Health | Medical Futures Lab

Feb 28 2014

Communication, Design, e-patient, Electronic Medical Record, Health, Prototyping, Technology

Ping. Have It Your Way.

Ping. That must be my daily reminder. How am I feeling now in terms of arousal and valence? Well, I just had my weekly meeting with my research advisor. He was really getting into the nitty-gritty and suggested that I should have been farther along with my project. I don’t even like this project. I wish I could just get it over with… Anyway, probably low valence. It was a pretty negative experience. Also high arousal… He really stresses me out, and I could feel my blood pressure rising.

Photo Credit: mzstatic.com

One of the greatest benefits of mood tracking is increased self-awareness. Mood tracking apps like Moodscope and Mobile Therapy remind users to take a step back and to reevaluate their life choices. They can reflect on what is bringing them happiness and what is bringing them down. By connecting their moods with other factors happening in their lives, users can develop a greater understanding of themselves with respect to their environment.

The beauty of mood trackers is that they also provide spatial and temporal information. Users can link their moods to their immediate spatial surroundings and to the time of recording. By randomly sending pings throughout the week, these apps can help users determine where and when they tend to feel upset or happy.

Additionally, mood trackers do not only take in information, they can also offer advice. Mobile Therapy offers therapeutic exercises, including breathing visualization and muscle relaxation. It also offers strategies to quit smoking, treat anxiety, and detect relapses in psychotic disorders. Ideally, these mood tracking apps could personalize therapeutic exercises to a user’s specific input. You could “have it your way” by inputting end goals, such as cultivating happiness or controlling the relaxation response.

Photo Credit: play.google.com

With most mood trackers, it is also possible to add information through texting—users can share paragraphs of information if they feel inclined to do so. Therapists and physicians could use these self-reflections to see how their patients are doing over time. Appointments with health professionals are short, and they are not necessarily indicative of how the patient normally acts. Some patients may experience white coat syndrome, so there is an additional benefit of having records of patients outside of the doctor’s office.

In the future, perhaps these apps could notify the patient’s physician directly. Jon Cousins describes the benefits of connecting his data to those close to him: “We leave traces of ourselves with our numbers, like insects putting down a trail of pheromones, and in times of crisis, these signals can lead us to others who share our concerns and care enough to help.”

If physicians have access to their patients’ personal information, they can individualize their treatments. While there would be a lot of information to handle, this issue could be alleviated with efficient organization and clean programming. It is possible to automatically assemble the relevant information in a visually aesthetic way, and these apps track not only the physical health of users, but also their mental and psychosocial health.

Feb 28 2014

e-patient, Health, Medicine, Technology

Looking Into ePatient Outlets: PatientsLikeMe

As a continuation of my first blog post discussing CrowdMed as a possible ePatient outlet, defining the movement with a community of curious patients and a medically educated crowd base, this time I will focus on PatientsLikeMe to provide a different approach.

PatientsLikeMe is a free public website that provides a patient, clinician, or caretaker to register and provide, receive, and share health information. Users are able to input symptoms, medications, and treatments to find people undergoing similar medical situations. Communication is facilitated through both a forum type infrastructure and user comments.

Individuals are able to search the information database for not only patients with similar symptoms, but also for a wide range of medications and treatment opportunities for a particular condition. Treatments can be searched based on frequency of use amongst patients, user rating, efficiency, and side effects. In addition to medical and pharmacological solutions, users can browse through dietary, physical activity, or mindfulness treatments suitable for their personal needs.

In addition to acquiring a wide range of helpful information, the website allows people to track their health and invite others (doctors, family, friends, etc.) to their “care team” and share the status of their health. The tracking information can be easily be shared with those not on the website through an easy print format which the individual can choose to print or email to someone else.

The website automatically stores the shared health history to a database to match the user up with pertinent clinical trials or be used for research.

Different from CrowdMed, this ePatient outlet is geared towards personalizing one’s involvement in sharing and receiving health information. The website is structured so that all information provided by other users is easy to understand even with low health literacy.

PatientsLikeMe is very attractive in that everything from health tracking to research can all be done under one website. With the ease of having access to variety of resources in one spot, the site is able to lower some effort barriers that may restrain patients from transitioning into ePatients.

