As people with diabetes, it behooves us to pay attention to how digital health tools will benefit, harm, enlighten, confuse, empower, disempower and influence people, now and in the years to come.
Two futurists are hoping to make that easy for us, with a new book called "ePatient 2015: 15 Surprising Trends Changing Healthcare." The authors are Rohit Bhargava, Founder of Influential Marketing Group and author of the best seller, Likeonomics; and a longtime contact of mine, Fard Johnmar, Founder of Enspektos, LLC, and a self-proclaimed "digital health futurist and researcher."
In the intro, they write: "The goal of this book is to share 15 trends that are poised to fundamentally change the way health and medical care is delivered and received in the near future. Rather than focus primarily on new technologies, our approach is decidedly human-centric. We look at how people will start to think and act differently in health and position technology as an enabler for some of the changes to come."
It sure is a trendy title on a hyper-buzzed topic, so I was understandably skeptical. But what I've seen of this book so far (an extended excerpt) looks rather intelligent and meaty -- even if the brief "health fables" at the outset make it sound like we'll all be easily managing our health with a handy little all-knowing Tricorder device in the near future. And doctors will instantly and empathetically "access, share and analyze your high-level electronic medical records and health history." Right, as soon as we get this national healthcare system mess figured out!
But it's not all pie in the sky. The authors share many smart observations about where we're going with health technology, both positive and negative. I hope they don't mind me letting the cat out of the bag here too much, but I figure anyone reading this blog is only going to be interested in this book insofar as they know some particulars: What are these themes and trends you speak of, and why should I care? So I'm actually listing the 15 trends below in this post, but starting first with a few key questions posed to co-author Fard Johnmar.
On Real-Life Value...
DM) What would you expect someone currently living with diabetes (the bulk of our readers) to get out of this book?
FJ) We'd like people living with diabetes and others grappling with other conditions (and their families) to view the book as a clear, concise (and hopefully understandable) guide to the benefits, drawbacks and foundations of the current technology-accelerated health landscape -- and also an opportunity to think carefully about where we're headed.
In the book, it sounds like you're saying the term 'ePatient' will soon be outdated, because ALL patients will fit in this category. Can you elaborate on that?
Yes, we suggest that it's now time to move past two frames of reference we've collectively used thus far regarding ePatients:
1. That using the Web, social media and mobile tech is still an unusual activity
2. That people have to proactively use technology, or aggressively manage their own care to be empowered, equipped, or engaged
Instead, we are entering an era in which:
* Patients will be empowered to interact with health providers in small, but very significant ways by simply being able to monitor their health status and gather sophisticated data about themselves.
* Data, powerful computer programs and other tools will be used to equip patients with the tools to better manage their care -- even in cases when they are not proactively seeking and using these technologies. For example, some companies are using data to predict when people are going to enter a depressive episode and proactively communicate with them/provide them with tools to ensure they are getting the attention and care they need. In this case, people are not asking for or seeking these tools, but they are being provided proactively.
* As people are forced to assume more financial burden for their care, it will feel very natural and important to engage with other patients and caregivers and health providers to ensure the care they receive is both effective and affordable.
Overall, we believe that being an ePatient won't be anything special, but will simply be how people engage with the health system. They won't be a special class of "super patients," but regular people using technology, information and other tools in large and small ways to manage their care (and the care of those they love).
You note a trend of "Increasing Privacy and Security Concerns." What would you suggest patients do to address that now, before it moves further in 'the wrong direction'?
This is another place where knowledge is vital. I would almost guarantee that most of your readers have no idea about the vast amounts of health data being collected and analyzed by insurers, mobile app developers, web sites and others about their health activities. People need to be aware what information is being collected about them and how it could be used -- for good or ill -- and begin to take steps to ensure they are comfortable with data collection activities and make decisions. In some respects, data is becoming one of the most valuable commodities in health, and people need to be aware of the data gold rush that's occurring behind the scenes.
In terms of specific actions patients can take: one small step would be to actually read the privacy and security policies associated with the apps, websites, devices and other tools they use. Think about what you are sharing about your health on these places. Not everyone is going to be willing to demand their medical records or analyze them. However, many people are using apps, devices and other tools, so understanding what's being collected and how it is being used is vital.
What about the trend you note of "Multicultural Misalignment" in healthcare? What can we do now to ensure that this moves in the right direction?
This trend is somewhat directed toward those powering the health technology innovation economy. But patients can help ensure developers and companies producing health technologies are focusing on their needs -- especially if they are older, from communities of color, etc. -- by voting with their attention and money. Rewarding innovators who develop tools that are culturally and lifestyle appropriate is the single best way to ensure they are paying attention and producing technology-powered products and services that are aligned rather than misaligned.
Under your "Digital Peer-to-Peer Healthcare" theme, all of the trends listed there seem to be happening already. What do you expect will be the biggest concrete and/ or system-wide change in this area in the next few years?
Two words I would use to describe this would be: emotion and value. In recent years, the conversation about how people use the web and social media has centered around its use as an information source. Less attention has been paid to how these tools are being used to positively impact how people are managing their day to day health.
During research with ePatients conducted specifically for this book, we found that many are using the web to seek and deliver emotional and moral support to others. This is important because this tell us that the web -- as it is in other areas -- is a social support mechanism for people who may not have resources close to home.
Many ePatients told us the web has even had a positive impact on their ability to manage their (and their family's care) over the past few years. There's still a debate in some circles about whether the web is helpful or harmful. We know that it's immensely helpful.
