Diabetes and mHealth: Use, reimbursement, future outlook

Mobile health (mHealth) offers new ways to empower patients with diabetes in caring for themselves and making decisions that support their health. As a chronic disease, diabetes requires patients to spend a lot of time on self-management. This means that patients, not their providers, make many of the decisions that determine how well they control their diabetes.

Research consistently shows that diabetes management is one area in which mobile devices can enhance care and improve the quality of life for patients, says Leonard Egede, MD, MS, Allen H. Johnson Endowed Chair and Professor of Medicine, Medical University of South Carolina, Charleston, South Carolina. Given this, some current research is focused on how to best use mHealth to complement the healthcare system and support patients in their daily self-management.

Employing mHealth

Individuals with diabetes can use mHealth to self-manage their disease. This can include providing educational information; providing reminders for taking medications; tracking diet, physical activity, and blood glucose readings; or offering methods for communicating questions and data to providers.

Egede points out that nearly half of patients with diabetes do not have good glucose control. Self-care is important to controlling glucose and minimizing complications later in life. By sending data to providers, they can monitor patients’ decisions and address concerns.

Many mHealth applications already make it possible to self-manage diabetes in a variety of ways. “How to best integrate these options into a user-friendly manner is an important area of current research,” Egede says.

What payers are covering

Currently, some payers are offering reimbursement for the use of mHealth technologies. For example, some give reimbursement for nurse management, which could include providing feedback to patients who use mHealth for monitoring purposes. However, it is not enough to fully cover costs. In addition, there are no current incentives to patients for monitoring themselves through mHealth other than their own personal benefit, Egede says.

Next: Reimbursement barriers  and future outlook

One barrier to this is the fact that current reimbursement by payers is set up to pay for time spent with a patient rather than the processes put in place to support patients outside of their visits. “With a chronic disease like diabetes, it is important for payers to offer incentives to patients and reimburse providers for putting systems in place that help treat the overall condition and support patients in their own self-care,” Egede says.

The advantages to payers for paying for diabetes care using mHealth could be lower costs to the payer if patients take better care of themselves and do not need expensive treatments later in life for complications, Egede says. Currently, cost-effectiveness data on whether this is true is lacking, which is one reason payers have not yet offered to pay for many mHealth technologies. As more research is completed, studies will be able to answer payers’ questions regarding whether this is a cost-effective way to provide care.

Looking ahead

One of the ways mHealth may be used to treat individuals with diabetes in the future is to provide personalized feedback and ways to obtain more regular feedback from their providers.

For example, blood glucose monitoring is helpful only if the patient knows how to respond if their blood sugars are too high or too low, and how to change their behavior over time to normalize their blood sugars.

Using mHealth as a way to provide personalized feedback to a patient using pre-determined responses, and giving the option of asking questions to healthcare professionals to increase their knowledge and skills is an important next step for employing mHealth in the future.

Karen Appold is a medical writer in Lehigh Valley, Pennsylvania.