It is that time of year in New England when we prepare for winter. Various activities such as caulking windows, checking insulation, and servicing heating systems predominate in home owners’ conciousness. I can’t help but think what it was like 300+ years ago when the original settlers from England arrived. For a long while, heating a home meant lighting a fire in the fireplace. Until the late 1800s and the invention of the thermostat, a device that is exquisitely sensitive to changes in ambient temperature, heating a home was a very haphazard process.
Fast forward to 2010 and there are countless innovations that provide ambient reminders to prompt the homeowner to engage in a different way with the electricity and heat in the home and maximize energy efficiency. Today’s consumer has incentive to be more energy efficient both because there is great public hew and cry about our dwindling energy resources and because there is a direct economic benefit to conserving energy.
In healthcare, by analogy, we haven’t made it to our equivalent of 1883 and the invention of the thermostat. Consider that the treatment of hypertension is still determined based on readings done in the doctor’s office a couple of times a year. Yet, we can now easily measure ambulatory blood pressure and get a much more rich picture of what is going on, but we persist in this 19th century style of care management. There are many other examples.
Connected health can become like the thermostat in the management of chronic illness. The patient measures relevant physiologic information on an ongoing basis and feeds it into the cloud, usually wirelessly. Based either on software rules or a provider’s analysis, feedback is given to the patient electronically, thus completing the thermostat analogy.
So one can easily conclude that we have much to learn in healthcare from energy science and application.
However, the reverse is also true. The peddlers of smart sensors for the home are naïve if they assume everyone is equally motivated to maximize their energy savings. From our work in connected health, we can predict that there will be a wide range of interest — from those who micro manage their energy consumption to the disintersted individual who turns the heat up in mid January so he can wear shorts and a tee shirt around the house.
Our work in connected health has shown that engagement with measured information about oneself is variable and unpredictable. On the one hand, we have the ‘quantified selfers’ who are forever measuring data about their health, reporting it out and adjusting lifestyle to be more healthy – very thermostat like. On the other, we have patients that we’ve cared for at our Center who are completely disinterested in measuring and learning from biometric information, regardless of how much their doctor recommends it or how much their health will benefit. In fact we’ve started a quest to understand and predict these various personality types.
I’d be willing to bet that if I can learn whether you are interested enough in your daily step count to meaure it, set a goal and achieve it, you’ll also be likely to put those smart energy sensors all over your house and track your power utilization fastidiously. Likewise, if I can’t engage you in a coversation about tracking your blood pressure to help avoid heart attacks and strokes down the line, you’ll likely be disinterested in better managing your energy consumption as well.
If we are to truly maximize the use of technology to manage personal information and motivate behavior, we must better understand who are the most likely to adopt these tools. At the Center, we are looking at ways to identify those groups of patients — accounting for such factors as age, health status and social environment — who will embrace connected health solutions to better manage their health and wellness.