Sunday, May 13, 2012

Can Mobile Health and Social Media in Healthcare Improve Patient Engagement?

With Meaningful Use stage 2 looming and healthcare payment models gravitating toward value and outcomes, mobile health and healthcare social media are all the rage. So, I figured I would jump on the bandwagon.

Everyone knows patient-centric healthcare apps and websites have been around for a while. Sites like WebMD, Patients Like Me and  others have been in use for years and web-based personal health record abound. Still, patients are seemingly not as engaged as they could be. Why?

Last year, I decided that I wanted to drop a few pounds. To guide that venture, I downloaded an app called My Fitness Pal. It was nice and easy because I could log calories by scanning bar codes on food. I used it religiously for a couple of months, lost some weight and haven’t touched it since. Why?

When I or someone I care about is sick, I might do a web search to find out about the condition or ways toward relief – usually finding what I am looking for through someone like the Mayo Clinic and confident that their information is trustworthy… but that interest is over in a flash. Why?

Clearly, I am not an engaged patient. The reason is simple. I am not sick all the time. In general, I am quite healthy, but for the occasional head cold. At the same time, I have known people with more serious conditions like diabetes, cancers, etc. The funny thing is, those people are not sick all the time either or at least they don’t want sick all the time.

Even though I work in healthcare and am immersed in healthcare daily, I don’t find personal healthcare interesting. It is terrible to say, I cannot even recall the last time I had a physical. It’s not that I have any aversion to taking care of my health, but amid work and day-to-day life things – I just don’t think about it. As for doctors, well… to be honest, I have seen the business side of healthcare so long that I cannot be engaged with someone when I know he/she is not engaged with me.

All these healthcare apps and websites are great when I need them, but when I don’t – I forget them. Initially one might say that’s ok. If you don’t need it, don’t use it. That, however, is wrong. Prevention and a healthy life style are key to controlling healthcare costs.

So, if people like me are not interested enough to seek information – the powers that be should send it to me, right? Wrong! Currently, my email inbox has 8,498 unread emails (no, I am not exaggerating). I scan through the senders, read very few subject lines, open even fewer emails, and ignore the rest. My email is a black hole for junk mail (haha spammers, I just ignore you!).

Twitter, perhaps? The messages are delivered in a timely manner. They are short..perfect, right? I don’t think so. I don’t read about 90% of what I follow on twitter. Now, I do scan the tweets from just about everyone I follow (from time to time), but not frequently enough to really learn much. Further, a lot of it just isn’t pertinent to me – so I ignore a lot. Heaven knows what I overlook in my rush to get through it all.
I have mentioned before that I am a HIT product manager.  As a product manager, I love challenges like I described above. So, let’s dissect my disinterestedness product manager style and see if we can find a solution that will bring patient engagement to fruition for unengaged patients like me.

1.       I am not always sick and I have other important things to attend that often supplant the importance of my own healthcare
2.       I am bombarded with messages that I don’t have time or inclination to read
3.       I am willing to seek health information when I want it
4.       I am only interested in things that I consider important to me or those I love
5.       I do not believe that my healthcare is any more important to my doctor than it is to me (and that is not very much)

Based on this, I see that the way to engage me is as follows.

1.       Combine healthcare information in a meaningful and organized way with my other interests.
2.       Don’t overwhelm me
3.       Make the information specific to my interests, but give me the option to search for other things when I want it
4.       Deliver it to me but not by email
5.       Make me believe healthcare providers actually care about me

Perhaps now it seems we are no further than we were before. Isn’t this what most sites are already doing? No, I don’t think so. For most things, I have to go to them or if the site sends me things it is irrelevant, untimely, or just too much. So, I go back to the age old principal in innovation– KISS (keep it simple stupid).

There are two non-health related technologies that are simple and from which I think healthcare could take some lessons.

First, think about text messaging. It is simple. People, like me, read text messages. I don’t have time for yet another overdone website. Texting could be a great way to remind patients about preventative visits, reminders to follow up, reminders to fill medication, or simply how are you feeling messages that build the patient-doctor relationship. Clearly, there are some doing this already – but why so few? The right HIT vendor could automate texts creating ‘personalized’ messages based on criteria pulled from the doctor’s EMR.

Another fabulous idea is Pinterest. It exceedingly well organized collage of the often disconnected things I like – from architecture to healthcare. Like I said above, people are not sick all the time. A site like Pinterest has the potential for making healthcare part of the other things I do rather than something I have to seek out. While pictures may not be the best way to do it – the basic idea of ‘boards’ or organized groupings of my diverse interests is simple yet brilliant.

I think the basic idea here is that in order to successfully improve patient engagement through mobile technology, HIT providers are going to have to find ways to include healthcare in patient’s other interests. Further, simplicity rules. No one has the time or inclination to be overwhelmed by more information that is already required of us. Patients don’t have time to log health stats in disconnected locations.  Lastly, patient engagement will only come when patients feel that our clinicians are engaged with us in return – that we patients are more than dollar signs. 


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