Effective management of Long Term Conditions (LTC) depends on systematic outreach programs and structured outcome assessment. The central component of such programs is telephone outreach where by the care manager systematically contacts patients to follow up with their symptoms and medication adherence. Research suggests that telephone outreach is effective at improving adherence, satisfaction and clinical outcomes. However, telephone outreach makes follow-up inconvenient -missed contacts are the norm. As a result, it’s proving to be time consuming and very expensive.

Online patient-provider messaging has the potential to increase the feasibility of outreach programs, and reduce the cost of effective LTC management.  Randomised clinical trials are starting to attest to the effectiveness of the online alternative to telephone outreach programs for LTC care.

One randomised clinical trial of depression follow-up care by online messaging reported that patients assigned to online messaging had significantly higher rates of medication adherence when compared to those assigned to telephone outreach (1).  Additionally patients assigned to the online messaging had lower Symptom Checklist depression scores and reported to be more satisfied with their treatment. 

Another randomised clinical trial of hypertension control also reported increased effectiveness of online messaging management program versus usual care (2).  The online alternative was especially effective at controlling blood pressure in those with high systolic blood pressure at baseline, which is usually more difficult to treat and is associated with greater cardiovascular risk. This trial was special as it made use of clinically validated home blood pressure monitoring technology paired with hypertension management by a trained pharmacist through fortnightly online messaging.

The simultaneous use of e-monitoring technologies in addition to specialist supervision is proving to be more effective and efficient than the traditional telephone outreach programs at improving patient satisfaction, medication adherence and clinical outcomes.  The How are you?’s patient health record is an excellent platform for LTC outreach programs – patients and providers can communicate through the online messaging feature and patients can also share relevant biometric data. Patients can sync their medical devices to their patient health record such that their care manager can always view the most up to date data and preventing errors in measurement readings.

1. Simon GE, Ralston JD, Savarino J, Pabiniak C, Wentzel C, Operskalski BH. Randomized trial of depression follow-up care by online messaging. Journal of general internal medicine [Internet]. 2011 Jul [cited 2012 Oct 17];26(7):698–704.

2. Green BB, Cook AJ, Ralston JD, Paul A, Catz SL, Carlson J, et al. Effectiveness of Home Blood Pressure Monitoring, Web Communication, and Pharmacist Care on Hypertension Control: The e-BP Randomized Controlled Trial. 2009;299(24):2857–67.