People are tracking everything today from calories burned on walks using activity tracking devices like FitBit and Jawbone UP, to wirelessly monitoring blood pressure using Blipcare or blood glucose using a device from Telcare®. The market for various types of self-monitoring devices and applications is on a steep ascent and it’s worth noting some of the trend data supporting the growth. While many people are tracking their health without any prodding by their provider, the future of self-monitoring lies in the intersection where self-reported data becomes available in the provider EHR. Once this critical link is established, the foundation will be in place to have a more continuous track of health and wellness data that can be analyzed as part of a shared decision making process between a patient and her provider for an optimized plan of care.
According to a recent Pew Internet Research Study, 19% of all people without a diagnosed chronic condition are monitoring something such as weight, blood pressure, or exercise activity; whereas 40% of all patients with one diagnosed chronic condition, and a very significant portion of patients with two conditions, 62% are monitoring some aspect of their health data1. These numbers by themselves are impressive in showing how actively involved (engaged) many patients are today with tracking their health or wellness. As the numbers suggest, the need for self-monitoring tends to increase with multiple chronic condition patients such as those with both hypertension and diabetes.
Consumers have a lot of options to do self-monitoring. In addition to hundreds of over the counter devices found at retails stores and online, there is a burgeoning consumer mobile application market emerging. Searching for just the word “health” on the AppStore on my iPhone device alone yielded 8,397 individual applications. Gartner has predicted that smart phones and tablet devices will eclipse the number of PC’s for the first time in 2013, meaning that more people are gaining access to smartphone devices that can quickly allow for a slew of new tracking activity with improved user interfaces and easy to use applications.
Providers recognize the importance of having patients actively participate in their care through self-monitoring. In their recent annual study, Manhattan Research reports that 70% of all physicians surveyed indicated that they had at least one patient who has shared self-monitoring data with them in a visit. It was also noted that 75% of all physicians believed that self-monitoring of conditions improves outcomes.2 It is estimated that up to 90% of the care must be self-managed outside the health system3, meaning it is up to the patients themselves to actively follow their medication prescriptions and dietary and fitness regimens to realize positive outcomes.
The big question that arises, then, is whether providers have the means to digest the patient self-reported data? In short, the answer is limited. Providers have a wide variety of third party device/portal solutions that help track remote patient data. Many providers have patient-facing portals that provide secure messaging or online form features in their patient facing portals. Few if any of these solutions, though, shares the data back into the provider’s core EHR system which arguably limits their overall utility.
Actual sharing of the information back into the provider’s respective EHR, however, may provide the insight into the data for it to become more meaningful in actively treating patients with their health and wellness. Imagine if your provider had a simple means to view and discuss your activity since the last visit right within your electronic chart. What has been the trending of your readings and have you done things different from what was discussed at the last visit? This becomes a meaningful discussion in which future care decisions are made on shared decision making basis against a greater set of data.
Patient reported data whether through devices that track biometrics or else patient reported outcomes, also represents a significant new source of data that becomes part of an overall healthcare intelligence strategy (please see my earlier blog posts for more on Healthcare Intelligence).
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1- Pew Internet Research Center, “Tracking for Health”, 2013
2- Manhattan Research’s “Taking the Pulse®” US Survey, 2013
3- California HealthCare Foundation. Chronic Disease Care Reports and Initiatives: Patient Self-Management. 2008