Do you remember that car game that begins with some variation on the statement “I went on a picnic, and I brought with me one ______.” As items were added to the picnic list, the challenge was remembering each of those important additions to the basket. As I sit here trying to review my iPhone notes from Health Ca.mp DC, I feel a bit like I’m in an amazing, epic game of “I went on a picnic.”
Today I really did kind of go on a kind of thought picnic; I experienced what was perhaps the most inspiring, thought-provoking health event I have ever attended. From the moment I walked in the door at Kaiser’s new Center for Total Health, I started riding a wave of inspiration that only grew throughout the day as I connected with people whose sleepless nights are motivated by the same health issues that keep me up thinking – people who are thinking about, researching, practicing, innovating in the same tech + health mashup that I have been circling for 20 years.
For the uninitiated, Health Ca.mps are unconferences that are structured around the hallway conversations we seek at most industry conferences. After a brief warm-up of 4×4 presentations (4 slides, 4 minutes) the conference participants make up the agenda by pitching ideas for sessions wall-spaghetti style. Since the topics generate organically, this approach means that participants spend the day talking about the issues that fuel their fires, and no one has had time to prepare a PowerPoint, which results in sessions of dynamic conversations that build and feed off of each other.
Some of the themes that emerged from the day helped me as I am considering how to hone my research and structure my studies at Hopkins. Some examples:
- “Cc Me” – The idea of patient-centered healthcare was a strong current throughout all of the sessions and hallway conversations I participated in. It seems so obvious that the patient needs to be involved in his or her healthcare, but at what stage, how do we actualize this process, what needs to be built, and who should be the ones to make this happen? Patients? Practitioners? Data nerds? Other stakeholders?This patient-at-the-center idea was further explored through the idea of a patient long-term care plan – beyond acute or chronic care, can technology offer a way for health consumers to make goals for themselves and work towards keeping them? We talked a lot about the patient’s day-to-day; what obstacles do health consumers encounter on a daily basis that may prevent them from practicing healthy behaviors? What goals do patients set for themselves (e.g. “I want to be able to hike a mountain”); how do these goals translate to practitioners (To hike, patient may need physical therapy and nutrition counseling); and how can we better translate the difference in language from patients to practitioners and back?
- Behavior change theory + metrics: How can we go from user engagement –> behavior change –> useful data & measurement of impact? One participant invoked BJ Fogg’s theory of linking new, desired health behaviors to existing behaviors as a way of creating habits. Several people put forth the idea of tying a personal connection to behavior change. For instance, a pediatric endocrinologist made an SMS app that allows her to interact with her patients via text to remind them to adhere to treatment protocol for diabetes, but she incorporates elements of their previous personal conversations (going to prom, new boyfriend, etc.) to draw that really important personal connection that then actually led to better adherence.
- What is the informed patient, and who are the informants? A comment from a practitioner that he dislikes the “informed” (air quotes) patient prompted a discussion of what a truly informed patient would look like and from which sources should their information come? This conversation was also closely tied to a discussion of privacy of health data, especially once social media is thrown in the mix. If Facebook, Twitter, blogs, and Pinterest can offer clues to health issues, should doctors be using these sources in diagnosis or management of chronic care? What data should be shared, with whom, and for how long should that data be made accessible?
- The Nudge. I’m currently reading Thaler’s book, Nudge, and it was fantastic to hear so many people talking about how we can reduce friction in healthcare & behavior change. E.g. If a tech intervention or a behavior change process is more complicated, people are far less likely to stick with it. We explored this idea with behavior change in mind; if a patient seeking to make a positive health change encounters friction in the process, that change won’t stick. How can we create tools that help patients reduce that friction? We also discussed friction with digital health applications; e.g. how can we create tools that health consumers will actually USE to manage their health data? Is it not behavior change in and of itself to get people to use these tools?
- Silos vs. castles – I heard a lot about different applications both in development and in progress. My concern is that so many of these apps were built in silos, to address very localized issues. Yet, elements drawn from each of these apps could create much larger and more useful systems that might allow patients to engage with their health in the way they want to. E.g. some people like gamification of health; others may find inspiration from circles of friends; giving people tested tools that would allow them to engage with their healthcare however they wanted, but that would be backed by a larger, invisible data system that could prevent future health innovation from happening in silos.
If I was playing the picnic memory game, I think by now I might have already lost. This blog is an attempt to hold on to threads of conversations, brainspasms, sparks, thoughts, and other fleeting ideas from the day. Alas, homework calls, and I need to get back to thinking about qualitative research methods that I can someday apply to researching some of the ideas that came up today.