Web-based health programs can save money and improve outcomes

There's more evidence that linking patients online to targeted programs that help them manage chronic conditions not only results in better patient outcomes -- the process results in lowering costs for care.

The DASH for Health program is an online tool that helps health consumers change nutrition and exercise behaviors.

A pilot program to test the cost-effectiveness of DASH was offered by EMC Corporation, an employer based in Massachusetts, to its employees as a free, opt-in benefit. Data generated through employees' use of the program was gathered and analyzed by researchers from Boston University's Schools of Medicine and Public Health.

Among employees diagnosed with heart disease -- including hyperlipidemia, hypertension and diabetes -- use of the Internet-based tool resulted in lower health care costs for those who visited the site at least nine times over the course of a year. Note that visiting the site more than 9x yielded even more impressive results -- representing a possible direct dose-response relationship. The research is published in the Oct/Dec issue of the Journal of Medical Internet Research.

In terms of outcomes, employees who opted into the program lost weight, lowered blood pressure, and improved healthy eating habits.

In terms of money, for people managing cardiovascular conditions, health care costs were $827 lower than for people who did not use the program.

Health Populi's Hot Points: There remains some skepticism among employers who instituted disease management programs during their first generation. Many of these programs didn't demonstrate clear return-on-investment. In the reincarnation of health management, innovators are building on lessons learned from previous failures and are focusing more on patient engagement, usability, and meeting people-patients where they 'live.' This is one building block toward Participatory Health based on greater employee engagement in managing chronic conditions.

Several surveys published from employee benefits firms expect that employers who sponsor health insurance at the workplace are complementing these plans with wellness and population health management programs. Taking a page out of the DASH for Health study at EMC will help health plan sponsor organizations yield positive results for both employee-patients and for the company's bottom line.

This program is another example of how to bend the cost curve of U.S. health finance over the long term. For more on this topic, see my column in the Washington Post's Healthcare Rx panel responding to the question: "Has Congress done enough to constrain long-term health spending growth?"