The keys to improving management of chronic diseases such as diabetes and hypertension lie in improving pharmacologic therapy, changing behaviors and ensuring consistent surveillance, according to Richard Milani, MD, chief clinical transformation officer at Ochsner Health System.
In a recent episode of the American Medical Association's "Moving Medicine" podcast, Dr. Milani, who is also vice chairman of cardiology for the New Orleans-based health system, discussed the challenges of disease management, advocating for continuous innovation in all three of those core areas to improve the health and wellness of patients with chronic illnesses.
Dr. Milani listed four challenges preventing the optimization of chronic disease management:
• Lack of time: "If we were to follow the guidelines for just 10 chronic disease, it would encompass about 10.6 hours a day. We'd have nothing left to do anything else, and we don't even have 10.6 hours a day, in terms of time for our patients," he said.
• Information overload: Medical knowledge is now doubling at a rapid rate, making it difficult for physicians to keep up with the latest findings and recommendations.
• Therapeutic inertia: Often, while improved treatment plans, behavior and surveillance will result in early progress, that progress will plateau before the patient reaches their desired end goal.
• Acute care delivery: While the U.S. healthcare system's episodic acute care model made sense a century ago, it no longer aligns with patients' needs — "the focus that we have to turn our attention to going forward is the health of the population, especially if we're going to go to a value-based system," Dr. Milani said.
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