Over the past years, the paradigm of medical care has embraced a patient-centered approach that prioritizes and anticipates one’s needs and prompts clinical intervention. Such a proactive attitude, however, has not yet become a pattern due to several financial and organizational barriers. Many hospitals claim to have limited resources for the implementation of preventive health care regularly, especially when it comes to the financial coverage of preventive interventions.
The controversy, in this case, is the fact that the overwhelming amount of EBP research points to the socio-economic benefits of the anticipatory approach to health care. For example, in an article by Jennings and Eng (2020), the authors clearly indicate that “Increasing preventive cancer screenings in the U.S. is an effective strategy to reduce health care costs” (p. 245). Another study concludes that the personalized preventive approach “is statistically associated with reductions in outpatient expenditures, Medicare expenditures in year 5, emergency department (ED) utilization, and unplanned inpatient admissions, accompanied by significant increases in evaluation and management visits and expenditures” (Morefield, Tomai, Slanchev, & Klemes, 2020, p. 75). Based on this evidence, it is reasonable to ask why the economic systems of health care overlook such a beneficial opportunity.
In my opinion, the answer to this question addresses two major aspects: heavy reliance on patient autonomy in health decisions and the unwillingness to invest in telemedicine and digital solutions to preventive health. This reflection was, in fact, inspired by one of my patients who is receiving treatment for type 2 diabetes. This patient is a 68-year-old man, so the majority of his medical expenses are covered by federal Medicaid insurance. He is a heavy smoker and drinks alcohol at least once a week, so he is at high risk of hyperglycemia and other complications of diabetes. Because of severe blood sugar spikes at his age, the patient is frequently admitted to the hospital with hyperglycemia and low blood pressure, which makes him faint. As a result, the patient is readmitted to the facility every two months with an average hospital stay of three days. Since it is already evident that the patient faints and struggles with blood sugar spikes because of a lifestyle incompatible with the disease, it is critical to question the preventive measures of the treatment.
One of the potentially successful ways to accomplish the proper level of prevention is to let patients rely on technology rather than their perception of health. The patient discussed above cannot be blamed for incompetence and ignorance in terms of his well-being because, after a medical intervention, he tends to feel better and forget about his medical condition. Indeed, over the years of my nursing experience, I have realized that people are unlikely to think about their health when nothing bothers them. The ones who do, however, are usually more financially capable and address health care without preventive care and recommendations.
For this reason, it is crucial to provide patients with an opportunity to be reminded of their health status before it is too late and they rush to the hospital. Telemedicine, including apps linked to a tracking device, is an extremely beneficial way to promote this change. Evidence suggests that a mobile-phone system for senior patients with type 2 diabetes contributes positively to the patient’s blood sugar and overall well-being (Sun et al., 2019). Procurement of such devices for a facility and software development yield financial advantages for the administration and patients in the long run, as hospital stay, readmission rates, and federal coverage of medical bills result in more frequent and costly expenses. Hence, it is high time for public health advocates to perceive telemedicine as a futuristic concept rather than a full-scale modern solution.
References
Jennings, N. B., & Eng, H. J. Preventive cancer screening: A strategy to reduce US healthcare costs. Journal of Medical & Clinical Research, 5(9), 245-250.
Morefield, B., Tomai, L., Slanchev, V., & Klemes, A. (2020). Payer effects of personalized preventive care for patients with diabetes. The American Journal of Managed Care, 26(3), 70-75. Web.
Sun, C., Sun, L., Xi, S., Zhang, H., Wang, H., Feng, Y., Deng, Y., Wang, H., Xiao, X., Wang, G., Gao, Y., & Wang, G. (2019). Mobile phone-based telemedicine practice in older Chinese patients with type 2 diabetes mellitus: Randomized controlled trial. JMIR mHealth and uHealth, 7(1). Web.