More recognition of the web's immense value and its role as a powerful emotional/moral support tool will be some of the most profound results of the digital peer-to-peer health care movement. This will influence everything from how physicians view (and recommend the web) to how it is incorporated into technologies (mobile and otherwise) in the future.
Thank you, Fard!
* * *
Three Big Challenges
The authors write that in their process of analysis for this book, they realized the trends aligned three big challenges the health industry faces today:
• Problem #1: Skyrocketing Medical Costs - Thanks to growing need for medical care, changes in legislative policy and more costly treatment options - the costs related to medical care are dramatically increasing day by day.
• Problem #2: Generic Medicine - The standardized models that encourage universal treatment courses for patients are widely understood to be lacking, yet these approaches still dominate how medical care is delivered.
• Problem #3: Limited Social Support - Dealing with diseases or conditions (particularly when they are more rare) can be a solitary experience and support from outside the medical community from family, friends and other patients can often be missing or lacking coordination.
Bhargava and Johnmar go on to identify three corresponding themes, in which their 15 trends can be categorized.
Trending in Healthcare
And... drumoll please... here are the trends:
THEME #1 - HEALTH HYPEREFFICIENCY
Innovations in computing technologies are helping to make health and medical care more efficient, safe and effective for all patients.
- Trend #1 — Empathetic Interfaces: Health technology moves beyond focusing mainly on accuracy and functionality to incorporate more intuitive design and processes aimed at making digital tools more responsive to emotional needs, or more human-like.
- Trend #2 — Unhealthy Surveillance: New surveillance technologies combine large amounts of digital, clinical and behavioral data to track the health of individuals or groups and also raise significant privacy and security concerns.
- Trend #3 — Predictive Psychohistory: Big Data, in combination with powerful computers, are increasingly being used to make large and small-scale predictions about individual and population health.
THEME #2 — THE PERSONALIZED HEALTH MOVEMENT
A philosophical and operational shift that considers the unique genetics, behaviors and medical histories of individuals instead of treating them based on inflexible or non-personalized guidelines and traditions.
- Trend #4 — The Over-Quantified Self: As the volume of clinical and health information collected from wearable computers, passive sensors and more increases, consumers will struggle to find true actionable value beyond "feel good stats" in this flood of data.
- Trend #5 — Medical Genealogy: Genomics and advances in genealogy will combine to allow patients (and providers) to use ancestral history and genetics to predict the risk of disease, how they may respond to medications and more. Over time, this valuable data may be passed on to future generations.
- Trend #6 — Augmented Nutrition: A growing number of tools and technologies provide instant access to detailed nutritional information to help consumers make healthier choices in real-time about what to buy in stores or eat in restaurants.
- Trend #7 — Healthy Real Estate: Increasing awareness of the role communities play in health and well-being will influence where people choose to rent or buy homes. Key considerations — especially for seniors — will include whether streets are walkable, the quality of nearby care and access to social or religious institutions.
- Trend #8 — The Device Divide: An outgrowth of the digital divide (disparities in access to digital technologies), financial considerations may prevent patients,providers, hospitals and clinics from accessing the latest technological innovations in health.
- Trend #9 — Multicultural Misalignment: Health technologies will be less effective if they are not optimized to account for differences in age, ethnicity, culture and more. A range of organizations and businesses will work to provide unique and effective digital health tools to diverse populations.
- Trend #10 — Natural Medicine: New science will continue to validate old beliefs about the value of spices, tonics and herbs. This will result in more mainstream credibility for natural remedies that were once dismissively called "alternative medicine," but now have a body of tangible results to prove their value once and for all.
- Trend #11 — MicroHealth Rewards: Inspired by federal legislation and a deeper understanding of behavioral science, insurers, corporations, health providers and others will apply game theory to encourage people to adopt and sustain healthy behaviors by offering them tangible rewards (or punishments) as incentives.
- Trend #12 — Neuro-Influence Mapping - Advances in brain imaging technology offer new insights into patients' behavioral profiles to support the development of unique personalized treatment programs that factor in which method of influence (fear, authority, conforming, etc.) may be most likely to work.
THEME #3 - DIGITAL PEER-TO-PEER HEALTHCARE
A range of Web, social and mobile tools are helping patients collaborate on things like navigating the new health insurance landscape, selecting providers, assisting in their own care and providing emotional support.
- Trend #13 — CareHacking: Forced to increasingly take responsibility for their own care in a complex system, digitally savvy health consumers combine information from doctors, the Web, electronic medical records and other sources to "hack" the health system to educate themselves, navigate loopholes and ultimately get better, lower cost and faster care for themselves and those they love.
- Trend #14 — Accelerated Trial-Sourcing: Patients with chronic diseases and other conditions use social tools to find one another, complete the usually costly and complex first stage of discovery for a clinical study and then recruit the right pharmaceutical firms to conduct the research.
- Trend #15 — Virtual Counseling: Seeking emotional and logistical support, people forge one-to-one relationships online to offer assistance with navigating the new health insurance landscape, provide virtual moral support, "sponsor" one another and share unique knowledge about conditions, ailments and caregiving.
The book obviously provides more depth, background and illustrating scenarios on all of these trends -- plus a lot of discussion about the role and plight of (e)patients in the years to come.
"ePatient 2015" was launched Dec. 12; you can buy the book at epatient2015.com for $9.99 and up depending on the format, eBook or hardcover.