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Archive for the ‘Collaboration’ Category

Includes Provider Portals (Patient, Provider, Physician), Payor Portals (member, provider, agents/brokers), and User Experience

7 Features the Market Wants in Your Patient Portal: Blog Series

In case you missed it, we recently concluded our blog series on What the Market Says You Need in Your Patient Portal. Two of our healthcare experts, Melody Smith Jones, Manager of Connected Health (@melsmithjones) and Nick Lecker, Director of Architecture and Interoperability teamed up to take a deeper look into the 7 features that the market wants in your patient portal:7 Features the Market Wants in Your Patient Portal Blog Series

Healthcare consumers are at the center of the industry’s evolution and patient portals are going to continue to be a vital tool for connecting, engaging and empowering them.

 

Market Driven Patient Portal: Integration of Data

In our last conversation about  “What the market says you need in your patient portal” we discussed the needs of integration and interoperability. This is an area that, while interesting to the IT team, often does not get a lot of attention. This is not because this topic lacks interest, rather, it’s just not the most appealing topic to talk about. For example, when you are Market Driven Patient Portal: Integrate Dataremodeling your bathroom, you discuss the fixtures, the new shower, the new faucets, even the fancy commode; but do you get excited talking about the plumbing? Likely not, however it is the ability to move and connect the items of interest together that makes the project all come together. If you do not connect something the right way you get water all over…or worse.

So, what does this have to do with clinical and financial data? For one, the data is generally in various systems and data stores throughout the organization and generally it comes from multiple organizations. For example, if you look at these concepts from a health plans point of view, the clinical data is coming from HIE’s, provider facilities, clinical labs, purchased data sources, and others. The financial data is coming from claim systems across multiple lines of business, GL systems, AR/AP systems, and others. All of this data still has to be aggregated, cleansed and organized to make it useful. This is not an easy task and having the strategy, the information models, the plan and the governance are all key to ensuring success of these efforts.

Another reason integration is important is it helps define the consumer of the information. Typically, financial data has been reserved to back office functions or it is used to help define/negotiate the cost of services whether they be premiums, reimbursements, subsidies, etc. With the advent of consumerism, the patient is demanding more information in this arena. Patients want to know what their total cost of services are. They want to know the details of the fees. They want the ability to compare costs, values, outcomes so they can make a well-defined choice. Patients generally look at the cost as the driver, yet there are behavioral changes that need to be overcome; e.g. the higher priced option must be the best, right?

There is a lot still to overcome in this area as providers have typically held on to this information and patients may not be able to understand the complexities of where the money actually flows. Integrating the clinical and financial data is a stepping stone in the path to a full consumer-driven healthcare model. Government mandates are forcing the need for change, however, breaking down the walls to integrate information will not be easy. Meaningful Use Stage 2 (MU2) will be one of the drivers to help make healthcare interoperability a reality.

Core to solving these problems is having a clear understanding of the business capabilities and processes that drive the solutions. Understanding (documenting) the business capabilities, defining the information needs (again documenting) and then defining the business processes (yes writing it down) that act between the capabilities and information will be the blueprints and guides to setting and achieving the vision. With the vision established, we then can begin the process of connecting the dots of where the information lives to where it needs to go and the format which it needs to be in. There are a number of technical challenges given that interoperability is not just a simple plug-n-play solution. The movement of the information needs to follow standards (which by-enlarge exist) yet all of the connections and the subtleties of the content need to be clearly outlined in the road map of integrating clinical and financial data.

This concludes our “What the market says you need in your patient portal” blog series.

Market Driven Patient Portal: HIE Across Diverse Care Settings

So far in this discussion about “What the market says you need in your patient portal” we have been driving toward changes that are core to new engagement models. However, we have not addressed a core enabler: “It’s all about the data!”

