Chronic diseases and conditions are now the leading causes of death and disability in the United States. Health problems such as heart disease, stroke, cancer, type 2 diabetes, obesity, and arthritis are not only prevalent and costly, but also preventable. This development has brought about a shift in healthcare, and as a result, in the roles and responsibilities of patients. Following this health transition and given the fact that, for the first time in history, more people are dying as a consequence of obesity rather than hunger, at least in developed countries, health policies are changing. The responsibilities of patients and their role in health management have grown substantially. Time and technology have led to a shift in healthcare: prevention and treatment are moving out of the hospitals and into the communities, workplaces and homes. This in turn leaves patients, employers and families with greater responsibilities for their health and that of their employees.
Self-management is the new key word in healthcare. Self-management may be defined as the correct actions and decisions that one makes in order to efficiently manage their long-term health condition. This implies that every individual has his or her own lifestyle, diet, day-to-day schedule and experiences emotions in a unique way, things that can significantly impact the health outcome and quality of life. Each individual is therefore responsible for making changes in these behaviors with the support of information, education, wearables of their choosing, but also with the help of healthcare professionals. These changes may include: diet and exercise, managing anxiety and depression, changing the work environment and probably even more importantly, monitoring their own symptoms and reporting unusual changes to their doctor. All of these and more can and may be improved with the help of new technologies that might very well change our way of thinking about healthcare.
The first step in self-management with the help of technology was actually the Internet itself. No longer were patients restricted to doctors’ offices and acquaintances for information and advice – websites, blogs and chat rooms all over the world provided a new and safe environment for them to discuss and manage their conditions. Smartphones and wearables made it even easier and people soon became aware of their own health and lifestyle, but also of the risks they were taking. As gadgets offered a glimpse into the future, self-management came naturally to most. The trend doesn’t stop here: Eterly has developed an app that works with gadgets and obtains data about the user’s lifestyle behaviors, data that could be a factor in predicting their life expectancy. Not only does the app monitor sleep while monitoring the heart rate and counting steps, but it also makes use of an intelligent chatbot that asks users questions about their diet, vitamin intake and mood. The AI-driven chatbot then provides users with health, exercise and lifestyle goals tailored to their needs, acting like a virtual personal trainer.
But apps aside, self-management may also be seen as disrupting the doctor – patient relationship. This means that the traditional arrangement is slowly turning into a partnership, where the patient’s role is much more important than before and their experience and information are used accordingly. Self-management does not only provide a new reason to develop apps and gadgets, but also supports the development of services that encourage patients to make positive changes in their lives and to maintain those changes. These services may and should include courses and seminars for patients recently diagnosed with chronic diseases, but also new generic education that provides information on how to prevent and manage common symptoms such as pain, burnout or stress. Personal trainers, telephone support and online support may be other fields that will soon grow and evolve even more as a result of self-management.
Strong evidence seems to suggest that self-management, education and information help expand what patients know about their disorders, allowing them to better manage their conditions and seek help from healthcare professionals when necessary. Because chronic diseases and conditions are now the leading causes of death and disability in the United States while also being very common, costly – but preventable, self-management might play an important role in improving health and increasing quality of life. It might also help in decreasing costs. Healthy employees provide companies with better productivity and results, while reducing costs in healthcare and decreasing absenteeism. Recent research suggests that self-management can enhance patients’ satisfaction, provide them with better management skills for their conditions, raise their self-efficacy, improve their social support skills and even upgrade their education.