Behavioral Segmentation for Enhanced Peer-to-Peer Patient Education.

The aim of this study was to develop a peer-to-peer virtual intervention for patients with type 2 diabetes from different segments: patients who take several medications (medication group), patients who do not take diabetes medications (lifestyle group), and a mixed group. Preliminary results showed that patients in the lifestyle group were interested in preventive strategies, reporting better learning experience and higher motivation than those in the medication group. Future research is needed to design approaches tailored to patients in the medication group.

Design for a Virtual Peer-to-Peer Knowledge to Action Platform for Type 2 Diabetes.

Many patients with Type 2 Diabetes (T2D) have difficulty in controlling their disease despite wide-spread availability of high-quality guidelines, T2D education programs and primary care follow-up programs. Current diabetes education and treatment programs translate knowledge from bench to bedside well, but underperform on the 'last-mile' of converting that knowledge into action (KTA). Two innovations to the last-mile problem in management of patients with T2D are introduced. 1) Design of a platform for peer-to-peer groups where patients can solve KTA problems together in a structured and psychologically safe environment using all the elements of the Action Cycle phase of the KTA framework. The platform uses Self-Determination Theory as the behavior change theory. 2) A novel patient segmentation method to enable the formation of groups of patients who have similar behavioral characteristics and therefore who are more likely to find common cause in the fight against diabetes.

Physician and patient willingness to pay for electronic cardiovascular disease management.

OBJECTIVES: Cardiovascular disease (CVD) is an important target for electronic decision support. We examined the potential sustainability of an electronic CVD management program using a discrete choice experiment (DCE). Our objective was to estimate physician and patient willingness-to-pay (WTP) for the current and enhanced programs. METHODS: Focus groups, expert input and literature searches decided the attributes to be evaluated for the physician and patient DCEs, which were carried out using a Web-based program. Hierarchical Bayes analysis estimated preference coefficients for each respondent and latent class analysis segmented each sample. Simulations were used to estimate WTP for each of the attributes individually and for an enhanced vascular management system. RESULTS: 144 participants (70 physicians, 74 patients) completed the DCE. Overall, access speed to updated records and monthly payments for a nurse coordinator were the main determinants of physician choices. Two distinctly different segments of physicians were identified - one very sensitive to monthly subscription fee and speed of updating the tracker with new patient data and the other very sensitive to the monthly cost of the nurse coordinator and government billing incentives. Patient choices were most significantly influenced by the yearly subscription cost. The estimated physician WTP was slightly above the estimated threshold for sustainability while the patient WTP was below. CONCLUSION: Current willingness to pay for electronic cardiovascular disease management should encourage innovation to provide economies of scale in program development, delivery and maintenance to meet sustainability thresholds.