Consumers demand access to information that meets their needs and they are not complacent Market Driven Patient Portal: Health Information Exchange Across Diverse Care Settingswith becoming hunters and gatherers for the information is truly about them. Consumers in today’s market demand accurate and up-to-date information about their health profile, just like they do with respect to their financial profile. However, the systems and processes to make that information available are not all there.

There are various sources of the information that are relevant to the patients/consumers (and also to the providers providing care to their patients). Much of this data has been distributed through the provider community. Some of the data is in the provider’s own systems. Some of the data is in the hospitals EHR systems. Some of the data is in outpatient facility systems. Other data is isolated and hard to locate.

With the push to HIEs some of the data is now becoming more available to the providers and to the patients they serve. However integrating the data into a holistic view is still a challenge. The information still needs to be gathered / extracted from the source systems, transformed into a structure that the HIE can understand and then there are the issues of translating the codes and values to normalized/consistent terms following a defined set of vocabularies. Additionally, ensuring a unified view of the individual can be a challenge. Enterprises IT groups are leveraging Enterprise Master Person Index (EMPI) solutions to construct the golden record of the individual but this also has its challenges.

Once all of the data is assembled (assuming that it is) the next challenge is to get the information to the right person at the right time. The HIE now needs to be integrated to the rest of the enterprise. Exposing the information in terms of the services or APIs can now begin. Finally the Portal (and this is just one of the consumers) can begin to consume these services and make the information available to the consumers. What’s also of importance is that the consumers can access this data from multiple perspectives. The provider can see full episodes of care across multiple care locations. The patient can see their health profile all in one location.

Having a single view of one’s health profile (or even the illusion of) is a powerful tool. Not only does it provide insights for better care, it breaks down the walls of information silos that have challenged providers and patient’s alike. Again, it is all about the data, and integration and interoperability are the key.

Market Driven Patient Portal: Avatars for Personalized Coaching

In our next installation from the “What the market says you need in your patient portal” series we bring you avatars. These avatars are closely related to our last post on gamification and serious games, but their real value proposition is in what I like to call “high touch digital healthcare.” Many may think that “high touch” and Market Driven Patient Portal - Avatars“digital” cannot exist in the same concept, but oh they can.  We are actually beginning to see that in some cases patients prefer high touch digital to face-to-face care.

Here are some examples:

  • Patient Education: In the realm of patient education, we had a study that used digital avatars with human characteristics to help women through preconception health.  In this case human interaction was not replaced.  Rather, the avatar augmented and furthered the patient experience through the use of digital technology.  The avatar asked initial questions and then triaged the more difficult interactions to clinicians.  This allows clinicians to have more time to deal with complex issues. Add this to a patient portal and you begin to see how patient health concerns can be triaged remotely with the requisite education embedded throughout.
  • Appointment Registration: I love that more and more healthcare organizations are making online pre-registration an option.  Going even a step further many hospitals and ambulatory care centers are digitizing the in person appointment registration, which I mentioned in an earlier post of this series. Let’s add avatars to this process, which adds a “human” touch to an otherwise clinical process (pardon the pun).
  • Patient Discharge: The discharge process is ripe for errors and omissions.  All too many times patients arrive home without having absorbed the right data they need to maintain their health.  The result is often costly readmission.  Even a couple years back I was able to witness a demonstration of the use of avatars during the discharge process.  Through an automated touch display, patients were able to navigate through their discharge instructions in an interactive way.  The avatar even threw in fun questions like whether or not the patient preferred the Red Sox or Yankees (read: the hospital was in Boston).  Patients provided rave reviews for their avatar led discharge experience.  In fact, the experience was rated higher than in person discharge by a wide margin. Now, let’s add this functionality into the patient portal as well to continue that interaction remotely to ensure that those discharge instructions are followed. I’d suspect that you would see a marked improvement in readmissions rates simply because discharge instructions are adhered to.

Overall, avatars and other forms of digital high touch are a win-win-win.  They are low cost (win), add a sense of fun to otherwise lackluster processes (win), and increase quality all at the same time (win). Stay tuned for our final posts in the series where we start to discuss the importance of health information exchange and interoperability as they relate to the patient portal.

