Category Archives: e-patient

A Doubtful Solution

Guest post by Nicholas Brown


For someone interested in healthcare, I was completely unaware of the true affect of

digital health on this field. As a matter of fact, I knew nothing of it. Surely, when a rash broke out

on my skin I turned to Google for answers and compared my rash to those I saw on Google

Images. Luckily, it wasn’t psoriasis. After my sisters got their wisdom teeth pulled, I did enough

WebMD and WikiHow searches to become a self-proclaimed expert on their treatment. New

gauze needed? I was ready. Without knowing its full effect, I was involved in these efforts of

digital health.

For me, the intersections of healthcare and technological advances of our current

society is amazing, yet paradoxical. Companies churn out and develop new systems and

machines that have capabilities to de-humanize surgery in the coming future. Nevertheless,

there is a clear and long lag. Hospitals are still very far behind the quick changes of healthcare

technology. Physicians and healthcare workers are further behind, and patients even further.

Between each step comes massive barriers and obstacles that decelerates the system.

Many Americans do not have the same experience I have with the changes within the

healthcare industry, and the most interesting thoughts and questions relating to class have

explored the effect of technology on different sections of the population. For low-income

Americans who have smartphones, but limited access to internet and cautious trust, there are

barriers of scarcity to overcome. For elderly, digital efforts must compensate for slower

understanding and lack of use amidst a fast-moving progression. For those with chronic

conditions, who find that pretty devices, but devices that are not wearable. These are massive


How can digital and technological advancements help solve these major issues while

they continue and create new problems? This is a question I continue to ask myself during

lecture and during project research. For me, I see it as another vicious cycle within our society,

and in an important field that many people trust. I guess that makes my perspective pessimistic

view. I think it realistic. Communication is a lost art within healthcare, and although digital

technology and social networks can alleviate that, the barriers they impose prevent

communication from a large portion of potential stakeholders.

The way we are approaching healthcare now, with several sides all walking with different

paces, looking at different pages, and following different missions, is conducive to moving

forward, but not to sustain connections between parts. Sewn patches make a quilt. Well

currently, I think the we see several patches, separate sections that we try to puzzle together; a

doubtful solution. The genuine solution comes when we find a way to sew the patches together.

ePatient Benefits for the Unconvinced Physician

When discussing ePatients, we’ve mostly talked about the patient perspective – how an individual can become more empowered, educated, electronics savvy, etc. – but what about the physicians?

Well, in interacting with ePatients, of course the physician themselves may also learn information they hadn’t known, learn to empathize more with the individuals, and even gain some tech skills in the process. These all sound great, but sometimes when a doctor is over worked and just plain tired from life, I’m sure the last thing they are thinking of is how to learn how to use a new app a patient has just brought in.

The culture of passive medicine is in part carried out by physicians’ attitudes towards such patients. Of course, if your patient is compliant to everything you say and doesn’t question any of your prescriptions or treatment notes – you’re life as a physician isn’t too difficult because everything is a one-way conversation. But with the incorporation of ePatients – the physician has to work to build that two-way relationship, which not all physicians are willing to do.

So for those physicians unconvinced by the new ePatient movement – how about a very concrete and quantifiable benefit? EPatients can help you make money.

Now this sounds a bit crude. Money should not be the core of medicine, but sometimes it is and to some people it is. And in this sense, ePatients can bring in money for physicians by increasing physician referrals.

It has been shown that referrals are most effective through word of mouth. If a previous patient likes the way you work, then you get a referral. It’s just that simple.

Now how do ePatients factor in? Well, if you think about the grand scheme of things, creating an ePatient means a closer relationship formed by the physician and patient by methods of direct and indirect communication. This communication should ideally make the patient feel more secure and welcome in the portion of the healthcare system you have introduced them to. So simply (and idealistically) speaking, you put in effort to be a more engaged doctor in the patient’s life and treatment plan, and eventually they will like you and get you referrals.

Now, all doctors should communicate with their patients because medicine is not just about the biological treatment, but the social and psychological treatment as well. Social aspects of physician-patient interactions can go a long way. But – if you are still not into this ePatient thing – then maybe take into account how the ePatient movement can factor into your business plan. Is it a little more appealing now?

Promoting Patient-Centric Adherence: Emerging mHealth Technologies

Last night we had our final Medical Media Arts Lab presentations—a bittersweet culmination of all of the hard work we as a class have put forth throughout the semester. My group finally had the opportunity to present a detailed plan and accompanying visuals detailing our mobile app solution for improving patient-doctor communication regarding shared treatment plans for Type II diabetics. Professionals in the audience gave us some very valuable feedback and suggestions, which, should the project continue, would greatly improve our existing design and the user experience. Our app focuses on improving patient adherence by creating shared treatment plans that take both the patient and doctor’s needs into consideration. To enhance our design, it was suggested that we add a reward component that provides positive feedback to patients who follow their treatment plans, as well as include an avenue for patients to socialize in an effort to increase motivation and accountability. I assumed that these were components our team would need to develop; however, it turns out that mHealth startups have already started to explore these possibilities, both within the context of diabetes, and for chronic and other health conditions in general.

