No matter their path, patients are all striving to live their best lives, whether they have just been discharged from hospital recovery, are undergoing remote patient monitoring, and/or use several e-health applications to document their health journey. Everyone wants to be well and feel well, and Metabolic Health should be front and center to allow patients – no matter where they are starting – a path forward to feeling good.
Assessing Metabolic Health: A Multifaceted Approach
Assessing Metabolic Health involves merging several different clinical and physical indicators including:
- blood glucose in a healthy range
- waist circumference (< 35” for women and < 40” for men)
- blood pressure, cholesterol, and triglycerides all within a healthy range.
These metrics were known to be important for some time now, but this cluster of metrics has never been formally named – and likely for good reason.
To date, the health system in the United States remains fractured. Here’s a great example. A patient may see an endocrinologist for their blood glucose. However their blood pressure might be monitored by their primary care physician, while their cholesterol and triglycerides could be managed by either one or neither depending upon their care. But when it comes to their waist circumference – well, I’m not sure, but mine has never been taken. In none of these instances has anyone put wearable data, medical device data, and patient insights into the health record to create a complete picture of a patient’s overall health.
Harnessing the Internet of Things for Patient-Centered Care
The advent of the Internet of Things (IoT) in healthcare has yielded a wide range of available data that allows for understanding the “whole patient” and “patient centered care” in a new way. If things are off balance metabolically, health balance is also compromised. Maybe, with blood glucose spikes, patients become tired after meals; or may experience “background hunger” that feels like they always need a snack. They may feel extra tired upon exertion because of this, and their blood pressure elevation may be giving them headaches, blurry vision, and elevated anxiety.
As to waist circumference – that is something many may not be aware of initially. “Central obesity” as it is termed can contribute to higher rates of depression, cardiovascular disease, and cancer. All in all, when metabolically things are out of balance patients just don’t feel well. And feeling well needs to be the focus going forward. If people don’t feel well, they can’t get motivated around other aspects of health.
Remote Care Management: A New Opportunity
The necessity to understand whole patient health has created an interesting opportunity for remote care management. What do I mean by this? Remote care management means that from afar, with or without prompting from the patient, the health care provider can look at current health information to see how a patient might be doing. In metabolic health, this may look like looking at continuous glucose monitoring data, and even – with the Locus Health technology – viewing this data along with insightful data from wearable health technology.
Using this insightful data is key for early detection that there could be an issue. For instance, let’s say a patient has been very diligent in walking most days and has had improving glucose control. But over the last few weeks, things went sideways – the provider sees there’s very few steps each day, no exercise activity logged, and glucose has been elevated. While there may be different reasons why, let’s assume the patient has had some bad news that caused them to be depressed– which means they are not at all active and either the lack of movement or the temporary stress has thrown healthy eating off the track. This is a great time to check in with the patient. Sometimes simply acknowledging that their health has been impacted by this stress event is enough to motivate a patient to seek help or realize they will have to make a change to get back on track.
Early Detection Is Key
Having the ability to view this particular patient’s movements trends over the last few weeks has given the provider the ability to provide early intervention as to what is going on with their health. Under normal circumstances, this patient isn’t scheduled to be seen for 6 months. A few weeks vs. six months is the difference in getting the patient back on track with the right help toward feeling better or beginning to address areas of complications or other health problems that might arise over six months of poorer health. This does not mean to imply that the patient shouldn’t be able to develop resiliency nor that the health care professional needs to be on constant alert. However, declines in metabolic health caught early are easier and much less costly to address when not left for long periods of time. They do, however, require the health care provider to have easy access to EMR-incorporated data from medical devices and wearables, which is something the Locus Health solution makes available to health systems.
Feeling Well Enough to Feel Even Better
We can all agree that feeling well must be the number one goal of metabolic health and that most patients with uncontrolled diabetes do not feel well. However, we know normalizing glucose makes people feel a whole lot better. So much in fact, that many will say they didn’t realize how bad they felt. We know how to do this; we just don’t take this approach currently. Instead we currently ask patients to make dietary and lifestyle changes and in six months blame them when the changes to baseline health do not happen. This is the model of care that has been used over the last decade or so on managing metabolic health. Assuming the patient can pull themselves out of whatever situation they are currently in, assuming they feel well enough. However, given access to the right data, the clinician can see glucose is high most of the time, they can also see the patient can’t possibly feel well enough to exercise. Without this data, though, it’s easy to say, “go exercise and eat better” and call it a day.
Metabolic Health is a Reality
The availability of data to monitor metabolic health is readily available and easy to use, if it is accessed and integrated efficiently to support provider assessment and intervention. With Locus Health solutions, clinicians will be moved into a state of knowing and recognizing when this health needs attention and ways to address it. Change can be hard, but evaluating metabolic health doesn’t have to be. You just need the right data in the right place at the right time.
Adoption of health technology, medical devices and wearables will continue to bring valuable insights into well-being. Lack of access and transparency with this data has been a convenient excuse for health systems to avoid incorporating it into a vision of whole-patient and patient-centered care. Bridging the gap between electronic medical records and the world of medical device technology is core to the Locus Health approach, and we hope you’ll follow our journey to bring wellness and metabolic health to a health care provider near you.
At Locus Health, Molly is working on integrating diabetes device data into the electronic medical record. If you’d like to learn more about this effort for your health system, or your device, please click here.