by Sam Nachbar
Shifting practices for information sharing and communications within the healthcare industry are altering the relationship between patients and their providers. Non-traditional health resources (enabled by the internet and made ubiquitous via mobile devices) are gaining popularity, and more of the information-gathering responsibility is being placed on patients.
Medical information is now portable, personalized, and participatory, with the availability of information allowing patients to get more involved in the healthcare process. Among the drivers of this increased patient involvement is open access to medical information, which is positively impacting consumers’ ability to process information.
In a recent, 2010 national survey by Brookings, their results indicated that “58 percent indicated that online material affected their healthcare decisions, 55 percent said the information changed their healthcare approach, and 54 percent claimed the electronic resources made them ask new questions about their medical personnel.”
Developers in the mobile medical space have recognized consumers’ interest in medical referencing. Of the 5,805 health, medical, and fitness applications within the Apple App Store, 73 percent were intended for use by consumer or patient end-users (California HealthCare Foundation, 2010).
As developers cater to the demand for mobile medical solutions, consumers are becoming more reliant on smartphone apps for healthcare decision making. In short, the cost of healthcare is driving budget-friendly solutions that emphasize patient involvement and wellness, with many users turning to their smartphones as a means of taking charge of their personal health.
Mobile Diagnostic Tools
General diagnostic websites such as WebMD.com, MedlinePlus.gov, HealthFinder.gov, and MayoClinic.com have become tremendously popular in recent years. Naturally, as people begin consuming more information via mobile these medical reference sites will transition to accommodate the market.
In 2010, the Mayo Clinic and WebMD released mobile versions of their reference material to provide consumers with easily accessible, action-oriented information. Another consumer reference app, Medicine Finder, helps users identify the right over-the-counter medication for particular symptoms.
Instant, uncomplicated medical reference applications are helping users become more informed about their health while helping people make real-time decisions.
Mobile healthcare applications allow people to monitor their own weight, blood pressure, pulse, and sugar levels while sending results electronically to healthcare providers.
By keeping a shared log of health information, Polka Personal Health users build a mobile medical profile that offers health reminders and communicates critical health information. The users’ health profile is secure, since it can only be accessed by individuals the user authorizes (doctors, family members, experts), and the application is great for tracking and managing valuable health information.
For diabetes, it is crucial that patients monitor their blood glucose levels and gear their insulin intake to proper levels. Rather than consulting with a doctor to monitor glucose numbers, carbohydrate consumption, and insulin dosages, patients can use the Glucose Buddy app to store and track this information from home.
The app calculates the impact of the user’s meals, activities, and other actions on blood glucose levels and puts diabetes patients in charge of their own monitoring. As a result, a patient’s cost of medicine is reduced and it keeps them out of doctor’s offices until they need more detailed care.
Minimizing routine trips to the doctor can generate considerable cost savings. A different Brookings Institution analysis in 2010 undertaken by economist Robert Litan found that “remote monitoring technologies could save as much as $197 billion over the next 25 years.”
The sending and receiving of personalized reminders via mobile phone is a further extension of self monitoring technologies that can greatly improve healthcare. Among the greater problems in medical treatment is the frequent occasion with which patients forget to take their prescription drugs.
It is estimated that only “50 percent of patients take their medication as prescribed…which means that we lose half the benefit of prescription drugs through human error, [costing] the system billions in poor health outcomes” (Brookings, 2010). Since the smartphone is an extension of one’s self for most users, it enables instantaneous communication that can eradicate much of this needless spending resulting from human error.
Pillbox, developed by Community Health Network, is an easy way to manage medication lists in an intuitive digital pillbox format. The app sends reminders accompanied by a visual representation of the pill to keep users on track with their medications. Pillbox and other types of virtual health assistants are reducing errors while helping doctors and patients stay in touch and monitor healthcare needs.
Electronic Medical Records
With electronic records, patients have much more information at their disposal and can easily interact with their own medical history. For example, Microsoft Health Vault and Google Health offer online medical records that strengthens users’ access to personal health information.
Again, this information is made available to others, usually primary-care physicians, at the patients’ discretion. Users with an active Google Health account and the Cloud PHR app can view their Google Health records (conditions, medications, allergies, procedures, test results etc.) in an iPhone friendly format. They can also view notices from their provider, enter new data, and add test results directly from their phone.
