Chronic Care Patients Are Dying for Change

Chronic Care Patients Are Dying for Change
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America has a hotshot, high tech system that can deliver world class, life saving technologies for surgeries, emergencies and other medical crises. But here's the disconnect: The vast majority of health care dollars are not spent in response to urgent medical crises. Today, over 75 percent of the U.S. health care budget is spent on care for patients with chronic conditions -- not traumas. In many important ways, we find ourselves with a great solution, but it's for the wrong problem, and the consequences are tragic.

According to the CDC, 7 out of 10 deaths among Americans are from chronic diseases. The world changed, but the health care system hasn't changed fast enough so today, chronic care patients are literally dying for change.

Americans are getting sicker and dying younger than citizens in 50 other nations, while at the same time we're generating astronomical health care costs that put the financial security of the United States in jeopardy. Rome is burning, and we're not seeing the big picture through the smoke. The brilliant business writer Peter Drucker wrote, "Don't focus on the work in front of you, focus on results." It's time to get focused on results that will change the health of the nation and, as a fortunate byproduct, will dramatically reduce our financial challenges.

How did this happen? Health care research has been focused on building better equipment, innovative medical devices and drug discovery. Noble undertakings, but very few of these advancements address the central health care problem of our time which is chronic disease.

Our prosperity has enabled a lifestyle that mints chronic disease. As the cartoon character Pogo says, "We have met the enemy and he is us." Since we are the makers of most chronic disease, it's urgent that we embrace this enemy, learn his secrets and create a battle plan to combat chronic disease.

Where do we start? With so many chronic diseases (diabetes, cardiovascular disease, kidney failure, etc.) the challenge can seem overwhelming. If only there were a "one size fits all" solution that could dramatically change the progression of chronic disease. Well, as it turns out, there is. It's called "medical adherence." When patients adhere to their care plans given to them by their doctors, the course of their chronic disease dramatically improves.

We're at a critical crossroad. For the first time, the biggest factor in whether a patient gets better or not isn't determined during a doctor visit. It's determined by what the patient does between doctor visits.

The economics of medical adherence are also compelling. If we figure out how to get patients to follow their care plans, we will save trillions of dollars over the next decade. If we fail, those trillions will be lost and along with it, much of our prosperity.

I recently had the privilege of being invited to attend "Non-Adherence Boot Camp," part of the Merck and Heritage Provider Network Innovation Challenge. Particularly powerful at boot camp were the panels of diabetic patients who shared their stories. There were several common threads. They feel alone, angry and scared. They're tired, stressed and sometimes embarrassed, especially when they need to give themselves an injection and friends or work colleagues are around. They want to be accountable to someone with sincere concern and knowledge. Sometimes they just want to give up, but mostly they don't want to die. They wonder what the future will hold.

These patients and tens of millions of others like them are crying out for 21st century solutions to help them, but so far their calls have gone unanswered.

Meeting the needs and managing the costs of chronic care patients are collectively the greatest medical and financial challenges we face today. Chronic patients need solutions that are as carefully crafted as the latest medical imaging device. However, their solution will not be 3D printed, constructed of nano materials or be the product of synthetic biology. If we listen to their voices we know that their solution will be one that helps them overcome their fear and sense of isolation and involves and engages them with both platform software and with caring individuals. These are things that medical professionals innately understand, but for some reason their industry has not pursued with appropriate funding and vigor.

For a chronic care plan to be adhered to it can't just be stated or written. It has to be felt.

"Tell me and I'll forget; show me and I may remember; involve me and I'll understand." These words seem like they could have been spoken in a diabetes focus group, but they weren't. They were written by Confucius in 500 BC, some 2,500 years ago.

It's time to stop talking and showing. It's time for health care to get involved with chronic care.

Bruce is CEO of Frame Health which is piloting a medical adherence solution with one of America's largest healthcare companies. Frame Health uses a proprietary assessment tool and very large psychographic database to gain deep understanding of individual patient motivations. These insights are used to generate individual patient care guides which doctors, nurses and other members of the care team use to help the patient adhere to their care plan. Frame Health is currently piloting its medical adherence solution with one of America's largest healthcare companies.

Frame Health is one of five semi-finalists in The Merck | Heritage Provider Network Innovation Challenge. The sponsors have called on entrepreneurs, data scientists, designers, health care providers, and big thinkers to create the products or services that will support patients with diabetes and/or heart disease in adhering to their care plans and ultimately improving health. Semi-finalists will be presenting their solutions at Demo Day on January 23rd in NYC. Check out their progress, watch their Demo Day presentations, and find additional open innovation challenges by visiting Health Data Challenges.


This blog series is produced in partnership with Health Data Challenges, creators of The Health Data Challenge Series, a formal initiative of the Health Data Consortium, powered by Luminary Labs. The platform seeks to foster the use of data to drive innovation that will ultimately transform health and healthcare through high-stakes innovation challenges. Learn more at

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