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Commentary

A Person-Centric Pre-Diabetes Program

As I have written in numerous articles, I am terrified of our upcoming tsunami of illness related to our collectively terrible lifestyle choices—in particular, pre-diabetes and diabetes. The NHANES health database has demonstrated that the healthiest generation in the history of the US was the WWII generation… my parent’s generation. My generation (I’m a boomer) will, because of amazing developments in advanced medical technology, live a bit longer than my parent’s generation. But each succeeding generation is expected to live fewer and fewer years due to the lifestyle choices Americans have been making for decades.

We have been watching the pre-diabetes and diabetes pandemic overrun our population for 4 decades. Now roughly one in 4 people under 65 and, about half of all people of Medicare age have pre-diabetes… right now! Only recently has it started to receive the attention it deserves. The Affordable Care Act mandates payment for prediabetes counseling for those under 65 and CMS recently announced their decision to pay for lifestyle modification coaching for Medicare patients. In addition, the AMA is strongly encouraging employers to do the same.

There will be no quick fix for this problem. In order for people to prevent life-changing consequences, people must first commit themselves to a long-term—actually, lifelong—acquisition of new knowledge, behavior and lifestyle changes.

Numerous entities, such as the YMCAs and other community centers, are developing programs that focus on bringing people into meetings and teaching them behavioral change techniques as outlined by the CDC’s diabetes prevention program, but in today’s world, people oftentimes do not want to go to a meeting. Plus, there are simply not enough programs to handle the estimated 89,000,000 people who have pre-diabetes.

A company in Birmingham, my hometown, named Pack Health, started by Will Wright and Mazi Rasulnia, PhD, has come up with an innovative way to help in a way that is scalable as well as personable. I have met these two remarkable individuals and their passionate team and let me tell you they are very smart and dedicated; and, because of their years at McKinsey, they have accumulated a boatload of business acumen.

To digress slightly, I firmly believe that by merging human and digital resources in a coordinated and integrated manner, we will obtain better overall health care than using either one alone. Sure there are hundreds if not thousands of digital apps out there, but all but a microscopic handful allow the app user to actually interact with a real person concerning their health.

Pack Health is unique in this small space. They start with the fact that up to 80% of health outcomes are determined by individual behavior and social factors. They face this fact head-on.

Their mission is to help the individual person facing health care challenges find ways to change their health trajectory. They first partner each patient (they call them members) with a highly trained (advanced degree), compassionate, and dedicated Health Advisor. They then use digital communication and data collection approaches to walk each member through a person-centered training program that includes relationship-based, one-on-one self-management coaching, easy to follow tools and step-by-step instructions on what has been proven to work. The training meets people where they are and uses an approach that configures with how the individual learns best. They also provide assistance with financial aspects of their health care, one of the most common reasons for people with illness to become non-adherent.

The goal of Pack Health is to use relationships to inspire members to change habits by emphasizing tiny steps over time and by giving them tools specifically designed to help people manage their condition on a day-by day manner.

By starting with the human connection and leveraging with technology, they are able to take advantage of rapid advancements in digital tools, smart phone technology, artificial intelligence and natural language understanding to be able to scale to the level our healthcare system needs.

Pack Health is demonstrating how smart people in other disciplines are coming alongside physicians to help improve the deteriorating health of our population.

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