Karolina Korth leads the Business Development Team of Emminens Healthcare Services, a Digital Health Company of Roche Diabetes Care-Emminens Healthcare Services, with special focus on diabetes and usage of technology to change behaviors.
The majority of the chronic conditions are caused by behavioral risk factors. Physical inactivity and modern nutrition frequently lead to obesity, and obesity is closely linked to diabetes or other cardiovascular diseases. So, in order to improve medical outcomes we should not only treat the condition itself, but understand and treat the root causes of it as well. That is why we can see a tendency in many markets, that healthcare systems striving for efficiency start focusing on behaviors.
Regarding impact on costs and health improvement, it’s evident that unhealthy behaviors and lifestyles have their price tags. Already now diabetes is the second most expensive chronic conditions after cancer. It is expensive not because of insulin, strips or glucometer devices. The major costs are due to complications, but 80% of these complications are avoidable. On average (quoting the data from the US) health care annual expenditures for patient with diabetes are 8 T$ higher compared with a patient without diabetes. So, if we manage to save 80% of these costs for diabetic population that counts worldwide almost 400 Mio patients, we are looking at significant savings.
We can currently see following trends around the world: increasing number of patients, increasing number of costs, decreasing number of doctors per patient and quite low percentage of patients achieving clinical targets. It is clear that current health care approaches are not prepared for chronic patients. In a chronic care the patient empowerment and engagement are keys in order to achieve clinical results and reduce costs. We often compare the relationship between an HCP and PwD as a relationship between a trainer and a sportsman. Even if you have the best trainer in the world, but you do not train on yourself enough, you are not going to make a marathon. If healthcare administrators are interested in improving clinical outcomes and reducing costs, patients and their lifestyle play a very significant role. But still, it is exactly the patients’ unwillingness to change lifestyle that is frequently named as the biggest barrier to the successful treatment.
So, why is it so difficult to change behaviors? First all, because we believe behavioral changes to be difficult and already expect ourselves to fail. It is mainly because of some unsuccessful trials we experienced in the past. But frequently, we fail because we don’t use the right processes to make the change happen. Secondly, we seem to rely on the assumption that motivation will solve everything. That is wrong. Motivation is necessarily but not sufficient in order to make changes. In order to conduct a change we need three elements: Motivation, Ability and Trigger. Ability is an important part. If you don’t know how to swim, there will be no words motivating enough. That is so important to define baby steps for a change. Which means, we should not tell people to run 10k, we should recommend to put on their sport shoes first and then with very tiny steps move towards a desired distance. If the action is very easy to make, you don’t need a big motivation to do it. Technology can help to define, tailor and track those small steps and with that significantly facilitate behavioral changes.
Educated Decisions to change behaviors
Also at Emminens, we believe that behavioral changes are the main lever in diabetes treatment. As the first step in this direction we developed Educated Decisions. This online education platform enables doctors to assign diabetes related courses to their patients. Those customizable interactive courses with short videos help patients to manage their condition in a better way. Educated Decision is also the first example of an educative diabetes solution that tests the knowledge of the patient before and after the course in order to measure the real progress.
Why is education so important in the behavioral change? If you refer to the equitation we mentioned before: you need motivation, ability and trigger to change behaviors. Knowledge is ability (e.g. ability to distinguish low-carb or high-carb food or to understand the way sport influence the blood glucose level). With our platform we make sure that patients can better manage better their conditions and that they feel confident meeting their daily health related decisions.