This ePatient outlet definitely highlights the empowered definition of the entire ePatient movement, giving the individual full control over their involvement in how their personal health information gets used and how they themselves act to provide for others within the virtual community. Involved users are not only free to educate themselves with healthcare options that can easily be discussed with a physician, they are, in addition, given the chance to take their health into their own hands with clinical trials and nonmedical treatments such as wellness exercises and stress management.

If CrowdMed is a helpful resource for finding answers under the ideology of “power in number”, PatientsLikeMe is the example of self-driven medicine with an interface chosen by the user’s preferences. This is a great illustration of patient empowerment, as patient empowerment is not only choosing what to be involved in, but choosing the threshold of involvement as well.

Feb 18 2014

Communication, Design, Health, Technology

The Plight of the Primary-Care Physician

Type in “reasons for shortage of primary-care physicians” into Google and you will be led to almost 3 million responses. Most of these articles list the same few reasons including:

The lack of financial stability involved in going into primary-care medicine
A shortage of primary-care residency positions
The current state of primary-care, where physicians see too many patients per day while navigating through the convoluted web of medical insurance

Photo Credit: www.dreamstime.com

Now type in “how to solve the primary-care physician shortage” into Google. Again, you will be bombarded with millions of articles, many of which discuss trying to utilize the power of other health professionals some of which include nurses, physician assistants, pharmacists, dietitians, and psychologists. While this seems like a viable solution, the most obvious impediment is communication between these different health providers. Currently, the primary-care physician serves as a reference point between their patients and a sea of other healthcare providers. This only reinforces the current problem with primary-care, where physicians are reaching a cognitive overload. So what can be done to solve this problem? Or more specifically:

Can advances in technology help a primary-care physician maximize their limited time?

Photo Credit: www.hcplive.com

The limited time between a physician and patient is one of the greatest problems in managing complex health problems. One potential solution, mobile applications, allow a physician to be kept up to date on a patient’s progress. Currently, applications allow patients to track various health parameters associated with their chronic condition, and send a report of these results to their doctor. However, the information sent their doctor is often in an unorganized format and is highly variable in form due to the large volume of mobile applications available on the market. In order for this solution to be effective in maximizing the physician’s time, the information must be conveyed in a standard format, and must be available to the physician prior to the appointment.

The other communication problem that drains the time and energy of primary-care physicians is trying to coordinate care with other health providers. Many primary-care physicians still coordinate care over the phone, which can be extremely time-consuming. We need to find ways to streamline communication among different providers. This could include a redesign of electronic health records to better facilitate between physician communication, or an app which not only links a patient to their different providers, but the different providers to each other.

While these changes alone will not solve the primary-care physician shortage we will face in the coming years, they will allow a primary care physician to maximize their time with a patient during a 20-minute appointment. This will lead to better health outcomes, which is the ultimate goal of medicine.

Feb 17 2014

Culture, e-patient, Education, Health, Medicine, Technology

5 Lessons from the Quantified Self Movement

When it comes to health, we often go through the motions, blissfully unaware of ourselves. We imagine that we cannot manage our health; when we get sick, it’s not our fault. We complain that our friends gave us the virus and that our classmates are the vectors of disease. Rarely do we accept the responsibility of sickness. That would be a display of weakness, and we don’t have the time to address our health. Just give us a pill, so that we can get back to work. We have school, we have jobs.

Hopefully, that passage elicited some cringes. Its message is not foreign, and unfortunately, we tend to extrapolate our American grab-and-go philosophy to health. We believe that we are far too busy to appreciate our health, and we only begin to pay attention to health when we are already sick. Wouldn’t it make more sense to nurture health while we are healthy? Why wait until it is too late?

Photo Credit: funnyjunk.com

The Quantified Self Movement (QSM) has its roots in health and wellness improvement. The idea is to promote self-knowledge through self-tracking. As Mark Moschel eloquently states, we are “taking control of something conventional wisdom has told us is not ours to understand.” We can effectively incorporate technology into our daily lives to track what is important to us. With the inception of mobile health technologies, health measurements are becoming readily available at all times.

