Guest post by Joel Rydbeck, director, healthcare technology and strategy, Infor.
Healthcare is undergoing rapid “digitization” – a move toward an integrated ecosystem of mobile applications and data exchange that integrate consumer data into the enterprise. For healthcare, this could enhance patient engagement and enable care to become more efficient and “real time”.
Nonetheless, moving to a more digital healthcare enterprise presents a series of challenges:
- How will the data be transmitted and is it semantically interoperable?
- Where and how much should be persisted?
- How can the data be made “actionable” for the clinician?
We’ve all visited a doctor and been asked “How are you sleeping?” and “Are you getting exercise?”. If you are among the growing number of people with a fitness tracker, you may think, “Hold on, I have that recorded”. So, you pull out your mobile phone and respond “I am getting six to seven hours of sleep a night and about 11,000 steps a day. Is that good?” While your doctor may understand your quick synopsis of the data, imagine if they were getting the data real-time. Would they know what to do with it? What if it contains disturbing trends? It would be unfortunate if crucial information wasn’t put to good use. But how?
Interactions like these prompted Washington University’s Olin School of Business and Infor Healthcare to collaborate on improving the usability of personal tracker data. This collaboration included conducting a small survey of 39 physicians from a broad spectrum of specialties asking their thoughts about the use of tracker data for clinical care.
The survey uncovered differing views on what information would actually be useful, showing:
- 56 percent thought active hours would be useful,
- 46 percent said miles walked or intensity of movement,
- 36 percent included steps taken as a useful metric,
- and 10 percent the said the degree of upward incline during movement would be useful.
The survey also asked providers what factors would enhance their likelihood of using tracker data for patient care. Majority would like to see better integration with their electronic health record (EHR), more patients using the devices, and additional data, such as blood sugar, being collected.
Physicians reported lack of education as a barrier to effectively using the data. About 50 percent believed that education, in the form of a short presentation or discussion, would be useful while 31 percent thought that a short guide would suffice.
While two-thirds of providers were open to discussing personal trackers with their patients, they did express concerns in using the data for care. The data must be proven accurate before physicians will place trust in it. Inconsistent or inaccurate data could lead to unnecessary anxiety and possibly harm. Also noted is that extraneous data can clutter the EHR and complicate patient care. Many of the providers mentioning drawbacks to using device data stated that the devices might work best as motivational tools for patients. More study towards interpreting tracker data for clinical use is needed.
Earlier this year, Annals of Emergency Medicine published a case study. “A 42-year-old man presented to the emergency department (ED) with newly diagnosed atrial fibrillation of unknown duration. Interrogation of the patient’s wrist worn activity tracker and smartphone application identified the onset of the arrhythmia as within the previous three hours, permitting electro cardioversion and discharge of the patient from the ED”. The clinicians were able to identify when the condition began and treat the patient accordingly. The diagnosis was faster, more accurate, and less costly for everyone.
Although the relationship between trackers and care teams is in its infancy, there are opportunities to explore. We hope healthcare providers and software developers will continue to collaborate and expand the use of personal trackers in the prevention, diagnosis, and treatment of disease, as well as improve the overall well-being of the population.