Digital Adherence Tools Keep Chronic Disease Patients from Falling through the Cracks during the COVID-19 Pandemic
September 15, 2020

Over the past six months, digital health solutions have clearly demonstrated their value by helping close COVID-induced gaps between providers and patients. Digital adherence tools have been especially useful. 


But rather than focusing strictly on medication adherence tools, health plans should be looking to more broadly applicable adherence solutions to keep at-risk and less engaged populations from falling through the cracks during and after this pandemic.


Of the three distinct waves of digital health, solutions in the third wave have the most significant potential for protecting chronic disease populations right now and post-COVID.

Shifts in priorities during COVID-19 pandemic

In order to understand why digital adherence tools have become so essential, we must first consider how substantially healthcare priorities have shifted since the start of the pandemic. 

From a patient perspective

Millions of people have lost their jobs and with them, their primary sources of income and employer-sponsored health insurance. In addition to these significant losses, they may also be dealing with other consequences of the pandemic, such as making nontraditional school arrangements for their children, changing care settings for elderly loved ones in order to keep them safe, and maintaining housing and shelter.


Many of the people who’ve lost their jobs and health insurance have enrolled in Medicaid, contributing to a surge in Medicaid enrollment. Realistically speaking, many new and existing Medicaid enrollees weren’t even in the best health pre-COVID. They may have had uncontrolled chronic conditions before. And since traditional healthcare delivery has transformed, they are certainly not in a promising position now.


Given the fear of COVID-19 and the resulting desire to avoid coronavirus exposure, many people are avoiding medical facilities, skipping appointments, missing refills, etc. It’s easy to see how patients in the most need could fall through the cracks during this time without remote monitoring capabilities.

From a provider perspective

Healthcare practitioners, who were already loaded with job-related responsibilities, now have even more. They are attempting to stay up-to-date on the latest COVID developments, deliver urgent communications, keep themselves and their staff safe, and get acclimated to delivering healthcare virtually. Many are even screening symptomatic patients between scheduled visits, which brings on the added requirements of keeping sick and well patients separate.


Juggling so many responsibilities can make it even more challenging for them to reach disengaged patients and get them to follow through on their care plans, especially since fewer patients are physically coming into medical offices.

From a public payer perspective

Public payers like Medicaid are seeing a spike in enrollment because of the downward financial trends caused by the pandemic. Because of this, Medicaid managed care organizations (MCOs) are responsible for keeping more people healthy in quite challenging times. Reliance on remote patient monitoring and digital adherence tools, therefore, has become essential.

Effects on chronic disease populations

These shifts and transitions at various levels result in a strained healthcare system where the most at-risk chronic disease populations bear a significant portion of the burden in at least two major ways.


First, based on what we know about risk factors for COVID-19, people with chronic conditions are predisposed to severe complications from COVID. According to the Centers for Disease Control and Prevention (CDC), there are two major risk groups for people with severe conditions: 

  • those who are definitely at increased risk—e.g., people with type 2 diabetes, serious heart conditions, cancer, and chronic kidney disease (CKD)
  • and those who might be at increased risk—e.g., pregnant women and people with moderate-to-severe asthma, high blood pressure, type 1 diabetes, and HIV


Naturally, this means that if people with these types of conditions get sick with COVID-19, they are more likely to experience negative outcomes, higher morbidity, and higher mortality.


Secondly, these populations are also at risk for more negative outcomes that are indirectly related to COVID. High-risk patients, borderline high-risk patients, and those who have been newly diagnosed with chronic diseases are three groups who, for various reasons, are likely to suffer from gaps in appropriate chronic disease management.


If these populations are continuously disengaged, the consequences will be severe from a health perspective and a healthcare spending perspective. Without digital tools to help bridge gaps in care, health plans can expect to see serious consequences from minimal or absent disease management, including increased hospitalization and death.


How digital adherence tools make disease management more attainable during the pandemic 

So, how have various types of digital adherence tools been useful in this climate? And what makes the third wave of digital health most promising, especially in this environment?


The first wave of digital health

The first wave of digital health consists of early adopter products that focus on general wellness. A popular example is the activity tracker, Fitbit.


These tools function to promote overall health and wellness but don’t replace specific healthcare services. They have more appeal to people who are already interested in wellness and motivated to improve their health to some extent.

The second wave of digital health

The second wave of digital health involves digitization of existing healthcare services. Here, we’re thinking about solutions like GoodRx for “shopping around” to find affordable medications and Teladoc for facilitating virtual healthcare visits.


These solutions, while practical, require patients to engage with them directly in order to be valuable. Most likely, the patients who are already most engaged in their own healthcare will be the ones utilizing and benefitting from the services.


But where does this leave disengaged patient populations who are least adherent to their care plans and have the highest risk of poor health outcomes?

The third wave of digital health

Historically, patients in need of the most help to get their chronic conditions under control have been left out of the purview of many digital health solutions. The third wave of digital heath must create motivation in previously unmotivated or disengaged populations in order to generate patient buy-in and move them towards healthy habit formation.


Wellth is the leading example of this type of digital adherence tool.

Wellth creates motivation to build healthy habits, even in the most resistant populations

Wellth stands apart from other adherence tools that merely focus on tracking and automated reminders. While there is certainly a place for reminders, these tools do little, if anything at all, to truly improve healthy habits at the motivational level.


As we previously discussed, people’s life circumstances have changed—sometimes drastically—and their priorities have evolved along with them. That means that even people who may have the best intentions may experience real barriers that keep them from following through on their care plans.


Rooted in behavioral economics principles, Wellth uses financial incentives and empathetic, individualized interactions to help our members overcome these barriers. By offering monetary incentives for care plan based-tasks like monitoring blood sugar regularly and taking medications on schedule, our members become more engaged with managing their chronic conditions and motivated to follow through. 


In this way, we help them cultivate healthy habits to help them improve their health status, especially during a time when it’s all-too-easy for their health to deteriorate.

Wellth supplements chronic disease state management by incentivizing preventative health behaviors

As an additional layer to our care plan adherence program, we also offer incentives to reward members for completing periodic behaviors, like vaccinations and screenings. 


Anticipating the COVID vaccination is a  timely example. While you already have the member engaged daily with the care plan adherence program, you can help members get in the habit of managing their disease states consistently, while also being forward-thinking and proactive about their health. 


Download the Wellth Program Summary to learn how we can support your health plan members in establishing healthier habits, during COVID and beyond.

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