Empowering  HealthCare  Engagement    by  Pu6ng  the  Person  at  the  Center

Mark  Scrimshire,  Chief  Ins2gator  &  Co-­‐Founder  -­‐  HealthCa.mp  Founda2on

We don’t have a good, consistent word for Patient in the Health Care World. Are we People, Patients, Consumers, Citizens, Care Givers, Family Medical Officers, Care Team Members?

In this session I want to run through this presentation to give you some “food for thought” and then open up for questions. Let’s have some interaction and learn from each other.

Participant Poll -1

• Do you use Social Media (Twitter, Facebook, LinkedIn etc.)?– No, I don’t actively use social media– Yes, I occasionally use social media– Yes, I regularly use one social media service– Yes, I regularly use multiple services

(Facebook, LinkedIn, Twitter, Foursquare etc.)

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The purpose of these polls is to learn a little about you, the participants, in this session.

Participant Poll -2

• Do you use an Electronic Health Record (such as HealthVault, Dossia, NoMoreClipboard)?– Yes I Use a Personal Electronic Health Record– Yes, I use an Electronic Health Record provided

by my Health Plan Provider, Employer or Physician

– No, I don’t use an Electronic Health Record

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We are supposed to be the professionals - but how many of us use a Personal Health Record.

Participant Poll -3

• Do you use a health/fitness tracking device/sensor? (such as Fitbit, Jawbone UP, BodyMedia, Zeo, Polar, NikePlus)– No, I don’t use a tracking device– Yes, I use a personal tracking device for my

health and fitness– Yes, I use a tracking device provided by my

physician or health plan

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How healthily active are we? Do you use a sensor or tracker to help you monitor your well being? Do you keep a record of that data? Does it influence your life?

Conflict of Interest Disclosure Mark Scrimshire, BA

Has no real or apparent conflicts of interest to report.

@ekivemark

I am an independent Health and Social Technology Consultant. As Co-Founder of HealthCamp I don’t have any particular axe to grind. I have worked with a lot of different organizations across the health care world. Okay - I LIED - I DO have a conflict of Interest. I, like many of you in this room, are consumers in a broken health care system. Together WE have to fight DPS - Disassociated Patient Syndrome.

So My Conflict of Interest is that I want to Empower Health Care Engagement - To do that We have to put the Individual at the center and empower them to manage their health and the health of their loved ones.

Learning Objectives

• Break down the glass wall in Health Care• Embrace:– Consumer-oriented Sensors– The “Life” record– Consumer Generated information– The power of patient stories

• Transform health and wellness with engaged health partners

@ekivemarkSo in the next hour I want to address three interconnected issues and suggest some approaches to solve some of these challenges.Let’s talk about the “Glass Wall in Health Care”.How Sensors are transforming our world.How the industry is witnessing an explosion in health relevant data, but is largely ignoring most of that data. How do we tap the power of Patient Stories. Addressing these areas will help us transform this industry in to one that really focuses on Vitality and Quality of Life.

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Who the heck is he?

@ekivemarkhEp://healthca.mp

Let me give you a frame of reference by telling you a little about me:

I am a “techie” at heart. I have been involved in Technology for many years working in a wide variety of roles up to and including CIO.

The blue tint is also there to give you a hint about my recent past working in Health Care. Yes, I am a recovering Blues Plan Technologist.

Picture: http://www.mccowngordon.com/images/projectTypes/DataCenterView1.jpg

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Who the heck is he?

@ekivemarkhEp://healthca.mp

This is not me! This is one of the HealthCamp events I have organized in conjunction with Kaiser Permanente. This was from 2010 at the Sidney R. Garfield Innovation Center where 250 people came together to create their own day of learning and discovery. HealthCamp is different from your typical conference. The participants define the agenda. In real time on the day. It brings those fascinating conference hall way conversations back in to the room.HealthCamp was created four years ago to provide a venue for networking and discussion that brings people together from inside and outside healthcare, breaking down the silos that we so often see in our industry.

Who the heck is he?9

@ekivemark

Who the heck is he?

I am a Health and Social Media Consultant. I have spent the last 5-6 years working with Web 2.0 and Social Technologies. HealthCamp has enabled me to weave together my experience from Four different worlds: Health, the Web, Mobile and Social.

You can find me in Social Media by using my “handle” ekivemark.

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Consumerizationof Health

@ekivemarkhEp://healthca.mp

Health Reform, Insurance Exchanges and the emergence of Smartphones and mass-produced sensors are ushering a new era of health care consumerization. As consumers are more aware of the costs of care and bear more of those costs they will seek alternative solutions. This is a good thing. We can’t settle for just “bending the cost curve.” We have to completely fracture it! In the words of Joseph Smith of West Wireless Health Institute - “we need to jailbreak health care!”

Health  May  be  Private

@ekivemarkhEp://healthca.mp

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HIPAA is the 800 pound gorilla in the room. It is the excuse used by many to avoid modernizing health care, to avoid sharing data with patients. The dark, dirty secret of HIPAA is that when you put the patient in control, many of the challenges and restrictions disappear. Just look at what happened with the VA’s Blue Button. Once a member downloads their health data file they can do whatever they want with it.

