We need to change behaviours, not write more prescriptions!

From: Reimagining primary care in an era of chronic diseases — Jeremy Lim, October 4, 2016. http://www.themalaymailonline.com/what-you-think/article/reimagining-primary-care-in-an-era-of-chronic-diseases-jeremy-lim#sthash.StJwo84s.dpuf

Doctors’ clinics can often be sterile environments where patients occupy the waiting time reading old magazines, spend mere minutes with their physicians …. Not at Iora Health, a clinic with yoga, books and cooking classes, and where patients get as much as 90 minutes of consultation time each visit.

It is one of a small but growing number of clinics around the world that is trying to do primary care differently in an age of chronic diseases — by targeting behaviours.

Iora Health, a primary care group with 34 centres across the United States, and rapidly growing, eschews the traditional clinic set-up and physician-consult-based model, offering patients a homely environment that exudes warmth, security and perhaps even a sense of family.

…. Today’s patients tend to have diseases like diabetes, heart failure and chronic lung disease, explained founder Dr Rushika Fernandopulle, a Harvard-trained physician. So what matters are behaviours that are, in turn, influenced by attitudes and beliefs.

Medicines are only one part of the treatment plan.

“Managing a chronic condition is a time-consuming and costly endeavour,” Livongo says on its website, adding that it “reduces that burden” by adopting the latest technologies and behaviour sciences insights, combined into a mixture of behavioural nudges and human coaching delivered digitally. According to founder Glenn Tullman, patients want to know just enough to live full lives despite their illnesses. He compares Livongo with modern devices such as smartphones that the average person can use with minimal or no training.

At home, Holmusk, a Singapore-incorporated health data analytics company with operations in Singapore and the US, estimates that only a third of chronic disease management success is decided by medicine. For the remaining two-thirds, success can be attributed to changes in behaviour. Using insights garnered from patient clinical and lifestyle data, Holmusk is rolling out programmes for mental health and diabetes.

In this era of chronic diseases, we need to change behaviours, not write more prescriptions.

What Iora, South Somerset, Livongo, Holmusk and other innovators are challenging us to do is to embrace a versatile, truly patient-centric health system that customises and adapts to what patients want and need to live long, healthy lives. — TODAY

* Dr Jeremy Lim is a partner in Oliver Wyman, the global consultancy and leads its Asian healthcare practice.