Market Driven Patient Portal: Gamification and Serious Games

More than half way through our “What the market says you need in your patient portal” series I bring to you one of my favorite topics: healthcare gamification and serious games.   Games are great at explaining complex systems.  There are fewer places one can find complex systems than in the micro and macro worlds of Market Driven Patient Portal - Gamification and Serious Gameshealthcare.  In healthcare we’ve seen games of multiple types.  Here are some of my favorite examples:

  • Games that help modify user behavior: Humana took a pioneer stance in the world of serious games in healthcare with their Horsepower Challenge.  Using the craze the followed games like Dance, Dance, Revolution, Humana used “exergaming” in 2009 to challenge 20 members of Congress and 2,000 5th and 6th graders nationwide as they “raced” across the country by taking steps with a pedometer.  She also harkened back to a healthcare game I mentioned in a post back in 2011, namely Re-Mission.
  • Games that train wellness behaviors: In the game Re-Mission, a nanobot named Roxxi is injected into the human body to fight particular types of cancer at the cellular level. Those playing the game are also asked to monitor the patient’s health and report any symptoms to the fictional Dr. West.  Each level of the game informs the player on a variety of treatments and on the importance of staying compliant with medical protocol.  HopeLab trial studies, that were published in peer-reviewed journals, revealed that playing Re-Mission led to more consistent treatment adherence, faster rate of increase in cancer knowledge, and faster rate of increase in self-efficacy. Most notably are blood test results, that showed the measured level of chemotherapy drugs in blood to be higher in players versus the control group.
  • Clinical learning labs: These are the types of gaming environments where practitioners can train in virtual learning labs on an avatar.  A great one is foldit: Solving Puzzles for Science.  foldit, funded through a University of Washington grant, is an attempt by game developers to crowdsource scientific research.  Within a few paragraphs of texts, the gamer is educated on what proteins and amino acids are and why their shapes, and what those shapes fold into, are important.  The goal is to have human “protein folders” work on proteins that do not have a known structure.  Scientists can then take folding strategies that human players have come up with while playing the game and automate those strategies to make protein-predicting software that can fight HIV and cancer more effective.  Beyond protein prediction, protein design has even more direct implications to disable a virus.  Thus far there are not many automated approaches to protein design, so foldit’s human folders are a great source of research.

Gamification is the term we use to describe serious games that go beyond strictly trying to entertain.  They have a “higher purpose”, so to speak.  Designers use game techniques to get players to do something not game-like at all.  The possibilities for embedding serious games into patient portals are seemingly endless, but my favorite is in the realm of personalized prevention. The patient portal is a powerful repositiory of patient data and can also function as an empowerment tool. Similar to the build of the patient portal itself, if you want to develop a serious game that works, you must, better than anyone else, understand the purpose of your game.  You must know to whom your game is targeted.  You must devote a lot of time to figuring out what motivates your intended audience.  That understanding must be crystal clear before you even consider how the game should be designed.  Document, in detail, what your experience needs to communicate with the gamer.  What kinds of puzzles best match this experience? Then consider what type of game genre matches these puzzles.  Lastly, consider what platform would need to be used to help the gamer bring action to play.

Building a game that is based on what motivates your audience is what makes a serious game a game.  The market will continue to push this functionality onto the patient portal.

Market-Driven Patient Portal: Social Collaboration

Next in our lineup of “What the market says you need in your patient portal” series is social collaboration.   This topic brings us to the core of a term that we hear a lot in the industry: patient engagement. What is that, really? Any form of engagement requires communication. Right now communication between provider and patient Market Driven Patient Portal - Social Collaborationis getting better, but I’d still say that the relationship is in its “healing” phase. The best way to speed that healing is through creating mechanisms that support healthy communication between the healthcare provider and the patient.

