Diabetic patients benefit most from personalized strategies

The population of people with diabetes is as varied as the American population. More than most other conditions, individuals of any age, ethnicity, income, weight, education, family history, geography, and overall health can have diabetes.

“Communicating in just one way to such a diverse group would be as ineffective as an international airport with signage in just one language,” says Sarah Ahmad, vice president, Consumer Health Innovation, Humana, Louisville, Kentucky. “In addition, getting the right message to the right person at the right time is critical for effective health education.”

Personalization is the key to a healthcare experience that optimizes outcomes, improves the customer experience and, ultimately, lowers costs to the healthcare system. It is critical to almost any educational effort, and particularly so in the case of diabetes.

“Unlike many other diseases, the complications and risk factors associated with diabetes are more directly influenced by an individual’s lifestyle and compliance with their treatment regimen,” Ahmad says. “Additionally, the disease itself is highly personalized. An individual’s blood sugar levels react differently to exercise, carbohydrate intake, stress, and a myriad other variables.”

The disease’s complexity, responsiveness to lifestyle improvements, and high degree of dependence on the individual’s actions mean that there’s a great opportunity to influence outcomes through education and behavior change, Ahmad continues. For example, according to the U.S. Department of Health and Human Services, if healthcare providers can influence a patient to change their behavior and achieve an HbA1c improvement of just 1%, that individual’s risk of eye, kidney, and nerve disease is reduced by 40%. That same 1% HbA1c improvement also lowers risk of heart attack by 14%.

Next: Personalized strategies

Personalized strategies

Humana approaches personalization along two primary axes: clinical and experiential. The clinical axis involves assessing a diabetic patient’s health status by analyzing his or her individual risk factors, clinical indicators, and predicted complication probability. “This allows us to identify people that most need our services,” says Ahmad.

The experiential axis involves assessing a person’s receptiveness to assistance, preferred mode(s) of interaction, sociographic data, and, importantly, barriers to health such as education and awareness, lifestyle and self-care, and medication adherence.

“This helps us understand how to design educational programs that best communicate with specific populations,” she says. “To do this, we first listen. We reach out to people on a personal level, within the context of their physical and virtual communities, to understand them as individuals and how they interact in the world on a daily basis.”

The critical elements of personalization are found at the intersection of clinical data and experiential understanding. “Prioritizing which individuals need, and as importantly, which ones want our help allows us to apply our resources where they can have maximum impact,” Ahmad says. “From there, understanding how to communicate with an individual gives us the power to reach people most effectively.”

Humana communicates information in multiple ways, including one-on-one and small group in-person classes, and by telephone, text, and traditional mail. It is also exploring emerging communication channels such as through blood glucose meters, wearables, and other mobile and wireless devices.

A key factor in the how it reaches out includes developing a thorough understanding of an individual’s environment and partnering with resources in their community to meet people where they are. This is critical to developing the trust necessary for people to be most receptive to advice and guidance.

Next: Impressive results

Impressive results

Using the high tech and high touch Prevent program from the digital behavioral health company Omada Health, 491 Humana Medicare Advantage beneficiaries have achieved clinically-meaningful engagement and weight loss outcomes thus far.

Six months after beginning the program, more than 85% of participants remained active-an engagement level among the best in class for intensive behavioral counseling. In addition, Prevent graduates lost an average of 8.7% of their body weight after six months.

Data from the Diabetes Prevention Program clinical trial indicates this level of weight loss in at-risk individuals over 60 years old is associated with a 71% reduction in type 2 diabetes risk at three years.

In March, Humana launched a new program co-developed with the American Diabetes Association that focuses on diabetes education and lifestyle change. It is also testing solutions and measures that evaluate impact on HbA1c control directly.

Looking ahead

In addition to helping people manage their specific conditions, Humana looks closely at how the healthcare system can be more effective by focusing on developing policies, regulations, and relationships that improve outcomes, enhance the consumer experience, remove cost, and enable ongoing change.

Finding new ways to leverage innovative partnerships, technology, data, and a more personalized approach to healthcare and healthcare education is the key to developing a system that creates health rather than only treating sickness, Ahmad concludes.

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