Sunday, May 19, 2013

How Data And Technology Will Write Us A Prescription For Better Health




We’re at the cusp of a revolution in personal health, fueled by personal monitoring and better analytics. In the future, will health care be as simple as taking your car for a tune-up?



Visiting a doctor and visiting a car mechanic have certain aspects in common. For each, we are expected to come in for regular check-ups (our annual physical and our 50,000 mile tune-up) and when we notice that things aren’t operating properly (sore throat, shaking from the engine). Another commonality is that in the past few years, a slew of products have been created to give ordinary citizens real-time information on the inner workings of each of those complex systems.

WHAT WE CAN NOW MEASURE

For less than $100, anyone with a smartphone can monitor and record all the functions of their car’s engine. The idea, of course, is that with information like this, we can be better drivers and better caretakers of our vehicles. For not so much more, we can also begin to track our bodies’ processes.
Though our bodies don’t have OBD-II ports like our cars, we do have other outputs. For example, a consumer device called BodyMedia uses accelerometers, thermometers and a sensor to track our galvanic skin response to help users track calories burned, distance walked (or run), and a host of other information. Another company, FitBit has a number of devices that use both an accelerometer and an altimeter to help track weight, activity, and even sleep.


Both companies, among others, help people track basic data that define the contours of our bodies’ functions. Some people, however, need to monitor specific data, such as blood sugar levels, white and red blood cell count, the oxygen levels in our blood, and other health information that can help manage conditions such as diabetes or certain organ functions.
And of course, we can measure the same things we’ve been keeping track of for more than a century: our weight and height (which we now use to calculate our BMI), our age, gender, and temperature. We also have access to sight and hearing tests on phones now.
So whether we visit our mechanic or our doctor, we can now give very detailed answers to that first question “what brings you in today?”

HOW DATA CAN CHANGE BEHAVIORS

Of course, gathering information into databases and presenting it as a spreadsheet is helpful for very few people. Far more informative are graphics or dashboards, and even better are visualizations formatted for mobile devices. This is another similarity between car- and body-monitoring apps. Whether using bar graphs, pie charts, or moving graphics resembling tachometers, dashboards and visualizations are powerful representations that help people monitor and then respond to changing metrics.
Another possibility is to remove raw numbers entirely and simply focus on goals. Instead of showing calories consumed or number of minutes spent in exercise, some companies are simply telling people “it’s 1:00 PM and you’ve walked only 20% of your goal today,” or “It’s only 1:00 PM and you’ve already walked 120% of your goal today!” For many people, this is a more effective way to help them change their behavior.
Changing behavior to improve our health is, after all, the desired outcome. The goal is to live a healthier life and data can help us do that. The difference between a sedentary day at the office and an active day outside may be more than a thousand calories. Yet, in that sedentary day, do we think to eat a thousand fewer calories? If the data were presented to us, we could adjust either our intake or our output--and now more people are able to see that data in real time.
Further, many applications gamify healthy living, giving badges for healthy choices and setting up friendly competitions among groups of people to meet their health goals. Employers, too, can offer incentives (like cash) for establishing good eating and exercise habits. Bit by bit, and byte by byte, it adds up to healthier individuals and a healthier nation.

THREE WAYS DATA CAN CHANGE HEALTH CARE

There are three ways in which people’s having access to their own health data plays a critical part in the health care transformation. Here again, it’s useful to think of think of how access to our cars’ data changes our relationship to mechanics. Here are three examples of how increasing individuals’ access to their own data can change health care:
1: Reducing costs through data transparency.
Data opens a door to transparency that helps consumers understand in advance what they need and better anticipate the costs of care. To go back to the car example, if someone knows they need a new oxygen sensor, they don’t have to pay for a diagnostic first to figure out what the problem is; they can simply call a few garages and ask “how much do you charge to replace an oxygen sensor.” Likewise, patients should be able to call their health care providers and see how much they’ll be charged for the care they need. This has recently started happening, as the government has forced hospitals to reveal some of their prices, but there is still a long way to go.
2: Reducing costs and increasing effectiveness through streamlining health care delivery.
Data enables us to do more diagnostics ourselves and, thus, when we visit our doctor we now have the ability to give them very detailed information. For example, with a $20 kit (and a smartphone), we’ll be able to say “here are all the numbers for my levels of glucose, bilirubin, proteins, specific gravity, ketones, leukocytes, nitrites, urobilinogen, and hematuria.” This knowledge of our own personal health helps streamline the process for health care providers, lowering costs. Diagnosing problems earlier also means treating them more quickly, which reduces costs.
3: Reducing costs and increasing effectiveness through coordinated health care activities.
If the private companies who are developing devices include a way to anonymize the data, and the people who use the devices allow their anonymized data to be shared with government agencies, like the CDC and HHS, it will allow for a profound shift in real-time health preparedness. Already the CDC has partnered with private companies to help people prepare for flu epidemics. If open government could meet big health data, and if everyone who was tracking their own health allowed for non-identifying information to enter into large public databases, this public health data could be used to reduce illness, decrease health care costs and improve individual and community health.
If more individuals begin to track and record their own health data, not only are they likely to improve their own health, but they will all contribute to a health care system that delivers higher quality care at a lower cost. Health care can be more personalized to each individual, and can focus more on maintaining wellness rather than on treating sickness. The implications for telemedicine and for data-driven health care are also significant. And with more devices and applications entering the market each quarter, the trend lines are encouraging.

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