Traditional methods of communication focused on the brick and mortar. There has been noticeable resistance to the idea of email, and far fewer providers offer social capabilities. So why will the market push for it? Because patients are accustomed to using social collaboration and they know it is far more convenient to use that tool over, say, picking up a phone or driving to the office. Providers will find that it is also much more cost effective than standing firm on the old way of doing things.

Patients use social to gather information. The healthy byproduct of this dynamic is a greater emphasis on managing wellness. Every social communication does not require direct communication between patient and physician. Instead, social relies on content to navigate a user towards answers and provides readily available mechanisms to find answers to questions. These “conversations” have the power to personalize experiences on an individual level, as well as deliver rapidly consumable healthcare information that can be personalized to the individual and their health needs. A social collaboration strategy is a success when you are able to engage and interact with the patient in a way that drives them towards the overriding goal of wellness. Everything that you do, or want to accomplish, on the patient portal should support that experience. This not only guides your content and communication objectives, but it can also result in lasting interactions that elevate consumer experience.

To make social collaboration effective, it is important to present content in a fashion and format that makes the most sense to the user. Let’s be honest, social collaboration can be a bit nerve wracking in a HIPAA regulated environment. As such, it is crucial that every social collaboration initiative include a formal governance program. This program will ensure that patient communications stay relevant to the overall goal of wellness. However, with the right strategy, you can embrace the power of social to influence the conversation and amplify the health of your population.

Market Driven Patient Portal: Dynamic Scheduling

Taking our “What the market says you need in your patient portal” series a step further, today we are going to address the market demand for dynamic scheduling.   When it comes to the marketing work of drawing patients into the brick and mortar, I often tell clients that, where their website and patient portal are concerned, if Market Driven Patient Portal - Dynamic Schedulingthey get the Find a Provider tool wrong, then they have gotten everything wrong. It’s an extreme statement, but it is meant to highlight a few key market dynamics:

  • The fact that there are four primary “conversion” tools that transform unknown consumers into patients. They are: Find a Provider, Find a Location, Schedule a Class, and Make an Appointment. The value of these tools is that they allow us to finally put a name to that unknown consumer that is interested in interacting with your organization in some way. It also gets them to the most important step, which is scheduling an appointment.
  • The dramatically high use of the Find a Provider tool by users of provider websites and patient portals. Go ahead and check your web and portal analytics (I’ll wait). Find a Provider is the most often visited page, right? Thought so. This is, by far, the most popular conversion tool that a healthcare provider has. It is the ultimate gateway towards getting that appointment scheduled.
  • Our ultimate goal is to get that unknown consumer, or a current patient, in for an appointment for highly important service line X. To do so we need to reduce as many barriers as possible that could be in their way.

Enter the new world of scheduling embedded into a market driven patient portal. In this world we allow patients to schedule appointments online by providing them with calendar capabilities. Yes, this is very different from the way that business is currently done. Why? Clinicians work in a very dynamic environment that makes it challenging to manage schedules. Even though it is dramatically different from the way business is currently done, the market is making existing scheduling systems obsolete. Why? It’s surprisingly due to that very same dynamic nature of clinician schedules. The healthcare environment provides a seemingly endless supply of tasks for the clinician. Trying to overlay that dynamic environment over the traditional scheduling system is fraught with the well known long wait times, and poor consumer experience, that patients currently experience. Dynamic scheduling makes appointments easier for both the provider and the patient. Here’s how:

  • Predicting Clinician Scheduling Chaos: Making sense of the chaos of a clinician schedule is no easy task. Dynamic scheduling embeds the power of mobile and analytics to exploiting knowledge of planned and emerging tasks. Ever hear of the butterfly effect? The premise there is that even seemingly chaotic events have a rhythm, but that rhythm is largely undetectable by we mere humans. With dynamic scheduling, mobile devices and wifi signals can triangulate location and analytics can span a number of different factors to make sense of a clinician schedule. This technology can be taken even further when you consider the life of emergency room clinicians. The dynamic scheduling application can sort data in real time to keep the clinician moving towards the patients with the highest needs.
  • Patient Self Service Appointment Scheduling: On the portal, a patient can then interact, in real time, with a clinician’s dynamic schedule and securely book their appointments online. In that way, scheduling an appointment takes on user processes similar to online shopping in retail. Once a date and time are selected, the dynamic scheduling system can automatically confirm the appointment and record it in the EHR system. No staff action required. Secure automated email and text message reminders can also be used to decrease the number of no shows.

