Healthcare Innovation

Chronic Disease Management: Empowering a Better Future, On Our Terms

man using livongo glucometer

Chronic disease management is a difficult proposition for an industry overburdened by demand and which operates according to predefined schedules and locations. Chronic conditions call for a health-care system that can provide support 24/7 whenever and wherever people need it. Yet today, that model largely remains nonexistent among traditional providers of care. People with chronic conditions often can’t see their physician when they need care the most. For example, patients with diabetes can’t see their physician when their blood sugar falls too low in the middle of the night or too high during the weekend. They also can’t receive care from their physician at work or at home. And when they do see their physician—such as during routine quarterly visits—they often don’t need care.

Recent innovations in telehealth have overcome this problem by connecting people with a physician remotely in real, or nearly real, time. One example is Doctor on Demand. While a significant improvement from the traditional model, providers and patients still lack the knowledge to improve their health continuously, knowledge that requires a system for understanding one’s health state at any point in time.

The health-care system, as it exists today, cannot fundamentally provide the level of personalized care people need. Unfortunately, many traditional providers of care don’t recognize this, and instead continue to see the problem as a lack of patient engagement in their health, rather than the need to empower them to live healthier on their terms. In On Our Terms: Empowering the New Health Consumer, Glen Tullman calls for a new system of care that puts people, not health-care providers, in charge of managing their health. As he states in his book, “Our greatest chance of overcoming the chronic condition epidemic in this country and across the world requires us to look to the last place we might imagine: the person who is living with a chronic condition on a daily basis.” This is a departure from the mindset that has dominated the health-care industry for decades. In many ways, it requires health-care providers to transform everything from their perceptions of people as patients instead of consumers, to their business models. For instance, it requires health systems to shift from a fee-for-service model—charging by the number of services provided versus health and financial outcomes attained—to one centered on creating value—better health, higher satisfaction, at lower cost. Read an excerpt of his book here.

Tullman’s vision for the future remains within grasp. Imagine the future we can create for people with chronic conditions by empowering them with the wisdom to know what their body needs at any moment. Or imagine the physical and emotional damage we can prevent by empowering their personal care team—their friends, family, colleagues, roommates, etc.—to know how and when to provide support. Similarly, imagine the clinical and financial outcomes we can achieve by providing people real-time, and in some cases, preventive care, whenever and wherever they need it (think OnStar powered by data science). The future of chronic disease management will look very different from what the cumbersome and ineffective process it represents today.

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on our terms book now released

Livongo CEO Glen Tullman on Managing Diabetes and Other Chronic Conditions

Livongo CEO Tullman’s new book explains how healthcare can evolve from a model built around cures to one centered on prevention and real-time, remote care.


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