Today, we have devices that make the Fitbit and Nike+ seem archaic. With the Cardiio iPhone application, we can detect heart rate and respiratory motion through an iPhone camera. By using Eulerian video magnification developed by MIT, these unattached sensors have accuracies comparable to hospital-grade monitors. Apple also recently patented a new model of their iconic earphones that can detect blood oxygenation levels, heart rate, and body temperature, while you casually listen to music.

Photo Credit: cardiio.tumblr.com

Given these available technologies used by the members of the Quantified Self Movement, we learn several lessons:

1) It is possible to be engaged. If Cardiio can detect your heart rate while you are holding your phone in front of you, you are hardly deviating from your typical daily behavior.

2) Make time for your health. It’s truly fascinating that health is treated so nonchalantly, as if we have more than one life and can suddenly resurrect ourselves from preventable illnesses and death.

3) If it is possible to track health while healthy, it is certainly possible to track health while sick. Arguably, unhealthy patients have a greater incentive to track their health because they want to get better.

4) If self-tracking devices can take measurements automatically, there is no excuse of being too busy. You are going through the motions of everyday life while these recordings are happening.

5) These communities are vibrant and alive. You won’t be alone, and you can become engaged before you become a patient. We can even imagine QSM members as healthy patients practicing preventative medicine.

So join us. There are meetups around the globe, and registration is just a click away. You can even join us here in Houston. See you there!

Feb 11 2014

1 Comment

Communication, e-patient, Health, Medicine, Technology

Looking into ePatient Outlets: CrowdMed

The ePatient movement promotes individuals become active participators in their overall health and wellbeing. In light of the debate on how to define ePatients, I probed into CrowdMed to see how it approached the concept.

From the very front page of the website, CrowdMed presents its purpose as to solicit the “wisdom of the crowd” to ultimately help solve medical cases. Once registered, the user may decide to post cases, provide answers to cases, or the combination of the two.

To post cases, the user can go through a step-by-step process to provide a variety of information including symptoms, demographics, personal medical history, family medical history, lifestyle, and any other diagnostic or imaging test attachments pertinent to the case.

To make the case more appealing for the pool of users, the uploader is given the option of attaching a cash prize to the case. Once the case has reached a quota of possible diagnoses, the user is notified, and they are able to take this information to their doctors to choose the best solution. The case owner is then required to award that solution provider the monetary prize.

For those who are looking to diagnose rather than provide cases, one is able to search through the cases by keywords or basic sort. The interface also provides a chat function in which the “medical detectives” can communicate with the case presenter for a more open discussion.

From what I have gathered thus far, the ‘e’ for ePatients carries meaning from electronic to engaged to empowered and more depending on the individual user.

CrowdMed absolutely fits the electronic definition, as it allows for easy sharing of medical imaging and lab results via the Internet; however, the engaged and empowered may be more descriptive of the users already equipped with medical education.

The website certainly allows patients to share their case with the public to explore other possible diagnoses, but the case becomes much more meaningful if you already have a background working as a health care provider. Even the most medically literate patients may have difficulty interpreting such information provided.

CrowdMed may not fit into the open forum type ePatient community that I had imagined when first research; however, the site may have opened another interpretation to the ePatient movement. ePatient as not only the web savvy, but the educated.

By patients being able to share and receive feedback from other healthcare providers, the patient is able to bring in information that may assist or even education their personal physician about new possibilities. This may create more cohesion within the physician-patient interaction and thus bring in the patient as a greater stakeholder in his treatment decisions.

For subsequent posts, I would personally like to continue exploring other ePatient outlets. Next, I will specifically focus on PatientsLikeMe to not only give a comparison, but also provide further insight into the interpretations of ‘e’.

CrowdMed (www.crowdmed.com)

Disclosure: I initially got the idea for looking into the website after talking with a friend who works for the company. All the functions discussed in the post was information I obtained after browsing through the website as both an unregistered and registered user. Permission was obtained to publish this post.

Medical Futures Lab

Category Archives: Health

Ping. Have It Your Way.

Looking Into ePatient Outlets: PatientsLikeMe

The Plight of the Primary-Care Physician

5 Lessons from the Quantified Self Movement

Looking into ePatient Outlets: CrowdMed

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