Popular online health record services, like Kaiser Permanente’s My Health Manager are transitioning to mobile, as well. This website has a user base of over 3 million people.
Since providers are already accessing patients’ health records online, the stage is set for mobile health management. A number of apps already offer personal health records (PHRs), including: Allscripts, CareTools iChart, motionPHR, and Pain Care. While the mobile PHR segment is attracting new entrants, these emerging apps are not always helping patients interact with physicans.
Analyzing the effectiveness of PHR apps in their current form, Dr. Joseph Kim noted that “we’ll see a huge change in the next couple of years. But will physicians know how to use these systems effectively? There isn’t much robust clinical decision support backed by evidence-based medicine yet for these applications” (California HealthCare Foundation, 2010).
However, with the implementation of the American Recovery & Reinvestment Act of 2009 (ARRA), stimulus funding was made available for distribution to health providers who implement PHRs according to “meaningful use” criteria. As consumers and providers get more engaged in tracking health information electronically, PHRs will gain adoption. When implemented well, electronic medical records will shorten evaluation cycles and enhance consumer’s ability to control costs in ways that do not weaken quality.
Social Networking for Medical Care
Observation indicates that mobile interactions have become associated with deeper engagement in health-related social media than patients tied to a desktop computer. ”Mobile internet users are more likely than those with tethered access to post comments and reviews online about health and healthcare,” observed a report by the Pew Research Center in 2010.
Mobile is the ideal platform for asynchronous communication, with consumers are showing an increased willingness to participate in social media healthcare discussions on their phones. By facilitating dialogue among chronic sufferers of various maladies, social networking has hinted at great potential to improve care.
Particularly for rare illnesses where it is hard to generate the patient numbers required for clinical trial, crowd sourcing appears to be an effective concept that takes advantage of the collective experiences of large groups of people.
Recently, consumers have been using social media tools to bring comparison shopping to the doctor’s office. The lack of price information in healthcare is a “black hole” in the market that some companies see as an opportunity. Castlight Health, for example, is a user-friendly web-based shopping tool that shows individualized out-of-pocket health care costs. It gives consumers the information needed to shop for healthcare.
A mobile version of the service is scheduled to be introduced this year so that people can access the information from the exam table. Recognizing the lack of pricing and quality data about healthcare on the web, Castlight managers aims to create a more effective and efficient system by bringing price transparency to healthcare.
Alan M. Garber, a professor of medicine and the director of the center for health policy at Stanford believes that “price transparency could significantly change the way healthcare is bought in the United States. The notion seems ridiculously simple and obvious, and in any other industry, you would say, ‘Duh, we already have that.’ But in healthcare, it’s revolutionary” (NYTimes, 2010).
As employers continue switching to health plans that require patients to pay more out of their own pockets, it’s almost a certainty that employees will become more conscious of their health expenses. No doubt this will accelerate the opportunity for apps that involve Yelp-like crowd-sourcing of price and quality information as a means of differentiating between healthcare options.
Consumers Can Help
The technology for consumer-driven healthcare is already available. Consumers are eager for personalized medicine and the accessibility of health information is empowering people to make the most of their health benefits.
In the future, more of the information-gathering process will be completed by the consumer. As Peter Neupert of Microsoft’s Health Solutions Group has written, “let consumers do some of the work that expensive healthcare professionals shouldn’t be doing anymore. In the past 10 years, technology has removed travel agents, bank tellers and so on from the middleman position” (Brookings, 2009). Healthcare is next.
The future of healthcare will involve even greater collaboration between patients and physicians, as consumers exert more influence on the marketplace, driving quality up and costs down. Historically, patients have been an underutilized resource. Now, better use of digital and mobile technology can help people save money and lead healthier lives.
The mobile healthcare market is at the cusp of tremendous growth. According to the Pew Research Center’sMobile Health 2010 report, “78% of wireless internet users have looked online for health information while only 17% of cell owners have used their phone to look up health or medical information.” In other words, the majority of health information gathering is still being done online. However, cell owners ages 18-29 are 12% more likely (29%) than the average cell user to look up medical information via mobile.
As might be expected, young adults who are already more familiar with mobile devices and thus comfortable with apps are finding smartphones to be helpful in gathering health information and making decisions. As consumers become more interested in trouble shooting and formulating their own opinions about methods of procedure, it appears the healthcare system will continue to shift from a hierarchical structure towards a system with greater transparency, collaboration, and patient involvement.