Removing the barriers to patient engagement: How consumer health technology can reach its potential

Feb 13, 2017 - reading time 5 mins

By Tim Blake

Managing Director, Semantic Consulting

With 15+ years’ experience in the UK, US, Asia Pacific and Australia, Tim has formerly held roles as Chief Information Officer of the Tasmanian Department of Health and Human Services (and member of the Tasmanian Health Executive Team), Director of Rural eHealth Strategy at New South Wales Health and Strategic Advisor at Australia’s National eHealth Transition Authority (NEHTA) and the Commonwealth Department of Health. Tim has significant experience in designing new models of care, health pathways, medication management, care planning, clinical informatics (including emerging standards such as FHIR) and the clinical and cultural factors affecting clinical interoperability of health data. He is passionate about activating and engaging patients, the use of mobile solutions in health, consumer health technology, precision medicine, consumer genomics and many other areas that are starting to disrupt healthcare in positive, exciting and complex ways. Currently, Tim is Managing Director of Semantic Consulting, a health consulting firm focused on leading digital change in healthcare.

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The last few years have seen an explosion in the use of consumer health technology as a new generation of healthcare consumers proactively engage in their own health and wellness.

However, despite the rapid growth in the use of consumer health technology, there is still considerable work required to drive the adoption of innovative digital health devices and solutions into the mainstream of healthcare. Why is this, and what can be done to further remove the barriers to patient engagement, allowing consumer health technology to reach its potential?

What is consumer health technology?

Today, the phrase ‘consumer health technology’ typically brings to mind the current generation of physical activity tracking devices. Initially these were little more than step-counters, but have quickly evolved (subject to the constraints of battery life) to track multiple forms of exercise, heart rate, skin temperature, etc.

Whilst of significant personal interest, most personal health data gathered today through consumer health technology has limited clinical relevance, leading to scepticism amongst many health providers regarding the value of patient-acquired health data. Philips’ Future Health Index 2016 research showed that one of the top perceived barriers to connected technology adoption from healthcare professionals was trust in accuracy of data collected by the devices.

However, to look at the current state of this technology without regard for its rapid rate of progress is to misunderstand where we are going. We undoubtedly stand on the edge of a ‘Cambrian explosion’ in consumer health technology which will revolutionize medical diagnosis and health monitoring, underpinning the development of radically new models of care with the patient at the center.

Within 20 years, healthcare consumers are likely to wear more diagnostic power on their wrists and in their clothes than we have available to us through entire health systems today. This will support proactive diagnosis, early intervention and continuous monitoring that drives previously unachievable quality, safety and efficiency in healthcare.

Indeed, consumer health technology is already much more than physical activity trackers. Although slowed by the need for vital regulation through bodies such as the U.S. Food and Drug Administration, we are seeing the emergence of sophisticated sleep monitors, wearable Electrocardiograph (ECG) devices, Wifi-enabled blood pressure monitors, glucometers and scales, Artificial Intelligence (AI) based diagnostic tools delivered via smartphone, and much more. Traditionally only for use by health professionals, these devices are rapidly being consumerized, with a strong focus on user experience and affordability.

Barriers to mainstream adoption

But how do we bridge the significant gap between the emerging technology of today and the culture and practice required in the future to make this technology successful? How can we take innovative technology and apply it in clinical contexts that are often challenged by change?

As we move towards a future of healthcare that will look radically different from today, there are many barriers to the broader adoption of consumer health technology by both health consumers and providers. These include:

Silos of personal health data, not integrated models of care – It takes time and a deep knowledge of healthcare to integrate the data flowing from consumer health technology into existing clinical workflows, let alone to develop new models of care that integrate patient data with caregivers and health providers. Unfortunately, much of the innovation occurring with consumer health technology today results in new silos of health data, which aren’t integrated with existing clinical information systems. Much work remains to ensure that consumer health technology disruption is bringing ‘integrated innovation’ to the healthcare system, making use of relevant health data standards to ensure interoperability of personal health data.

A clinical culture that doesn’t value data quality – High quality data is the currency of our future health system. A health system that values the innovative and disruptive change made possible by consumer health technology is one that understands the role of data quality in improving the quality and safety of care. High quality data begins at the point of care, through well designed systems that support the capture, validation and coding of health data. Unfortunately, our medical schools are still not, on the whole, preparing the next generation of health providers to understand this fundamental principle. As innovators in healthcare, we must seek to change this.

Separating the signal from the noise of personal health data – As the types of data generated by new generations of consumer health technology quickly becomes more clinically relevant, and are gathered at greater volumes, we risk drowning health providers in a flood of data. Innovators must focus on how clinical relevance can be quickly extracted from large data sets, using aggregation and pattern recognition (though AI) to give health providers insights, rather than hinder them with vast quantities of data.

An unconscious bias towards the ‘worried well’ – Many of today’s consumer health technology solutions are developed with an unconscious bias towards healthcare consumers who are already engaged with their own health and wellness – the ‘worried well’. To drive greater engagement across the socio-economic spectrum, much additional thought needs to be given to solutions that cater for health consumers with poor functional and health literacy – precisely those patients most likely to suffer with many of the chronic diseases that are placing the huge burden on our health systems. A stronger focus on user experience, and a greater reliance upon iconography and colour in design will be critical to engage patients from lower socio-economic backgrounds.

Consumer health technology drives patient engagement

The large-scale democratization of medical information via the internet and mobile devices is causing a seismic shift in healthcare, fundamentally changing the relationship and power dynamic between patients, caregivers and health providers. We are in the early stages of the ‘healthcare reformation’!

This cultural shift can’t be wound back, and is driving engaged and empowered patients to behave increasingly as consumers of healthcare. After decades of being stuck in outmoded models of care, engaged patients are now beginning to use consumer health technology to drive the transformation in healthcare that we have needed for so long.