One of the most intriguing movements in the healthcare industry today is participatory medicine. Participatory medicine holds a lot of promise and seems to be gaining momentum among both patients and healthcare professionals. Nevertheless, participatory medicine is far from the standard of care, and one of the biggest barriers is actually getting patients interested in their own health.
Personal Health Records (PHRs) seems to be the strategy that insurance companies and tech giants like Microsoft and Google, as well as their partners at hospitals, clinics, and pharmacies have pursued as a way to engage patients. The thinking seems to be, “If you build it, they will come.” And indeed, early adopters have. By April 2010, 7% of Americans were estimated to have used a PHR. This is a respectable number for a relatively new product line, but unfortunately the data on which this number is based doesn’t include details on how often PHRs are used, or how many of those that have used a PHR routinely do so. I suspect the number of routine users of PHRs is somewhat lower.
In retrospect, it seems that the “if you build it, they will come” mentality of PHRs was a little like putting the cart before the horse, especially given the ambiguous nature of the data made readily available to patients. It’s like patients were being asked to go straight from having an occasional curiosity about a medical condition to being completely immersed in every detail of their medical history.
Perhaps a more effective strategy to getting patients interested in their own health care is a bottom-up approach that starts small and then lets patients build from there. Specifically, I think that simple, easy-to-use wellness devices with network connectivity may be one way to get people more interested in their own health. There are some really cool wellness and fitness monitoring devices hitting the market, including FitBit, Basis, and Nike Plus. There are even some exciting devices such as weight scales and blood pressure monitors (the Withings blood pressure monitor is shown above) that combine beautiful design with network connectivity to offer users a vastly improved value proposition to monitor their health. To top it all off, these connected devices are beginning to integrate themselves with PHRs!
An increase in the amount of health and wellness data collected by patients has the dual benefits of (1) increasing the utility of PHRs for patients, as now patients have a reason to routinely login and use PHRs, and (2) increasing the utility of PHR-EHR connections, as now physicians can benefit from viewing the data collected (for free) by patients. In other words, the data gives the patient and physician something to talk about. The data and the patient’s activities in collecting the data provide a starting point for collaboration and shared decision making, two essential components of participatory medicine.
