Advances in participatory management of chronic diseases

Physicians do it, patients do it, grandparents do it. Everyone seems to be checking and sharing their health status online these days. A concept, participatory medicine, has evolved to describe patient engagement: “networked patients shift from being mere passengers to responsible drivers of their health,” and “providers encourage and value them as full partners.” To paraphrase a quote from Amir Kishon, CEO of Wellness Layers, the trinity of “me (personal information relevant to the patient such as medications, nutrition planners, medical diaries etc), we (sharing information with other patients and experts) and information (medical information unique to each individual) equals an exponential increase in patient engagement. Technological advances such as Google Glasses and The Smartphone Physical add to the desire of ordinary citizens to manage their health. Moreover, almost two-thirds of surveyed baby boomers (who are frequently affected by chronic diseases) have indicated a willingness to download an app recommended by their doctor.

Chronically ill patients were 70% more likely to download an app to track their medical issues compared with half of the users who would download an app looking for general information or weight loss assistance. The development of chronic disease management platforms such as The Verizon Wireless Converged Health Management (CHM) Device has enabled storage and remote monitoring of physiological measurement devices that can be used by the patient at home. While efforts to integrate complex chronic disease algorithms seamlessly with the appropriate platforms can seem daunting to doctors and patients, evidence suggests that diabetics engaging early and remaining active in a remote glucose monitoring program had better clinical outcomes than unengaged patients. Feasibility studies for transforming health care on a larger scale through analyzing the de-identified data of thousands of patients are currently under way.

These patients are likely to have concerns about revealing personalized medical information to numerous parties in order to optimize their care. The two major issues to address are health care privacy as outlined by the US Department of Health and Human Services and identity theft that may arise due to weak security (think weak passwords, lost electronic medical records, etc). While no entity can claim to be HIPAA-compliant (HHS and OCR do not endorse any private consultants' or education providers' seminars, materials or systems, and do not certify any persons or products as "HIPAA compliant"), there are tools available to facilitate communication of a patient’s care team in a controlled, auditable environment. In addition, the development of strong identity verification and multi-factor authentication tools may aid in thwarting cyber-attacks.