What do you think of the market drive towards dynamic scheduling?

Market-Driven Patient Portal: Telehealth Beyond the Virtual Visit

Last month I published a post entitled “What the market says you need in your patient portal” that garnered a lot of interest. In that post I addressed the balancing act that healthcare executives face when market based initiatives are sidelined in order to drive focus to regulatory requirements such as Meaningful Use. Sometimes the market and regulatory requirements are in sync. However, when those regulatory initiatives get delayed things get complicated. My advice is that, beyond Meaningful Use, ultimately the market will determine what true patient engagement means, and I highlighted seven features that a market driven portal should have. I will spend time during this series going into detail on those features. They include:google-smart-contact-lens-glucose-sensor-640x353

  • Telehealth that moves beyond the virtual visit
  • Dynamic scheduling
  • Social collaboration
  • Gamification and serious games
  • Avatars for personalized health coaching
  • Health information exchange across diverse care settings
  • Integration of clinical and financial data

Today we will begin with telehealth. The topic has been in the news quite a bit recently – mostly in terms of telehealth reimbursement. The world of telehealth is not only in a state of transition currently, telehealth is also one of the major net deltas that we will see between healthcare of today and the healthcare of ten years from now. So, what does telehealth look like beyond the virtual visit? We are pushing towards a world where technological innovations will make the brick and mortar less and less relevant even in the world of healthcare. One of the more interesting developments in this area is a push by X Prize, by way of multiple multimillion-dollar prizes, to innovate technologies in such a way to diagnose common medical conditions with no intervention from a health care professional. With this drive in the marketplace in mind, telehealth in a market-driven patient portal you would find:

  • Socially Enabled Patient Portals: In a socially enabled patient portal, physicians and patients can work together toward their combined goals of better health using tactics like dynamic messaging, activity feeds, blogging, and open question forums.  These technologies are particularly effective in rural and low-income areas and are being used to enhance the quality of care for diabetic populations in low-income areas, for example.  These technologies show great promise for providers and health plans interested in managing chronic disease in a cost-effective fashion, especially for the uninsured.
  • Robotics:  Children’s hospitals have been the early adopters of telehealth technologies. Some innovations of interest are in the realm of robotics. Boston Children’s Hospital has an impressive telehealth program with a video-monitoring robot. These 4-foot-6, 17-pound, two wheel robots help with post-operative consultations and care primarily as a means of videoconferencing, giving the families of hospital patients a way to keep in touch with doctors and nurses in between post-surgical appointments. Equipped with cameras, audio gear and a video screen for a “face,” the robots are operated remotely by Children’s Hospital staff. In addition to facilitating communication, they can take video and close-up photos of surgical scars or other key areas of interest to help medical staff monitor recovery.
  • The Smart House: When it comes to uncovering issues early, the tracking of vitals, combined with analytics that readily alert clinicians when those vitals show potential for problem, have been crucial to telehealth outside the virtual visit. We are seeing innovations that embedded fiberoptics into carpeting that can track the activity of patients in and out of their bed while at at home. There is also an innovation called the Health-e-Chair that incorporates a vast array of biosensors to measure vital signs including weight, blood pressure, temperature, ECG, auscultation of heart and lung sounds, blood oxygen saturation, motion analysis and reflex response time. The chair incorporates a communication unit with a remotely controlled camera.
  • Nanosensors: Taking the tracking of remote patient monitoring microscopic is no longer just something we will get to eventually. There are innovations on the market now that can make a big difference in population health. Diabetes is a serious issue in the world of healthcare (understatement of the year award nomination). One of the leading causes of blindness in the world, diabetes patients have a risk of developing retinopathy, which could ultimately lead to blindness. Nanotatoos have already proven out in diagnostic efforts to track blood glucose levels, for example. Google and friends are also innovating around embedded camera functionality into contact lenses to find early signs of diabetic retinopathy.

