How Lark Can Reduce the Burden on the Healthcare System through COVID-19 and Beyond

As the COVID-19 pandemic wears on, now-familiar themes of news stories include rising numbers of cases and deaths, how hard the economy will be hit, and ever-more-stringent measures to try to slow the spread of infections. Another recurring theme is the burden on the healthcare system.

Coronavirus and an Overburdened Healthcare System

A surge of COVID-19 patients is nearly sure to overburden the healthcare system. Early estimates were for a potential 200,000 to nearly 3 million coronavirus patients needing intensive care. Resources of all types, whether or not specific to COVID-19, are expected to be in short supply. They include the following.

• Ventilators
• Personal protective equipment (PPE) for healthcare workers, such as masks and gloves
• Hospital beds
• Doctors, nurses, and other healthcare workers
• COVID-19 test kits and reagents

The results can be devastating if the actual number of severe cases of coronavirus turns out to be anywhere near the number projected. Patients with COVID-19 might not receive the care they need and they are not the only ones who will be hurt. Other patients may become casualties due to lack of access to the space, medical attention, or medical equipment they need. The economic costs can also be astronomical.

Social distancing and similar measures can help reduce the number of COVID-19 patients requiring medical attention at any one time, but other strategies can help, too. For example, Lark’s chronic care management (CCM) programs may reduce the number of high-risk patients who get COVID-19, reduce the number of non-COVID-19 patients who visit healthcare facilities in person, and lower healthcare costs.

Vulnerable Populations with Chronic Conditions

The Centers for Disease Control and Prevention (CDC) say that certain populations are at higher risk for developing more severe cases of coronavirus [1]. These include people who are at least 65 years old, who are immunocompromised, such as when undergoing cancer treatment, or who have underlying conditions, such as heart disease, lung disease or asthma, and diabetes. Patients with hypertension also appear to be at higher risk, possibly due to the increased strain that high blood pressure places on the heart.

The CDC recommends having enough groceries, medications, and other household supplies on hand for two weeks in case you get sick. In addition, the CDC emphasizes staying at home, washing hands, not touching common surfaces, and avoiding other people as much as possible. Lark’s programs for Diabetes and Hypertension CCM programs support these aims by helping its patients stay as healthy as possible and get basic healthcare without setting foot in a crowded clinic.

Reduce Exposure for High-Risk Populations

With doctors’ offices and other healthcare facilities expected to be overrun by coronavirus-infected patients, they are hardly safe places for high-risk populations such as patients with diabetes or hypertension. Lark CCM programs for hypertension and diabetes enable patients to limit their exposure to the virus by helping them get care remotely.

Medicare patients now have expanded coverage for telehealth services, enabling them to talk to doctors, nurses, or other healthcare providers remotely. Without setting foot in a healthcare facility that may be crowded with patients with coronavirus, Medicare beneficiaries can get services such as advice for their blood sugar or blood pressure, or refills on prescriptions.

Patients who do suspect that they have COVID-19 are advised to call their healthcare providers before going into a clinic or emergency room. Providers all over the country are putting in place policies to cover care for COVID-19 cases, including covering testing when possible, and remote phone or video chat appointments for milder cases. 

Reducing Costs and Freeing Up Resources with Better Chronic Condition Self-Management

In chronic conditions such as diabetes and hypertension, reducing or hitting targets for blood sugar and blood pressure, respectively, can allow patients to maintain health. This can lead to benefits such as fewer expensive complications, such as kidney disease, diabetic neuropathy, and stroke, and fewer hospitalizations and trips to the emergency room. Not surprisingly, outcomes such as lower A1C (glycated hemoglobin) in diabetes, and lower blood pressure in hypertension, are linked to cost savings.

Importantly, especially when looking in the context of the coronavirus pandemic, keeping patients out of healthcare facilities also frees up resources. Each patient with diabetes or hypertension who stays out of the hospital or emergency room is a patient who is not using a hospital bed, taking up significant amounts of doctors’ and nurses’ time, and causing healthcare providers to use extra disposable gloves and hand sanitizer. 

Lark’s Chronic Care Management (CCM) platforms for diabetes and hypertension have demonstrated significant reductions in blood sugar and blood pressure, respectively. Patients who used Lark Diabetes had an average A1C decrease of 1.3% by the end of three months [2].  To put that into context, a 1% reduction has been linked to a 21% lower risk of diabetes-related death and 37% lower risk for microvascular complications [3], as well as reductions in annual per person costs of $804 to $1,896 [4].

Lark Hypertension patients showed similar positive results, with an average decreases in systolic and diastolic blood pressure of 8.4 mm Hg and 6.4 mm Hg, respectively, after using Lark for six months [5]. In comparison, a decrease of 5 mm Hg SBP may lead to a 7% decrease in all-cause mortality, including a 14% decrease in stroke mortality [6]. In addition, a model suggests that a population-wide reduction in blood pressure of 7.2/3.8 would lead to an estimated annual national cost savings of $18 billion on medical expenses [7].

Lark’s Infinitely Scalable Solution

Any solution that is going to have a significant impact on the healthcare system needs to be able to serve large numbers of patients, quickly and at cost. Targeting diabetes and hypertension makes sense, since they are high-risk conditions for COVID-19 and they affect so many people. About 1 in 6 American adults (35 million) have diabetes, and nearly 1 in 2 (108 million) have hypertension. 

Lark for Hypertension and Lark for Diabetes are infinitely scalable, fully digital platforms to help patients self-manage their chronic conditions. Powered by artificial intelligence (AI) and delivered remotely via smartphone app, Lark can be scaled quickly and at cost while maintaining personalization for each patient.

Self-management is a significant part of the care plan for patients with chronic conditions such as diabetes and hypertension, as daily choices can determine the course of the condition. To help patients achieve treatment targets with self-management practices, Lark uses proven behavior change theories and strategies to help establish new habits, such as eating better, increasing physical activity, taking medications as prescribed, and monitoring blood sugar or blood pressure as the doctor recommends. 

Furthermore, Lark escalates cases when patients record an out-of-range value indicating a possible concern. Plus, Lark is available for patients 24/7 for every decision they need to make.

The healthcare system is being overburdened as coronavirus infections are sending patients to hospitals and emergency rooms nationwide. Lark Diabetes and Hypertension Management programs are helping relieve the burden in important ways. First, it helps patients manage their conditions to stay healthier, which can keep them out of ERs and hospitals to free up resources for other patients. Next, by keeping these high-risk patients away from in-person medical facilities, Lark helps lower their exposure to COVID-19 so they are less likely to get infected.

References                                                

1. Centers for Disease Control and Prevention. People who are at higher risk for severe illness. March 26, 2020.
2. Stein N, Delury K. Lark’s AI for Diabetes study shows that patients significantly reduce A1C. White paper.
3. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258):405–412. doi:10.1136/bmj.321.7258.405
4.  Fitch K, Pyenson BS, Iwasaki K. Medical claim cost impact of improved diabetes control for Medicare and commercially insured patients with type 2 diabetes. J Manag Care Pharm. 2013;19(8):609-20.
5. Lark and Omron. Omron Home BPM and Lark Hypertension Management Program Deliver Significant Blood Pressure Reduction in Uncontrolled Population. 
6. Chobanian et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–1252. https://doi.org/10.1161/01.HYP.0000107251.49515.c2
7. Palar K, Sturm R. Potential societal savings from reduced sodium consumption in the U.S. adult population. Am J Health Promot. 2009;24:49–57