Let’s remember - privacy is a choice, a personal choice. That is why I say “Health MAY be private.”

Exerciseis  oPenSolitary

@ekivemarkhEp://healthca.mp

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Exercise and nutrition is one of the main routes to optimum health and while Health may be private - Exercise is very often solitary.

but...@ekivemarkhEp://healthca.mp

Effec%ve  Wellnessis

Social  and  Fun13

Don’t under estimate the power and influence of our peers, friends and loved ones in achieving effective wellness. Effective Wellness is both Social and Fun. We need to architect social in to our health platforms from the outset - not tack them on as an afterthought.

Is there a recipe for

Engagement?

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@ekivemarkhEp://healthca.mp

So let’s consider if there can be a recipe for Engagement. I believe there is. It may not be simple. There may be more than one way to bake that cake. But there are some important ingredients. Let’s look at those ingredients....

Picture: http://www.flickr.com/photos/girlhula/321810053/

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OEIA

U

@ekivemarkhEp://healthca.mp

I have tried to drill down the ingredients in to 5 elements. To make it easy to remember I went back to basics: A E I O U. Do we all remember learning that in school?

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OEIA

U 16

OpenImmediateEasyAc2onable

Unobtrusive

@ekivemarkhEp://healthca.mp

We live in a world where Attention is at a premium. So if we are going to provide information. Make it ACTIONABLE. Let’s make it EASY - to Understand, to consume. Yes - I want to see the death of the traditional EOB. It was neither an explanation, or a benefit. Indeed EOBs were a tax on our attention.It needs to be IMMEDIATE - Real Time. At a recent conference our health care systems was described as providing data like a speedometer telling you how fast you were going four years ago.We need to be OPEN. Monolithic systems will no longer cut it. We can’t all do everything. We need to leverage what others are doing. So we need to build OPEN Bi-directional systems that play well with others. We also need to make our systems UNOBTRUSIVE. We need to design for consumers that have a thousand other things to do. So we need to design solutions that fit in to a person’s lifestyle.

We are seeing an explosion in Consumer

Wellness Sensors

17Fitbit

Nike  PlusWithings

@ekivemarkhEp://healthca.mp

We are seeing an explosion in the number of consumer-oriented sensors. Yet, the industry risks largely ignoring these devices because they don’t control them. Instead we prefer to acquire and deploy medically oriented solutions that cost many times more yet don’t necessarily provide the same leap in quality of data and they don’t get utilized because they have not been designed to fit a person’s lifestyle.

And don’t go looking for that perfect device. People have personal preferences. You need a strategy that leverages any of these devices.

We have moved beyond the world of industrialized production line medicine. We are entering a world of personalized medicine.

Sensors contribute to theaccelerating growth in data

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125 200 275480

750

1200

1750

2005 2006 2007 2008 2009 2010 2011Exabytes  1018 Source:  IDC

@ekivemarkhEp://healthca.mp

The explosion in sensors is contributing to an explosion in the amount of data that is available. That data is not only coming from wellness devices, but also from Smartphones, computers, networks and millions of connected devices. Sensors are the new frontier of the Internet and of Health Care. How can we tap this? How can we handle the exponential increase in volume of information and How do we make sense of all that data?

Do we want to be the data aggregator, or do we want to be a data aggregator plus data accessor. Combine our core data with data from a myraid of other sources. This brings us to...

© Absolut_photos | Dreamstime.com © JLProductions.co.uk

We have a “glass wall”

in HealthCare19

@ekivemarkhEp://healthca.mp

The glass wall in HealthCare. Consumers are collecting data about themselves at an increasing rate. Big data is the next frontier in HealthCare. We need to embrace user generated data. We need to tap the growing personal life streams that each individual is generating.

This is the coming “Mind Shift” in Health Care. We have to smash the glass wall.

We have to overcome the fear of liability. We need to think about a Health Engagement Metric. A metric that doesn’t measure our Healthiness but rather measures our engagement in maximizing our health and wellness.

The Personal Health Record will become the “Life Record”

‣ Google, Microsoft & others are spending millions to leverage life data

‣ Web businesses know value of big data

‣ Web powerhouses build hard to re-create data:‣ Amazon – Enriched media catalogue

‣ Google – Search index

‣ eBay – Seller reputations

‣ The Life record - a battleground that will change the dynamics of the health sector‣ Who will the consumer trust?

‣ Will consumers let their record be held hostage?20

@ekivemarkhEp://healthca.mp

To that end I believe that talk about EMRs/EHRs and PHRs is often misguided. Yes, the EMR and EHR have a growing role in health care: Capturing and leverage institutional knowledge to deliver the best care in a team-based setting. But the PHR will disappear as we know it. The PHR must give way to the “Life Record.” Why? - Because we don’t know what information may be relevant to our health in the future. But we do know that Computers are effective tools when we need to search, filter and correlate enormous volumes of data. Owned by the individual, the life record will become a tool that we will allow our trusted care team to tap in to. And the Life Record will be managed by an organization that an individual trusts. They will not want that data held hostage.

