When talking with my family and friends outside of healthcare I get mixed reactions to what eHealth means. Responses can range from simple to sad.
“Is that like MRIs and stuff?
“Do we have electronic records like at the store?”
“My doctor has a Blackberry…. but I can’t email him, so I don’t know.”
However, after further discovery I find out many of my friends have some sort of electronic device that makes their health better. I just have to open Facebook[i] to see who is going for a run with their Nike+[ii] shoes, or Foursquare[iii] to see who might be visiting a gym. I can log into PatientsLikeMe[iv] and find others tracking their illness and collectively learning about how to be healthy.
Consumer focused solutions are some of the most exciting changes in eHealth. They shape the way we think of health. Through out nursing school I was presented with a few definitions, but more recently I’ve come to use Huber et al (2011) proposed definition:
Health is the ability to adapt and self manage[v]
This definition speaks to me because it is about what an individual can do to improve their own health, but I’d take it a step further. Caregivers also need to be able to part of the adaptation and management of the changes to the individual to empower and support individuals that may not have the resources or lack the personal capacity to be fully independent.
This idea of health as self management, when paired with the consumerization of healthcare products, is exciting. During early development, new technology is often cost prohibitive, but prices slowly come down as production methods improve. Now apply this to healthcare, in the past the ability to take an ECG required an expensive machine.
Blood pressure cuffs were something you’d only see in a hospital, pharmacy or your family doctor’s office. Now both of these devices are reasonably affordable, and not only that but they allow you to track and monitor your own health. Many of them even give you feedback to help you improve your health.
What excited me about this is how it makes eHealth increasingly accessible for those interested in monitoring and improving their health. Many of these platforms, such as PatientsLikeMe are free, giving anyone with an internet connection access to these services. And the continual monitoring is also important, because one number is easy to dismiss, where as continual reminders, prompt tips, and trend lines are much more engaging and harder to ignore. Personally, I had to struggle with this as realization as I slowly saw my WiThings[vi] scale flutter up and down enough for me to dismiss it as water weight, or just one bad weekend. However, once I saw the trendline, the truth sank in. It was unfortunately and undeniably going up and to the right.
Not only do these technologies engage the user in their own health, but they also provide a community and a social activity. For example, I can share my weight and blood pressure from WiThings with friends and family members. Flip this around and I could keep an eye on my father’s blood pressure and weight and check in on him if I notice any changes in his health.
Other devices like Nike+ or the EndoGoddess[vii] create games and challenges or reward users for monitoring their health. The EndoGoddess app gives diabetics iTunes rewards so children can download a song if they enter their blood sugar scores a certain number of times. How exactly is that social? Well the app is not a social network like facebook, but it has a built-in social component. When users sign up, they can send out a request for support from their friends and family. The request actually collects small amounts of money that will be used to buy iTunes credits that are used as an incentive to the diabetic user. As they successfully learn to monitor their blood glucose and make healthy decisions they are given rewards and the ability purchase songs or games. I find these particularly fascinating because others are more engaged and involved in promoting and supporting others health goals. Your friends don’t have to be health experts, but they are given some teaching and explanation of why these behaviours are important and invites them to support and encourage you in your healthy behvaiour.
Unfortunately at this point there are few healthcare organizations that are capturing data from these non-traditional sources for use in the traditional healthcare settings. In the future, I hope this trend will change. Why not recommend patients explore the kidney transplant group? Especially since our organizations are not currently offering any equivalent or similar service. These tools can provide valuable social support, and if we engage with them they can be useful tools to help us collect better health data to understand illness. More importantly, they help individuals feel empowered and that their actions can meaningfully improve their understanding and ability to adapt and live with their illness. That is powerful and exciting, which is why anyone asks what I’m excited about in eHealth I end up talking about mobile phones more than Electronic Health Records.
Rob Fraser is not associated with any of the products or companies referenced in this article.
[i] Facebook is the world’s most popular online social network.
[ii] Nike+ is an online platform that collects and tracks user’s running activity that is collected from manufacturer’s devices (podemeter, GPS watch, heart rate monitor, mobile apps, etc.)
[iii] Foursquare is a location based mobile application that allows users to check in at places they are visiting.
[iv] PatientsLikeMe is a platform for patients, researchers and healthcare providers that allows users to input and track health related metrics (blood serum levels, mood, feeling, drug therapy levels, etc.) and share their information with an online community that has the same illness
[v] Huber, M., Knottnerus, J. A., Green, L., Horst, H. V. D., Jadad, A. R., Kromhout, D., Leonard, B., et al. (2011). How should we define health? British Medical Journal, 343(jul26 2), d4163-d4163. doi:10.1136/bmj.d4163
[vi] WiThings creates wirelessly connected healthcare monitoring devices such as weight scales, blood pressure cuffs, and baby monitors. That can be wireless connected to store and share data.
[vii] EndoGoddess App allows users to store and monitor blood glucose levels and provides rewards for entering data such as free iTunes music downloads that are purchased by their social network.