The New Consumer Awakening: Digital Health
We are witnessing the emergence of a data-powered revolution of healthcare. The digital age has broken down barriers on access, distance, socioeconomic status and time zones. In addition, devices to access digital health are affordable, mobile and intelligent (i.e., smart). As noted by Todd Park
, U.S. chief technology officer, "We are beginning to see what happens when you unleash the power of American innovators and data to transform health care for the better from the ground up. It's no surprise to the doctors, hospitals, patients and entrepreneurs who have been working so hard to improve health care. But it is, indeed, great news for the nation. "
A notable trend that has emerged is that patients are "co-pilots" in their care. Traditionally, patients have had "little access to information and knowledge that could help them participate in, let alone guide, their own care. However, the Institute of Medicine design rules propose that patients have shared knowledge and free flow of information. At a minimum, they need access to information from their providers' EHRs - their own diagnoses, medications, allergies, lab test results, visit summaries, and other findings over time. A continuous healing relationship is a two-way interaction (whether electronic or face-to-face) between patients and their providers."
A convergence or coming together has also occurred, which has allowed for the explosion of digital health. While technology and data have existed for decades, it is only when various elements converged and matured that consumers could achieve increased access to digital health information. For example, the Internet, applications, and devices (personal computers to tablets) all have evolved and are utilized in daily life. Computing has become more mobile, agile, powerful and affordable. Consumer mobile devices, such as tablets have become more affordable and cell phones have morphed into smartphones, which put powerful capacity at one's fingertips.
The future is now and consumers are looking for more healthcare solutions. According to the U.S. Food and Drug Administration, there were 17,288 health and fitness apps on the market in mid-2012 along with 14,558 medical apps. " Given society's embrace of mobile devices, consumers inevitably are turning to mobile apps to manage their well-being and health care. According to the latest industry data available, there are presently 31,000 health, fitness, and medical related apps on the market today. This rise in consumer use parallels increased traction among physicians and other health practitioners. Some of the best examples are:
Social Content or Information, which can be found from several sources:
- Websites (health specific), professional health organizations, physician practices or clinics, hospitals / health systems.
- Mobile apps: American Heart Association, American Diabetes Association.
- Hospitals and health systems reacted to the proliferation of health and medical content during the late to mid-‘90s. Examples are Mayo Clinic, Intermountain Healthcare, and your local health system's website.
- Various elements of information can be found on many provider websites: blogs, risk assessment tool, health library, and request for appointment.
Wellness and Health Management- An important aspect of consumer digital health are the many applications designed to manage and monitor your own health. Sensors are now available to attach to your Smartphone or tablet (applications are free but the sensor has a price tag). Examples are:
- iHealth Wireless Blood Pressure Wrist Monitor
- Jawbone Up (sleep tracking, 24/7 activity tracking, food/drink tracking).
Nutrition- There is an abundance of nutrition-focused applications (looking to loose weight, eat gluten-free, and manage your diabetes).
Chronic Disease Management- The management of chronic disease is one of the greatest challenges to our population's health and cost of medical care. (Example, www.patientslikeme.com)
Personal Health Records - Your physician or health system may offer access to an application for personal health records that may include communication to their practice.
All these solutions sound so wonderful, but what does this all mean? On the surface consumers may have found a way to engage in their health and wellness and they also have access to vast sources of information at their fingertips. However, what about:
- Privacy (HIPAA)
- Limited access or restricted access
- Security (HIPPA)
- Data-mining without your permission
We all understand some of the potential hazards in using current technology, the Internet, websites, and applications as we know them today. However, it is unclear what other challenges that may present themselves, in what has been termed the "Wild West" of the Internet. Theft of patient data and patient identify is on the rise so caution is required!
Going forward, the ongoing challenges for consumers are:
- With a universe of available health and medical information, it can be daunting as to what will work best for you as a consumer. You will have to find the application/tool that gives you the right amount and correct information you need.
- Can each consumer understand and place into the right context what the next appropriate action might be? A specific example is the posted quality information about hospitals. Can this be deciphered by the average consumer? How can you assess whether a treatment that is recommended is your best option?
- Consumer health literacy varies. How do we evaluate how well a person understands the information that is being supplied to them? Is an online video vignette better than textual information for a particular consumer or population?
- Security and privacy may remain an open and potential issue. It is important to understand what this means for you and your family when using online sources or mobile applications.
- Consumer expectations with unrestricted access to all health information may not be realistic today from all providers. Many physicians report being inundated with the many questions that their patients bring to them upon researching on the Internet.
- Patient identify fraud is on the rise. Since HIPAA was instituted, many data breaches are documented annually. We also know there is a link between breaches and potential fraud.
The new rise in digital health can be termed a ‘Pandora's Box' (a prolific set of troubles). But, it is here to stay, as patients are the biggest stakeholders in their health.