One in five Medicare patients are readmitted to a hospital within 30 days of discharge, and one in three are readmitted within 90 days. It’s estimated that 75% of all hospital readmissions are preventable. Telehealth provides many benefits as a virtual visit. However, it is taking telehealth beyond the virtual visit that the market will push towards as we work to bring down the cost of care and reduce readmissions. Stay tuned for a future post on how the integration of all of this data takes this effort a giant leap forward.

Anything you think I’m missing? I’d love to hear your thoughts in the comments below.

Apple HealthKit: A Game Changer

I have been an athlete all my life, but since I’ve reached my 30′s, had 5 reconstructive surgeries, and moved back to the Midwest to a completely sedentary job, staying fit and healthy has become more challenging than ever before.

As an Apple lover for years, I have a myriad of Apps I enlisted to help. Between TargetWEIGHT, MYFitnesspal, MapMyFitness, myWOD, and Nike Fit Band, I have been unsuccessful in maintaining the health and fitness level of my satisfaction.Apple HealthKit: A Game Changer

When I heard about the Apple HealthKit platform and the ability for it to sync with third party application data, the question I posed to myself was, will this help me? I have no chronic illness. I’m not sick. I just want to be healthy. After doing some primitive research, if Apple can pull this off as they say they can, it will revolutionize not just my health technology experience, but the way any doctor in my future will diagnose and treat me.

The Apple HealthKit in addition to the Myhealth App promises to connect Apple Applications & other devices to one another, and to your physician if you choose to. Alleged, my myriad of applications will update one another automatically so I can work (at my nutrition & fitness) smarter and more accurately. Or, if I choose to use the Myhealth, this data will aggregate within the application in a single profile to use and share. Myhealth has 47 different tracking options to help me reach my goals, along with tracking my health milestones and medications/allergies. Furthermore, in case of an emergency, this historical account of my vitals, fitness level, and health milestones such as a chronic illness diagnosis are logged and can be shared with the ER Doctor. This may be critical in saving my life.

I am very conscious however that many folks are extremely uncomfortable with having this type of data in the cloud. I believe this will be a large barrier for Apple along with other 3rd party development partners to overcome. However the technology to keep this information secure exists, and I believe it can be done right. The challenge for Apple is to relay to the public the capabilities of internet security. Now educating Baby Boomers, Generation X, and Y’ers on Cloud Security and gaining the trust to make this Application helpful to all generations may be a challenge and will come with time.

Luckily, as a thirty-something that needs to keep track of my own family’s health along with my aging parent’s health, having health information at my fingertips may not just be convenient but literally may be a life saver. The Mayo Clinic thinks so, they have partnered with Apple along with Epic to make this endeavor successful. You can read more at:

http://www.imedicalapps.com/2014/06/apple-partnership-epic-game-changer/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+iMedicalApps+%28iMedicalApps%29

Connect with Consumers as People, Not Numbers

It is a tumultuous time for the healthcare industry, and health plans are not immune to the disruption. The Affordable Care Act has raised a new level of consumer awareness about the purchase of healthcare and the competitive health plan environment. Battles for market share drive the need to understand member demographics and behaviors in order to more effectively communicate with them. Health plans are trying to differentiate their services and offerings to gain a competitive advantage. Additionally, a newer, younger Connect with Consumers as People Not Numberscustomer segment has higher expectations of speed, information and mobile accessibility.

