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next up: Patient Centered Technology 4/26

Next week, on Friday 4/26, I'll be speaking at RichTech's Health Forum. I'm talking about the rise of patient-centered technology. More info and registration here


Title: Patient Centered Technology — how smart phones and the web are empowering patients and changing healthcare

In March 2013, Dr. Eric Topol gave Stephen Colbert a complete physical…with his iPhone. The web and connected devices have proven to be disruptive technologies and healthcare is no exception. Today, an increasing number of patients have access to some or all of their medical records through Electronic Health Record systems (EHRs). Smart devices, mobile apps and fitness gadgets also allow people to collect an unparalleled amount of self-generated health data. You can even get a DNA profile for less than than it costs to fill up an SUV.

What does all this mean for patients and the future of healthcare delivery? We’re already seeing a shift. Some call it consumerism, and sometimes it is referred to as mHealth (mobile health) or eHealth (electronic health). Often these terms are spoken about in conjunction with participatory medicine.

We'll will examine where we’ve been with patient-facing technology in healthcare, where we are today and where we are headed. It will include discussions around EHRs, the quantified self movement and the future of the doctor/patient relationship as influenced by technology.

Health Affairs is the new shirtless dancing guy

2/13 update: Videos for the panels are now available on the Health Affairs site. Sometimes it’s about the idea, and sometimes it’s about validating existing ideas. Last week, the well-regarded health policy journal Health Affairs hosted a briefing on The New Era of PAtient Engagement. I attended and left feeling satisfied, even excited, and also frustrated and a tad disappointed.

The briefing was a forum for researchers and authors of articles in the February edition to present their work. Many of the topics focused on ways to activate patients or to get patients engaged in their care. Proponents, supported by compelling data, argued activated or engaged patients have better outcomes and reduced costs.

The presentations ranged from reports on data, to emotional appeals. Some, in particular Jessie Gruman, did a nice job of mixing both. Kristin Carman presented an amazing Framework For Understanding The Elements [of shared decision making] pictured here: Framework

I sensed frustration from some attendees. We proved the value of engagement years ago, this isn’t new… and why aren’t there actual patients represented on the panels?. Some even, appropriately, called attention to the fact that Health Affairs requires a subscription to view most of the articles (some where funded by PCORI and made publicly available).

Personally, I was disheartened by some word choices. Implying patients need to be activated suggests patients are passive and something has to be done to them in order for them to care about their health and interactions with healthcare providers. That misses the mark.

What about phyisician activation? we have an opportunity to collaborate on a new model which reduces the power-distance index between providers and patients. We should be helping health systems and providers find ways to reduce the stress and fear for patients who are already engaged.

I appreciate all the concerns, and agree with many of them. But I am, none the less, excited about what Health Affairs has done. It’s important for us to have forward-thinking visionaries who knew were focused patient centered care years ago. It’s important to recognize the importance of what Health Affairs has done.

Five years ago, would a major publication have dedicated an issue to patient engagement? I doubt it. Howard Koh, MD, Assistant Secretary for Health, US Department of Health and Human Services, opened the briefing and called attention to its significance. His presence alone suggests the patient experience and engagement is on the minds of top officials.

I’m reminded of this video of the shirtless dancing guy:

My takeaway from the Health Affairs briefing is the same as the video’s message: it’s not about being the first, it’s about validating those who dare to put forth new ideas. In this case, patient engagement, shared decision making, and participatory medicine are not new. What is new is the attention from major publications, providers, policy makers, administrative leaders and researchers. That’s something worthy of a happy dance.