. Physicians,
on the other hand, are very particular about the professional approval and evidences of the
successful past record of the app. But healthcare professional rarely have the technical knowledge
and skills required to develop such mobile applications themselves.
Addressing Chronic Diseases with Mobile Apps
Smartphone and tablet applications have been predicted to have significant impact in contributing
towards reducing healthcare costs for providers, payers and patients. Below are some useful insights
indicating the promising use of mHealth in the overall healthcare system:
Source: seguetech.com
Figure 08: Health care consumer segments: Online and onboard consumers
Source: Deloitte Center for Health Solutions, 2012 Survey of U.S. Health Care Consumers
 80% of doctors use mobile devices at work
 One-fifth of smartphone owners have health apps
 75 million: The number of adults using mobile phones for
health information in 2012
 59% of consumers who use mobile health services report
the services have replaced some doctor visits

9. Managing Chronic Care Through Patient Engagement 9
Mobile apps, as we see, are transforming the way healthcare is being delivered. The wireless health
market which is estimated around $23.8 billion will reach $59.7 billion by 2018.
But the question remains: Can mobile apps actually reduce the cost of healthcare? Yes, say most
analysts.
mHealth is predicted to provide various healthcare functions at considerably lower costs ranging
from reducing costs by encouraging behavioral changes to substantial decreases in the areas of
chronic care management by as much as $200 billion over the next 25 years.
Conclusion
Chronic diseases will continue to rise in the coming years in the US and worldwide. The objective for
both healthcare providers and patients using home health solutions is to achieve optimal level of
health via regular monitoring and self tracking. It will require patients to participate more in the
wellbeing than just following compliances and medications prescribed by the provider. Patients will
have to actively engage and take charge of their overall health management in order to enhance the
quality of their health and life. On the care providers’ side, patient engagement via home health
solutions will allow physicians to timely access patient information, therefore helping them more
efficiently manage their patients through enhanced best practices and improving patient outcomes.
Successful chronic care management through patient engagement will require support from patients
and healthcare professionals, patient education on chronic diseases, financial contributions from
social, support from governments, innovation from technology companies and better coordination
between developers and health providers. All these, put together, will have the potential to
transform the healthcare system.
Addressing chronic diseases: mHealth apps can potentially save US more than $23 billion annually.
An Accenture report, which conducted an analysis and aggregation of early trial data of mobile
monitoring solutions, showed that mobile apps can save on average, a 15%-20% reduction in hospital
days and 30% fewer ER visits. It will also save $2000-$3000 per year in healthcare cost per patient,
particularly for diabetes and heart diseases. With the internet reaching to a more and more places
and the proliferation of wearable devices, these data look encouraging and very much promising.

10. Managing Chronic Care Through Patient Engagement 10
Contact Information
Key Management Group, Inc
125 Baylis Road, Suite 260
Melville, NY – 11747
Phone: 631 777 2424
Email: sales@kmgus.com
Web: www.kmgus.com
Twitter: @KeyMgmntGrp | @HealthITplus
LinkedIn: www.linkedin.com/company/374848
About Key Management Group, Inc
KMG is a NY based Software Development company providing high-quality IT solutions to the
Healthcare & P&C Insurance verticals worldwide. Leveraging a resource base that covers almost
the entire spectrum of technology – right from the legacy systems (IBM i & Mainframe) to the very
latest on Microsoft.NET & Java, KMG provides a wide range of services including, software
development, application support & maintenance, legacy migration/web-enabling solutions,
testing, business analysis support & even BPO/KPO.
KMG has its headquarters in NY with 3 Offshore Development Centers in India (Gurgaon, Mohali
and Kolkata). KMG has around 30 professionals in the US of are supported by another 300 in
India.