Despite this new focus on consumer engagement, health plan infrastructure and systems are typically inadequate to meet user demands. New levels of integration are required between front-end portals and back-end systems, so health plans’ growing social and collaborative relationships with customers can be maintained. To keep costs low but yield improved customer service and satisfaction, scalable cloud-based applications are becoming increasingly viable solutions.

Having a customer relationship management (CRM) solution at the center of the overall business strategy allows health plans to adapt to new regulatory requirements while meeting the needs of the connected consumer. Tools that enable personalized user experiences in a secure, yet flexible, environment, make connected health a reality.

A comprehensive CRM solution includes marketing, customer acquisition, retention and overall care management. CRM systems help healthcare organizations have a more personalized approach when reaching consumers (they are people, not numbers) and enable patients, providers and health plans to share information easily – creating an integrated experience and improved patient outcomes.

The consumer-centric approach is all about empowering consumers to be more involved in their health journey. In order to connect with consumers, healthcare organizations must engage with them in new ways using a more personalized method. Customer relationship management (CRM) technologies allow healthcare organizations to do just that; they are a natural fit for the healthcare industry that has adopted the “retail” model.

The food, retail and healthcare industries are going to continue to merge as we head toward a more holistic health model, and CRM will be an integral part in the success of this evolution.

Is your organization using a CRM solution? How have you seen CRM solutions evolve in the healthcare industry? Share your thoughts with us on Twitter @Perficient_HC

Creepy or Cool? A View of Connected Health in 2025

One of the fun aspects of my job is research.  I get to research the Connected Health trends to understand where the market is headed and how to then prepare healthcare organizations for those changes to capitalize off of the advantage of public health meets good timing meets technology.  I typically chart the trends out through the next ten years.  Some recent information that caught my attention include this infographic by Bupa and a study by Thomson Reuters IP & Science.  Want to know what the world of Connected Health will look like in ten years?  There will be four major themes:

the-futureMicro Mobile: The biggest net delta to be seen in the world of Connected Health between now and 2025 will be in the form of mobile technology.  Mobile capabilities will continue to be provided in smaller form providing the Healthcare industry with opportunities to, for example, use contact lenses that can take pictures of the retina to identify early symptoms of diabetic retinopathy. Sensing capabilities from fiberoptics are currently being used within telehealth in the form of smart carpets that relay signals from footstep patterns.  These capabilities are forecasted to innovate into a form that could signal the possible onset of diseases such as skin cancer when applied to human skin.  Mobile capabilities imbedded in shoes, socks, and baby diapers will impact our ability to monitor weight, fitness goals, hydration, temperature, sleeping patterns, and other symptoms of illness.  Nano tattoos are already used to measure blood glucose levels.  These tattoos, that are half the width of a human hair, are expected to be able to detect precise temperature changes to indicate cardiovascular activity in the future.

Personalized Prevention: Now lets take microscopic mobile and pair it with the more prevalent DNA mapping that will occur in 2025.  Babies born in that year will be tested at the DNA level with full genomic mapping.  We are not talking once or twice.  We are talking continuously tested using nano-probes inserted in the body to identify potential onset of disease.  When it comes to the most costly chronic conditions (both in terms of dollars and hardship), a simple and inexpensive genomics test can be used to help a patient, and their team of clinicians, understand the risk of certain disease states. These individuals can then be given the right treatments and education from the start and throughout life.  Imagine the impact of this level of personalized prevention can have not only for the individual involved but for population health in terms of obesity, diabetes, cancer, and the like.

The Internet of Everywhere: The “internet of things” is defined as an environment where everyday physical objects are connected to the internet and are able to identify themselves to other devices.  We do that at some level today.  By 2025, the internet of things will be everywhere, and everything will be connected.  A report from Thomson Reuters IP & Science states “Thanks to the prevalence of improved semiconductors, graphene-carbon nanotube capacitators, cell-free networks of service antenna, and 5G technology, wireless communications will dominate everything, everywhere.”  What does that mean for Connected Health?  That means your nutrition can talk to you medication because your fridge can talk to your prescription bottles.  Really.

