Does giving patients more data actually increase engagement & improve outcomes?
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Drawing on insights from Telehealth trial for COPD, and the rise in wearable technology for self monitoring. Presented at Health 2.0 meetup, London April 2014
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Does giving patients more data actually increase engagement & improve outcomes?
- 1. actually increase engagement @alextarling does giving patients more data & improve outcomes?
- 2. user experience research is about:
- 3. actually increase engagement does giving patients more data & improve outcomes? perceptions emotions behaviour s beliefs
- 4. the Lothian COPD telehealth trial
- 5. the telehealth context of care $10,000$1,000$100$10$1 Quality of Life Cost of Care / Day Independent, Healthy Living Community Clinic Chronic Disease Management Doctor’s Office Home Care Assisted Living Skilled Nursing Facility Residential Care Specialty Clinic Community Hospital Emergency Department Acute Care ICU
- 6. patients completed daily ‘health sessions’: • daily symptom questionnaire with 8 questions: – “I am more breathless than usual” – “My sputum has increased in colour” – “My sputum has increased in amount”, etc – Answers are scored, scores above certain threshold trigger a clinical response • physiological measures on a daily/weekly basis or as needed: – Pulse Oximeter (Pulse, SpO2), Peak Flow Meter (FEV1), Weight Scales.
- 7. Community Respiratory Physiotherapy team the service model Patient and carers at home When alerted: physiotherapy team contacts patient by videoconference or home visit Patient’s daily readings and symptom scores uploaded Daily monitoring by Community Respiratory Team
- 8. remote monitoring vs. self care • service designed as remote monitoring with patients playing a passive role as providers of data not consumers – “As the doctor says: ‘You don’t have to tell us, we’ll tell you, we’ll phone you and tell you that your oxygen levels are down or whatever, and then there’ll be a prescription’” (spouse of patient) – “It made me more assured. In a way it was a relief, thinking that should I ignore my own thoughts on getting a doctor or something like that, this organisation would get hold of a doctor if their readings showed I needed a doctor” (patient) • apparent paradox in this service model... – strategy for chronic conditions is to increase self-care – the model increases professional surveillance of the patient – clinician concerns over increasing dependency on healthcare service
- 9. 1. participating in daily care plans as a regular, intentional, socially- connected activity for patients. 2. increased awareness of personal health status, awareness of significance of changes. 3. engagement and ownership: patients assuming a direct role in owning, interpreting and managing access to their own health data. despite this focus on remote monitoring, we saw examples of ‘emergent’ self-care and enhanced disease awareness:
- 10. actually increase engagement does giving patients more data & improve outcomes? behaviour s emotionsbeliefs perceptions
- 11. actually increase engagement does giving patients more data & improve outcomes? behaviour s emotionsbeliefs perceptions ... in order to evoke an emotionally resonant response data needs to elicit personal meaning..
- 12. Syste m One 95% 5% Subconscious Emotional Hot Instincts Doing “I love stories” Makes decisions Syste m Two Conscious Rational Cold/Cool Planning Thinking “I love numbers” Justifies decisions @DeniseHampson
- 13. actually increase engagement does giving patients more data & improve outcomes? behaviour s emotionsbeliefs perceptions ... in order to evoke an emotionally resonant response data needs to elicit personal meaning..
- 14. Consumer fitness and wellness self- monitoring:
- 15. actually increase engagement does giving patients more data & improve outcomes? behaviour s emotionsbeliefs perceptions ... in order to evoke an emotionally resonant response data needs to elicit personal meaning.. .. which has the potential to drive intentional, goal oriented action
- 16. actually increase engagement does giving patients more data & improve outcomes? ...no (however...)
- 17. they have an emotional engagement when patients develop meaningful interpretations of their personal health data which creates the potential for positive changes to beliefs and behaviours @alextarling
Editor's Notes
- On the Continuum of Care, people want to stay at home as long as possible. The home typically provides the highest quality of life, and the lowest cost of care. This chart represents the continuum of care expressed in dollars versus quality of life. The bottom right quadrant of the graph represents the acute care setting. Patient is in the hospital or a specialty clinic. The cost of that care is very high. New models of care are focusing on “staying left” or “shifting left” to the upper left quadrant of the graph. We all can agree that everyone would prefer to “Stay Left” on this chart. Not only is it better for people, but it also reduces the cost of care. Anything that care givers can do to help patients “shift left” not only improves the patient’s quality of life, but also reduces the cost of care.
- The first phase of the trial delivered a service using a monitoring centre to perform an initial triage on patients readings every day. Community focus: delivering services in patients homes
- Emotionally resonant response to information usually/always drives some sort of behaviour.
- There is huge growth at the moment in consumers adopting self-monitoring - one in 10 US consumers owns an activity tracker. 43% in US and UK, interested in purchasing a health monitor or fitness monitor. 32 percent of mobile device owners use fitness apps. First let me ask how many of us do some kind of personal health or fitness tracking at the moment? Who’s found that you used it to make a difference in your lives? Who’s found that is hasn’t made any difference, or its made a negative impact? Anyone started using this sort of tech and then stopped There’s some research out just now that says that a third of the people who have owned a wearable tracker stopped using it in 6 months. And that’s being reported as quite a high rate of attrition. So just having the capability to measure something about ourselves doesn’t guarantee change. As President Obama said, pretty much every American has weight scales in their house and that hasn’t done anything to change the levels of obesity. http://endeavourpartners.net/assets/Wearables-and-the-Science-of-Human-Behavior-Change-EP4.pdf http://mobihealthnews.com/28541/accenture-43-percent-of-consumers-interested-in-buying-health-and-fitness-monitors/ http://mobihealthnews.com/29358/survey-32-percent-of-mobile-device-owners-use-fitness-apps/ http://www.theguardian.com/technology/2014/apr/01/wearables-consumers-abandoning-devices-galaxy-gear?utm_content=buffer69346&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer
- Emotionally resonant response to information usually/always drives some sort of behaviour.
- Emotionally resonant response to information usually/always drives some sort of behaviour.
- Emotionally resonant response to information usually/always drives some sort of behaviour.