This is an opportunity and a challenge in Health Care. Google may have exited the PHR world but they, and other Internet companies, understand the value of big data and building hard to re-create data.

Our life record could become the next battleground.

How Do We Trigger That Leap of Engagement?

Baldface  Lodge

hEp://healthca.mp @ekivemark

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So the question is how we trigger the leap of engagement?

What we have to do is recognize some traits that are there in most of us. We need consider these traits when we design for consumer engagement.

Can we engineerengagement?

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hEp://healthca.mp @ekivemark

So, Can we engineer for Engagement. Remembering our A E I O Us - If you look at Facebook, Twitter, Google+, Pinterest and other Social sites the answer has to be yes, up to a point. We can leverage social activity through authentic engagement.

hEp://healthca.mp

Are  You  Ready?

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@ekivemark

Mobile  is  a  start...

In simple terms - everything that applies in Social Media can be applied in Mobile. Everything is going mobile. We want information at the point of action. The patient in the doctors office, or the hospital, or pharmacy does not have their computer to hand. But they have their phone. Mobile is no longer an option. Are you ready?But Mobile Only is not the answer. We need Mobile+. Phones, Tablets and Computers are different devices. Used in different ways. For some people their phone, may be their only device, but for a growing number of people multiple devices are used, for different purposes.

Empowered EngagementDemands Trust

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@ekivemark

hEp://healthca.mpOne essential component in all of our plans MUST be TRUST. Walk the talk. Be consistent. Be authentic. The consumer will have more information than you do and as such you need to either gain their TRUST or strike a bargain in order to gain access to their information.

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http://healthca.mp

Elements in designingfor engagement

@ekivemark

I like to keep things simple, so I thought about what elements in designing for engagement would work for someone like me....

The Patient: A Reluctant ConsumerWe have to remember that for the vast majority of encounters in Health Care - the patient is an unwilling consumer. They don’t want to be ill. Just like cars. They may love driving. BUT they hate when the Check Engine light comes on and they have to visit the dealership.

Laziness

hEp://healthca.mp @ekivemark

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We are lazy (or busy, or distracted). Don’t make us jump through hoops. Make my life easier - not harder. Look at the adoption of standalone Personal Health Records. The usage levels are pitiful. Only the most committed key in their data manually. We want someone else to do the work for us. I have seen personal health records provided by Health Plans where the PHR doesn’t even “know” you are a member of the health plan that is providing the PHR. Come on! #FAIL

WIIFM

http://healthca.mp @ekivemark

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What’s In It For Me. Put you patient or consumer hat on. What do I get out of sharing? I’ll take the free appetizer at Chili’s for having checked in there.

Competitiveness

http://healthca.mp @ekivemark

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We are competitive (although this picture makes me want to say - We should design for Stupidity). How many mayorships do you have on Foursquare? Look how we are incorporating gaming mechanics in to wellness applications.

How do we tap the power of Patient’s Stories?

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ICD-­‐10ICD-­‐9    >>

@ekivemarkhttp://healthca.mp

The industry is facing a transition from ICD-9 to ICD-10 or even a delayed transition to ICD-11. But what will the benefit be for the patient? Greater specificity may allow payers to more accurately gauge what and how treatments are applied but would we be better focusing our efforts on understanding our patients more effectively. Learning their motivations. Learning about the trade offs they make to balance their lives.

Picture: http://www.hccs.edu/hcc/System%20Home/Departments/Continuing_Education/Paula/Health%20Sciences/health3.jpg

hEp://healthca.mp 31

@ekivemark

Patients are still the most under utilized resource in Health Care. Yet care givers are probably the most over abused resource in health care. We must tap this resource and empower it. We must learn how to incorporate the insights from patient stories in to our treatments.

The narrative is out there...

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@ekivemark

The narrative is out there. A friend of mine lost her husband to cancer. When she looked back at his status updates in that final year, more than 60% of his updates gave indications of his cancer symptoms. Patient stories are out there - if only we took the time and effort to listen. And increasingly the devices we carry will provide deeper insight to these stories.

Let’s step up to the challenge and embrace the power of the patient. Let’s break through the glass wall in health care. To pile on in support of E-Patient Dave. "Don't just give me my damned data, Take it too!"

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hEp://healthca.mp @ekivemark

We  haven’t  even  scratched  the  surface  yet

We haven’t even scratched the surface of what is possible. We don’t have all the answers, but we must rise to the challenge and search for them. We must bring our unique perspectives and our expertise. But we must remain humble on that journey of discovery. So let me just end with an insight that was shared with me by an astute person who said:“My Wii knows more about me and my health than my doctor does.”

Picture: http://lewisshepherd.files.wordpress.com/2010/11/playing-kinect-at-mahockney-1024x867.jpg

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Q  >  Amark@ekivemark.com @ekivemark

Health and SocialTechnology Strategist

I hope that has given you some things to think about. Let’s open it up for questions. If you are like me and think about a question after the session then just reach out to me in Social Media and ask me.