Continuous Data Collection & Instant Reporting: These Connected Health innovations not only provide the ability for healthcare organizations to continually monitor health conditions but also with the ability to collect and report on this data.  This can drive positive behavior change through incentivizing verifiable behaviors.  At the organizational level, this can be used to augment current loyalty programs that rely upon CRM data.  Just imagine the power this also provides to public health research programs worldwide.

Creepy or cool?  What do you think about what is to come in the world of Connected Health?

Social Media Experiments & Public Health. To be or not to be?

So, I’m guessing you heard about the “Experimental evidence of massive-scale emotional contagion through social networks“, no?  That’s the official title for the Facebook study published in The Proceedings of National Academy of the United States of America that you’ve likely already heard about.  In this study you have a Facebook data scientist Adam Kramer and two academics, Jamie Guillory of UC San Francisco and Jeffrey  Hancock of Cornell University, that “subtly tweaked the news feeds” of approximately 700,000 Facebook users. The researchers used an algorithm for one week’s time to eliminate “negative” messages from some users’ news feeds. For others the algorithm eliminated “positive” messages.  For a control group they simply deleted a random selection of messages. Here is the stated significance from the research results:

We show, via a massive (N = 689,003) experiment on Facebook, that emotional states can be transferred to others via emotional contagion, leading people to experience the same emotions without their awareness. We provide experimental evidence that emotional contagion occurs without direct interaction between people (exposure to a friend expressing an emotion is sufficient), and in the complete absence of nonverbal cues.

FacebookPrivacyExperimentThere has been quite a media frenzy around the study.  Most of it has been negative.  The most compelling of those arguments is around “informed consent”.  The belief there is that even if we can agree that the results are of scientific importance (some don’t) and the methodology of the study is concrete (some don’t), it still violated the rights of research subjects.  After the ethical calamities that are the Tuskegee Syphilis Experiment and Project Chatter, informed consent essentially means that a research subject in a study needs to have basic information about the study, understand the nature of the experiment along with its risks and benefits, and have the ability to withhold consent without fear of harm or retribution.

However, there are also supporters of the study.   Ethicist and lawyer Michelle N. Meyer states that as a private company Facebook is not subject to an academic institutional review board.  She goes further to say that had it been, then this study would have likely passed muster. Supporters further state that, with social media being a relatively new phenomena, Facebook has a moral obligation to inform its users of the social or psychological impact of their website.  It’s likely that studies like this will continue.  With the media firestorm that erupted it is likely, though, that they will not be published.  That comes with its own set of problems.

My concerns move into the realm of public health.  As I mentioned in a 2011 post called “New Tools for Managing a Public Health Crisis“, data is the most important component in managing public health.  With a successful suicide committed in this world every 30 seconds, mental health is a major public health concern.  It takes precious time and resources to manage the health of a planet inhabited by 7 billion people.  This is an interconnected planet, and a public health crisis knows no barriers and time does matter.  One of the breakthrough lessons I received in my life was from Dr. Greg Smith, my graduate data mining professor at Xavier University.  He explained that “like things tend to cluster”.  This makes social media a great way to find the useful data needed to uncover a public health crisis. Social media technology enables two-way communication.  As such, experts are turning to social media outlets like Facebook and Twitter to not only communicate with the public about disease outbreaks and health issues but to also gather necessary data to discover outbreaks at their source.  Social media can also be used to recruit medical volunteers to a location and align response efforts once on the ground.  However, to make this all work, public health officials need to be given access to social media data, and this is often an issue.

So, ultimately, my feelings on the study are quite mixed.  I am a staunch supporter of ethics.  However, I am of the belief that this study passed the ethical bar.  Even more, I have strong feelings on the topic of mental health.  I do believe that social media, with all of its countless benefits, has a new and not yet verified impact on mental health.   I believe that it is data that will help us understand ourselves in ways that we did not before, and that data can save lives.