35 million heartbeats unnoticed

I was a teenager when Bruce Springsteen scored a big hit with Streets of Philadelphia. 20 years later, walking the streets of Philadelphia for the first time, I found out it was an even bigger hit in Europe than in the USA. I lively remember the impact of Philadelphia – the first mainstream film dealing with HIV/AIDS. In fact, connecting the dots retrospectively, it may have brought me here today.
My master thesis study in collaboration with Janssen was centered around the influence of HIV/AIDS patients on the future developments in this therapeutic field. It seemed a very evident thing to do for me at the time, i.e. involve patients in the progress of their health management. 15 years later, finding myself in Philadelphia at the IIeX Health Conference Module 1: Welcome to the New Paradigm, it dawns on me how progressive such a patient study must have been for Janssen in the early Nillies.
Still today, the perfect storm is here for a truly patient-activated health system. For plenty of other good reasons, the paradigm has not fully shifted yet. More than ever, patients are connected and empowered (by 2018, 80% of people will have mobile internet access – Garret Leahey, Google Life Sciences), yet our industry still very much struggles with how to inject patients into the heart of our organizations and become patient-activated throughout.
Patients (or let’s just say people who happen to be touched by a condition for a short or longer time) leave behind a lot of information along their journey. Unfortunately there’s way too few of us professionals mastering how to capture and to make sense of all this. Let’s try harder to insert people back into the equation. Let’s start asking the question how this observational and behavioural data may be really useful, both for the patients themselves as well as for all of those trying to come up with better patient service solutions.
It’s not because you put on a Fitbit, that you’ll lose weight. It’s not because a pediatrician prescribes children to wear a Fitbit that better HCP decision-making is guaranteed (especially not if some wiseacres attach it to their pets…). It’s not because we simply have the metrics, that we are necessarily getting closer to our desired end state. Better results are built on great insights and those require more relevant data. Or as Rob Key’s example endorses some data sarcasm: social conversations around Anne Hathaway (the actress) are seen to drive Berkshire Hathaway’s Stock (the American Multinational Holding).

So Shaival Kapadia (MD) rightfully asks how we can convert data so it can drive desired behaviour and support our patients in managing their conditions better. Of course there’s ample opportunities to tap into wearable, social and big data alike to fill gaps in the healthcare eco-system and to improve medical outcomes. Think heart failure: a heart beats about 100,000 times a day whilst a patient at risk of cardiac failure may get 1 cardiac check-up a year (about every 35 million heartbeats). Knowing there’s 6 million cases of heart failure a year in the US and that the disease is silent most of the time, this requires ongoing listening to increase chances of relevant intervention, decrease hospital re-admission and save a lot of money and suffering at the end of the day.
Indeed traditional medicine is very much episodic and it is our challenge to change that into continuous care. In this light, the new paradigm is mostly looking at technology. But beyond this, there’s also ample potential for exponential growth opportunities in the doctor-patient relation. Doctors touch no less than 82% of the population each year and 79% of patients are very to extremely satisfied with their doctor. We have to invest more in building an eco-system of partners with all the patient-physician relation at the center of it. (Mariya Filipova, Deloitte USA)
But no matter how strong the patient-physician bond is, it’s a mere fact that high quality facing time in the relation is very limited (on average only 12 seconds of a typical patient-doctor conversation goes without any disruption – Dale Cooke, PhillyCooke Consulting) and doctors are in need of better data points and patient insights to do a better job under such growing time constraints.
Of course this scarcity of the doctor’s attention is one of many drivers for consumers to turn to smart devices and digital resolutions. The trend is so ubiquitous and big that it’s even turning some of us into glassholes (Google glass wearers), glanceholes (staring at their smart watches) or cyberchondriacs (irresistible urge to visit health and medical websites) – thank you to @garrethleaheyIII for that vocabulary boost. As a patient you just need to go well-prepared into the doctor’s cabinet in order to get the most out of it. And even then it is just one doctor with all the human limitations this entails.
Facing our doctor, we can tap into his knowledge and experience. On social media, we can tap into the wisdom of the crowd. CrowdMed (having solved 800 rare medical cases to date) nicely shows how crowdsourcing, i.e. soliciting contributions of a large group of people considering a case from various angles, maximizes chances to come to better insights faster than the best of doctors can. Or consider X-Prize (a global open and incentivized competition to solve some big bold problems in this world) that put the challenge out there to design a device that fits the palm of your hand and that can diagnose at least 15 conditions: the problem is not the technological feasibility, but compatibility with the health operating systems available today.
The system and human resistance to innovation are the rule. In the healthcare industry this resistance is big, but many actors should accept the challenge to break it down into small barriers that can be overcome. If a teenage boy can disrupt pancreas cancer detection testing, all of us professionals need to try harder to make more of the time, the knowledge, the data, and the resources available to us, no matter how scarce we tend to find them or how difficult they may seem to be applied in the present-day reality. If we won’t, someone else will. And that someone may even be a robot before we know it…

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