When self-monitoring becomes real patient engagement


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).

What do you think?  Join in the conversation by commenting on this post.  Thank you!

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

4 thoughts on “When self-monitoring becomes real patient engagement

  1. How delightful it would be if EHR tech allowed for patients to UPLOAD relevant data to their patient record, allowing for real collaboration between patient and doctor. However, the current iteration of (most) EHR tech is partying like it’s 1975. I know several people with implantable medical devices that are NOT ALLOWED to use the data collected by devices implanted within their own bodies. Given that the prevailing wisdom inside the ivory towers – both the healthcare ones and the health IT ones – is that patients are stupid meat puppets, we’re not “there” yet. But I’m looking forward to the day when we are.

  2. Just having seen my GP for an overdue physical, I am aware of the value of having access to all my records. I had my blood labs in hand before our appointment, and was able to compare then over the past several years of labs, and to prepare with several questions for the doctor. Of course, I had to ask for the labs to be printed for pick up from the office because they have no electronic way to send the reports to me. This is being rectified, as all in their office understand the value of a prepared and engaged patient.

  3. I think that when a patient transmits or brings in information to the physician it is valuable information that can help the physician/pharmacist/nurse/case manager better work with the patient as it shows they are engaged. As a nurse and case manager, I always encourage people to keep a chart or document their activity if they are trying to change behavior, or symptoms if they have pain, nausea, decreased appetite. Bringing in the documentation allows the caregiver to see if there are trends, correlations medication/ stress/or activity. This should be part of the record and be part of what the treatment (including the patient) base treatment.

  4. I’ll be conducting a workshop on this very topic at Stanford’s MedX Conference this September. How can we bridge the gap between patients and clinicians using technology when data is siloed, when communication pathways are regulated, and when interactions live in a fee-for-service reality? We have a tidal wave of data that should be harnessed and managed for the greater good.

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