What are the key changes in healthcare, and how do they affect patients? Diane Brodalski of Danya International, which delivers innovative behaviour change strategies to help people to live healthier lives, recently identified some trends that are putting the power into patients’ hands.
The rise of empowered patients
The concept of patients taking control of their own health is not new. People use the internet to research their own conditions, and the rise of mobile technology means that they can access information anywhere, anytime. This has also changed the role of clinicians. They are no longer the only ones with the information, and it doesn’t primarily come from books. Instead, they too are engaging with mobile technology to access information, often side-by-side with patients.
Empowered patients share several characteristics. They are:
- Responsible: their knowledge supports better treatment decisions;
- Collaborative, working in partnership with their healthcare team;
- Resourceful, gathering information about their symptoms and family history;
- Smart consumers; and
- Understanding and supportive of patient advocacy.
Their philosophy is to learn from those who went before and help those who come afterwards, in the interests of better outcomes.
How did we get here?
First of all, there was the rise of online health information sites. WebMD is perhaps the best-known in the US, but there are many others, including NHS Choices in the UK, and provider sites such as the Mayo Clinic. WebMD has an average of 156 million unique visitors each month, and 59% have looked for health information in the last year.
One in three American adults has gone online looking for information that will help them to diagnose their health condition. This group, known as ‘online diagnosers’, tend to be younger women, and white. They generally have a college or advanced degree, and are from households whose income is less than $75k per year. Nearly 40% are looking for information about someone else’s condition. Around half of them talked to a doctor about what they found, and 41% had their online diagnosis confirmed by a clinician.
The other aspect to the rise of empowered patients is the growth of social media and networks that encourage sharing of information. Nowadays, most of us post information about our general health on social networking sites. Why would we not share it online with clinicians? Consumers have also become more active on data-sharing and peer-to-peer sites such as PatientsLikeMe. Technology has made it much easier and faster to share information.
Seeing into the future
Diane Brodalski believes that we will see a continued rise in access to information, empowered patients, and use of technology. At least one report has suggested that ordinary healthcare users have access to more information now than the US Surgeon General did in the late twentieth century. Half of all smartphone users have used their phone to access health information.
Patients are moving from being ‘passengers’ in healthcare systems, to driving their own health and care. There has been a huge rise in the availability and use of ‘health apps’, such as MyFitness Pal, and RunKeeper, which help people to keep track of their activity, whether fitness training or weight loss. Many workers also participate in wellness programmes, which use gamification to make keeping healthy fun.
What about electronic health records? Healthcare providers are using them, but patients mostly don’t yet have access. Kaiser Permanente’s app that provides access to health records is a big step in the right direction, but patient portals have generally been slow to catch on. It’s possible that the advent of ‘wellness platforms’ may change this. These focus on patient education and collaboration, rather than simply a record of what’s been said or offered by way of treatment.
Wearables are also a key part of likely future healthcare, with 69% of doctors telling WebMD that they believe that patients should wear technology to aid diagnosis. There are now systems for monitoring activity, sleep, heart rate and nutrition, and providing coaching on behavioural changes that will improve health, as well as baby monitoring and concussion checking apps.
Challenges
Technology, especially wearables, is still seen as a bit ‘geeky’, and the ‘so what?’ challenge remains ever-present. Only 5% of Americans wear technology for tracking, although 25% express interest ‘at the right price’. That’s still 70% who aren’t really that interested. But if these challenges can be overcome, technology offers potential to revolutionise healthcare. We are likely to see increasing numbers of people using technology to access healthcare in future, whether that’s through remote consultations or via wearables. Why? Because technology offers the ‘holy grail’ of more cost-effective, convenient, patient-centred care.