I came across these emerging businesses on the mHealth News website, outlined in an article entitled “Startups bolster adherence via social networking, mobile apps.” Ayogo and Get Real Health “offer a care coordination platform and mobile application, respectively, that seek to improve on…abysmal adherence statistics.” I was particularly interested in Ayogo, which utilizes a health behavior change and gamification platform called GoodLife to establish meaningful social interactions between patients, patients and their family members, and patients and their doctors around their health condition.


The platform also utilizes psychological triggers and secondary applications to personalize the user experience. The specific mobile app used by Ayogo is called Empower, which “helps patients who are newly diagnosed with a chronic condition to take control of their treatment.” The app organizes the patient’s treatment plan into a ‘health habit curriculum’ that uses behavior change principles, self-reporting, social interactions, and a rewards system to encourage adherent patient behavior.

Screen Shot 2014-04-25 at 1.32.59 AM

The app tries not only to engage patients in their prescribed treatment plans, but also to actually establish new habits in the patient’s daily life by having them complete small activities or games each day that both facilitate the patient-reward system, but also help the program tailor to the patients’ needs. By actively engaging patients with the app through games, rewards, and social features, Empower, and more broadly Ayogo, helps patients improve adherence to their treatment plans.

Screen Shot 2014-04-25 at 1.35.23 AM

It seems that the only missing component is the facilitation of real-time patient-doctor communication about the treatment plan. This app offers what to me seems like a brilliant, innovative proposal to a problem common across nearly all chronic health conditions; however, our development offers that extra, crucial component addressing the in-person patient-doctor encounter. As we move forward, app developers should remain open to learning and growing from the work of other startups. Mobile health is a rapidly growing field that offers much opportunity for profit and competition. However, let us not lose sight of the key stakeholder—the patient. As the race for the next innovation commences, we need to make sure that all possibilities are considered, collaboration is encouraged, and innovation is allowed to reach its full potential.

Sleep Profile Followup

The sleep profile quiz, if you’re interested!


The Risk That Comes With Too Many Choices

It’s hard to believe that there were no health apps over a decade ago and now new apps are being created everyday, with thousands being created every year. When researching diabetes-tracking applications for our project, I searched diabetes in the iTunes App store and I was given 968 results. When faced with so many choices, we often become overwhelmed and don’t make smart decisions. Barry Schwartz, author of the “Paradox of Choice” summarizes the risk that comes with too many choices by saying:

            “When people have no choice, life is almost unbearable. As the number of available choices increases…the autonomy, control, and liberation this variety brings are powerful and positive. But as the number of choices keeps growing, negative aspects of having a multitude of options begin to appear. As the number of choices grows further, the negatives escalate until we become overloaded. At this point, choice no longer liberates, but debilitates.”




When making a decision on which app to download, we end up relying on information given to us on app reviews or by the price of the app and while this information is useful, it can often be misleading. While an app might be expensive, it perhaps would better suit the users needs than the free app. And while one app works for someone else, every patient has different treatment plans and goals. In the worst scenario, the user becomes so overwhelmed that they don’t end up downloading an app at all. Here are some tips for making a informed decision when choosing an app:

  • Ask your doctor- Although not all physicians will know of useful applications, a physician that is familiar with treating patients with diabetes will probably have heard positive reviews of certain apps. Also, since your physician is familiar with your treatment plan, they will be better able to recommend an app suited to you then some random guest review on iTunes. Also, as the use of health apps becomes more common, physicians are becoming more aware of the variety of apps out there. One diabetes treatment app (BlueStar) even requires a prescription from your doctor!
  • Don’t solely focus on price- While it is often our natural inclination to download the free app, the one that costs $1.99 might be ten times better. This isn’t to say that price is correlated with quality of app, just try to focus on the features of the app instead of the price (as long as the price is reasonable).
  • Focus on the features most important to you- We can be tempted to download an app that offers the most features, but this type of app is often hard to navigate and confusing. Depending on your condition, choose the top three features you want in an app. For example, some diabetes patients want an extensive nutrition tracking feature while others are not interested in this feature. Once you narrow down your priority features, choosing an app will become easier.

Even though making a choice may be difficult, most of the health apps on the market will enable you to take better control of your health and will end up making it easier to manage your condition.


Get every new post delivered to your Inbox

Join other followers: