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In the Era of Virtual Care, Tech Tools Facilitate Patient Provider Engagement

Drug Topics Journal, Drug Topics December 2021, Volume 165, Issue 12

Mobile apps and fitness trackers predate the COVID-19 pandemic but are being utilized more ever before.

From home health monitoring devices to fitness tracking wearables, technology use in healthcare settings has significantly increased since the onset of the COVID-19 pandemic.1 Because the pandemic necessitated a switch to virtual care, patients and providers alike embraced digital tools—like those that facilitate at-home self-monitoring, improve medication adherence, or help manage lifestyle habits like diet and exercise.

“Pharmacists can guide patients on the most appropriate tech tools to use based on patient-specific factors to ensure optimal management of their medical conditions,” said Briann Fischetti, PharmD, MBA, BCACP, AAHIVP, an assistant professor of pharmacy practice at The Arnold & Marie Schwartz College of Pharmacy and Health Sciences (LIU Pharmacy) at Long Island University in Brooklyn, New York.

Electronic Health Record Platforms

Electronic Health Record Platforms Patients can use portals like Epic’s MyChart on their phone or computer, putting a tremendous amount of health information at their fingertips.

They can schedule appointments, receive test results, manage prescriptions, and review medical records. “I encourage every patient, even if they’re not comfortable with technology, to try out their health care providers’ patient portal. It’s a great way to engage with their care team and be an active part of their health care,” said Elizabeth Hall, PharmD, informatics pharmacist in outpatient pharmacy, The Ohio State University Wexner Medical Center, Columbus, Ohio. Brooke Fidler, PharmD, associate professor of pharmacy practice at Long Island University’s LIU Pharmacy, is also a proponent of MyChart.

“Many health systems use Epic as their electronic medical record system. It’s one of the more user-friendly portals,” she said. “[It] allows patients to message their provider for medication-related questions or refills.”

Mobile Apps

Hundreds of phone applications are geared toward monitoring medication adherence and managing chronic diseases like diabetes. “I recommend discussing a patient’s wants and needs for an application while also considering how technologically savvy they are,” said Maria Sorbera, PharmD, AAHIVP, BCACP, assistant professor of pharmacy practice at Long Island University’s LIU Pharmacy. Many applications are free or have tiered access. These applications are also great tools to assist motivated patients with improving their medication adherence and disease control, Sorbera added.

In many cases, an app can also serve as a medication list for patients to bring to new providers or to refer to if they’re hospitalized.

Medisafe helps users organize medications and improve medication adherence.
Users can enter all their medications, including the drug name, dosage, frequency, and indication, and set up reminders to take medication at certain times each day.

The Medifriend feature allows users to sync their app with that of a family member, letting others stay informed in case a dose is missed, according to Amanda Phoenix, PharmD, BCACP, CDE, an assistant professor of pharmacy practice at Touro College of Pharmacy and ambulatory care clinical pharmacist at BronxCare Health System in New York, New York.

MyFitnessPal can provide customized health plans based on individual user health goals, sex, age, and weight. Users can enter the foods they eat each day, then track calorie intake against a daily allowance, Phoenix explained.

This app uses the smartphone accelerometer to track steps and provides helpful workout and meal prep tips.

CalorieKing is for those who want to watch what they eat. Users can check nutrition labels and find the calories, carbohydrates, sugars, fat, sodium, and protein per serving.

“This app is ideal for patients who count carbs for diabetes management or for people who count calories to help lose weight,” Phoenix said.

For patients with type 2 diabetes, BlueStar allows providers to access patient health information remotely. Users can manually add their blood glucose and message providers with questions if their blood glucose is out of range. This is a great tool for patient health information remotely. Users can manually add their blood glucose and message providers with questions if their blood glucose is out of range.

“This is a great tool for patients who require touch points between visits and appreciate a collaborative approach to their care,” Fischetti said.

Notifications and Reminders

Notifications and Reminders The simplest way to track medication reminders is by setting an alarm or calendar notification using the apps on a mobile phone.

“This can be a good option for patients with poor health literacy or for [older] patients who aren’t technologically savvy,” Fidler said. A daily alarm can also be set on most glucometers to remind patients to check their glucose. For those more comfortable with technology, some free phone apps give reminders for medication refills and medication dosing at a prescheduled time. Pill Reminder and MyTherapy can also be used to remind patients to take medications.

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Messaging-based Platforms

Messaging-based Platforms Messaging-based platforms provide ways for pharmacies and other health care providers to communicate with their patients.

“We encourage patients to take advantage of these messaging systems because sometimes it can be difficult to contact a health care provider by phone,” Sorbera said. Most of these platforms require a pharmacy or clinic to pay for the service but are usually free to patients.

Klara is an all-in-one platform that allows patients to communicate with health care providers. Communications sent to patients are received as text messages with a confidential link that, when clicked, brings the patient to the messaging portal; patients don’t have to download an application.

MyChart also includes a messaging component for patients to contact providers, make appointments, and request medication refills.

Health Tracking Monitors

For motivated patients, wearable monitors can be a great adjunct to medication therapy and can assist with lifestyle modifications, Fischetti said. Basic health tracking tools include fitness-specific wearables like Fitbit and more general devices like the Apple Watch. These wearable fitness trackers can help patients set realistic goals. “You can ask patients to track their activity for 1 or 2 weeks [and] then review their baseline activity,” Fischetti said.

“From there, goals for the number of steps, calories burnt, and so forth can be set and monitored. Monitors also assist with accountability because patients know that we’ll review trackers when we meet.”

Social Media

In general, Fiddler doesn’t recommend social media sites to patients.

“Due to the abundance of medical and medication misinformation on social media platforms, I have found that it’s best to avoid steering patients to social media for medication management,” she said. “Patients may want to independently use social media for support groups and social support; however, I may caution them to ask their health care provider before implementing [the] recommendations discovered on social media.”

Pharmacists can direct patients who are looking for updates—or notifications on specific medical-related issues in the news—to reputable social media sources, Sorbera said. For example, pharmacists can direct patients who want current information on COVID-19 to the CDC’s social media pages.

Advising Patients

Patients should ask their health care providers for suggestions before committing to any paid application subscriptions, Fischetti noted.

“It may be tempting to have advanced features, but many patients may not need these features and it’s best to learn how to navigate an application prior to buying a subscription,” she said. The most important factors to consider before recommending one of these tools is the patient’s level of health literacy, how tech savvy they are, their insurance situation, and their financial means.

“Unfortunately, insurers can hinder the use of many advanced tools for home monitoring,” Fidler said. “However...a number of free applications and simple tools [are available] to aid in medication adherence and disease state management.”

Reference

1. Bestsennyy O, Gilbert G, Harris A, Rost J. Telehealth: aquarter-trillion-dollar post-COVID-19 reality? McKinsey& Company. July 9, 2021. Accessed November 10, 2021. https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality


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