Community vital in mHealth
Though the numbers of health and fitness devices are increasing rapidly, empowering users to record and monitor their bodies, support from the wider community is vital to ensure adoption, growth and continued use, argues Brian Mondry.
The general consensus is that web-connected technology that enables better personal health and wellness will be widely adopted globally. This optimism about such 'quantified self' data is not unwarranted, especially because the likes of Apple, Google, Samsung and Qualcomm have entered the space and are building platforms that will enable consumers to easily and effectively manage and analyse the data coming from a wide range of quantified self devices. Juniper Research projects the space will generate $53.2 billion in revenue by 2019, with the number of fitness devices alone tripling from an estimated 19 million in 2014.
So, it seems we are heading for a quantified self world where we are all wiser about the internal workings of our body and are all the healthier for it. But wait...
The projected shipments and growing infrastructure support the optimism around future growth in terms of adoption, but not retention. Thought must be paid to whether these devices, once bought, will actually be thoroughly integrated into consumers' lifestyles. I see potential parallels with the mobile health application space, where apps for everything from calorie tracking to medication adherence are downloaded but not actively used by the majority of people who download them. Already, a large percentage of fitness devices are gathering dust in drawers worldwide after a mere week or two of actual usage. So, perhaps if you build it, the people will come. But will they actually stay?
Health e-connectivity technology and its users need to be separated into two categories: general health and wellness, where people can afford to be lackadaisical, and chronic disease management, where non-usage can be a matter of life and death.
Of course, there is overlap between connected devices that are used for general wellness and those for more chronic conditions. A fitness enthusiast would be as interested in tracking heart rate via a biosensor as a heart attack survivor would be. But implications of non-usage are vastly different between these two groups.
• General health and wellness quantified self technology can be adopted by anyone who is looking to maintain or improve overall health and fitness. This ranges from someone looking to lose weight and track simple activity metrics such as daily steps taken, to fitness enthusiasts who might combine basic activity tracking with monitoring of heart rate and body mass index (BMI). Sleep and diet activity tracking, both passively collected and self-reported, would fall under this category too.
• Chronic disease management quantified self technology, on the other hand, would be adopted by or, perhaps in the near future, prescribed to, patients with conditions such as COPD, heart disease, diabetes, rheumatoid arthritis, asthma and serious obesity. This is by far the more important category, with implications that extend way beyond personal health to the future of the healthcare, insurance and pharmaceutical industries. Much as drug non-adherence has a devastating impact on health and healthcare costs, soon we may be calculating the spiralling costs associated with non-adherence around quantified self technology.
The more general media outlets covering this category primarily focus on 'wearables', such as biometric sensors, wristbands, clothing and watches. A growing array of wearable biosensors that track oxygen concentration in the blood, respiratory rate, blood glucose, muscle movements and much more are either available or in development. However, not all quantified self technology is worn. Web-connected glucose monitors, BMI scales, asthma inhalers and smartphone apps that measure everything from blood pressure to lung output are not worn but are equally vital entries in this category.
"The key attribute consistent across all of this technology is not wearability but connectivity"
The key attribute consistent across all of this technology is not wearability but connectivity, specifically the ability to have vital biometric and activity data automatically transmitted from these devices to the Internet, where it is stored in the cloud for easy access by the individual with the option of sharing data with family members, select groups of friends, doctors and healthcare provider organisations. We have already seen this in the general health and wellness space with Nike, Fitbit and MyFitnessPal providing community extensions for their devices and mobile apps. But the chronic disease space is where the biggest impact will be realised.
For example, a father with a teenage daughter with diabetes can monitor her blood glucose levels from the office or while travelling for business. A working mother with elderly parents who have various health conditions can monitor their vitals throughout the day. A multiple sclerosis (MS) patient's physician network can monitor how a new treatment is affecting mobility and other metrics without the necessity of multiple visits. A chronic obesity patient's close circle of friends or fellow patients can hold him or her accountable for BMI and required fitness activity in an encouraging, nurturing manner. With just a web connection and permissions for data access, they can pull the data from the cloud onto their smartphones or PCs, giving all stakeholders peace of mind and an early warning system for any potential medical mishaps.
By leveraging this connectivity, it is likely that the future of this space lies in the layering in of a community aspect. Online patient communities will evolve beyond traditional discussion boards to encompass sub-communities of connected device users – those suffering from specific diseases and using the same, or a variety of different, connected devices and mobile applications, where biometric and other self-tracking data is shared with fellow patients. So in addition to basic discussions around disease-related issues, these 'device community' members will serve as active supporters and cheerleaders for each other, supporting and competing with each other around the metrics important to management of a specific disease.
However, an online community of fellow patients using connected devices is just one type of community. The concept can also apply to a family unit, where parents, siblings, sons, daughters and grandchildren monitor and support a sick loved one for everything from proper exercise to medication adherence. It can also apply to a patient's network of healthcare professionals if a patient is lucky enough to have a physician network open to this idea.
In an online community of diabetics who are using US FDA-approved web-connected glucose monitors, each member will willingly share not only their patient profile, opinions and experiences around their condition but also daily/weekly metrics such as blood glucose levels, dietary behaviour, fitness activity and medication adherence. Members can support and encourage those who are actively managing their condition and push those who are not. A leaderboard can display those who are excelling around the key metrics, creating a competitive atmosphere that also serves as encouragement. Leaders would be encouraged to continue their regimens to maintain their positions. Stragglers would be encouraged to climb further up the leaderboard.
"The online community becomes a direct extension of the device"
Similar scenarios can play out in heart disease, obesity and asthma communities with different web-connected devices and metrics. The online community becomes a direct extension of the device. Both are inextricably linked, with the device stimulating community activity, the community stimulating device usage, and both working in conjunction to improve health and save lives.
The device and app alone can work quite well, but there is an historical precedent of people, including those with chronic conditions, not being interested in actively managing their own health. Let's not forget that older technical initiatives such as educational CD-ROMs and nurse-on-call programmes didn't get much traction when they were introduced years ago.
Technology may advance and change, but the same can't be said for human nature. However, adding communities of actual people to the mix – people who share the same condition, close friends and family members who have a loving stake in a person's health and well-being – will cause a transformation in empowered patient disease management.
About the author:
Brian Mondry is VP of Integrated Strategies & Digital Solutions at Kantar Health. For queries regarding this article and the associated research, email him at brian.mondry@kantarhealth.com.
Kantar Health is a global, evidence-based decision support partner to the world's leading pharmaceutical, biotech, device and diagnostic companies. For more information visit: http://www.kantarhealth.com
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