In 1937, Sylvan Goldman, the owner of the Humpty-Dumpty grocery store chain, invented the shopping cart. Determined to reduce the cost of having to staff his stores with enough clerks to personally help each customer with over-the-counter purchases, he changed the paradigm. He created displays and shelves where people could help themselves, and, to prevent any inconvenience, he invented the shopping cart so they didn’t have to struggle with armfuls of goods. For all intent and purpose, the creation of the shopping cart was the byproduct of a much larger cost-saving initiative.
In many ways, healthcare is undergoing a similar change. Faced with high and unsustainable costs, the industry needs to change and eventually to move toward a self-service model where patients are more actively involved in their own care. We have already begun to see this in the rise of urgent care facilities, which are reducing the volume of more costly Emergency Room visits; and this movement will continue as patients only see their physician when they are very ill or if they require specialized care. While this will decrease volumes and help reduce overall healthcare costs, to maintain a healthy population people need to be able to accurately monitor their health in between visits with sufficient insight to know they are well. Wearables are that first step of this evolution in healthcare.
The Washington Post recently published an interesting article on the wearable movement stating that it represents the latest efforts of large tech companies to “rebuild, regenerate, and reprogram the human body.” It is certainly a dramatic statement, and one that undercuts the reality that wearable technology is about empowering patients, not making them bionic. It is about enabling them to measure and better understand themselves, and providing them with data they can use to make more informed decisions. In time, wearables will be able to help predict a wearer’s potential decline into illness and help them decide whether or not they need medical intervention or to visit their doctor. For instance, a shirt outfitted with a sensor could send a text message to the wearer that her blood pressure has been on the rise over the last six weeks, offer the choice to submit the trend report to her electronic health record (EHR), and suggest she consult her physician.
The wearable movement is about ushering in an era of awareness, and not in a navel-gazing way. It is about becoming more cognizant of our bodies and the impact our daily actions, such as taking the stairs over the elevator, have on our overall health. It is about accountability, both to ourselves and to others— if we say we want to start exercising more, we can track it and measure it. Wearables are just one example of how the industry is beginning to design scalable solutions that help people live better, healthier lives while simultaneously alleviating some of the pressures on our costly, complex, and overwhelmed healthcare system.
From one to many: Scalable health IT solutions
A recent survey on patient expectations found that nearly 70 percent of patients are coming to their appointments with a list of questions for their physicians, and additionally, 40 percent consult an online source, such as WebMD, and 20 percent bring health data from personal health monitoring devices with them. These statistics point to a more engaged population and to the amazing possibilities wearables hold for us as a society.
The future potential for us to aggregate data in order to drive better insight about larger health trends, such as cancer clusters, is also discussed in The Washington Post article; however, we can do so much more. The emergence of disciplines such as Social Design, a field dedicated to solving societal problems through the thoughtful application of design, highlight this trend of using data to drive scalable solutions and actionable insights. For instance, students are studying how to eradicate urban food deserts, which are neighborhoods that have no direct and consistent access to fresh fruits and vegetables. Just imagine the possibilities if we were to leverage the aggregate health data of individuals to determine how far they walk on average in order to strategically set up a mobile farmers market or health clinic.
This will, of course, take time, and perhaps I was too quick and tidy in my summary of the shopping cart’s history. After all, it was not a success at first. In fact, it was initially a basket. And when the design evolved into a cart, people didn’t like the shape, felt it was clunky, or unbefitting of them—there were myriad reasons for poor adoption. Goldman had to make several iterations in order to arrive at what we now know as the modern shopping cart, but the bottom line is that this is a natural phase of the innovation process. And health IT is going through these modifications now. For instance, while we can track some health trends and vitals via wearables, we have no real way of driving meaningful action in a consistent way from them. But that doesn’t mean that future is far off.
The shopping cart changed our expectations as consumers, and even in a digital commerce world, it remains an icon for the empowered customer. We are the ones, after all, in control. We have access to the items we need and want. We can see our options, do our research, and carefully choose what we buy into and what we do not. We don’t need permission, but we can always ask for help. And this holds true for us as prosumers of healthcare: we, as patients, can choose our comfort level, ask our physicians about our personal data trends, and discuss the options for best managing our health. Wearables are our foray into empowering a healthier population in a cost-effective way.
Dr. Nick van Terheyden is the CMIO at Nuance Communications where his insider perspective allows him to put his medical and technology expertise to work for clients who are striving to raise the bar for healthcare delivery paying attention not just to processes and systems, but to people. Follow him on Twitter.
Opinions expressed by HIT Consultant Contributors are their own.
