Health Data Tracking Needs Coaching, Not Just Athletes
“Increasing the effectiveness of adherence interventions
may have a far greater impact on the health of a population
than any improvement in specific medical treatments.”
— 2003 World Health Organization report
Amid the recent attention and hype around Apple’s HealthKit and the Apple Watch reveal, we should keep the above statement in mind. Let’s also keep it in mind when reading about the Samsung Simband and Google Fit. Tech giants are placing a stake in the health frontier, set to face off for domination of the wearable device, sensor, and data collection industry currently estimated in the $330 million range in the U.S. (I suspect the number is actually much higher).
Marketing for these devices would lead you to believe that just by knowing your cholesterol level, heart rate, calories burned, blood pressure, and other metrics, you naturally become more healthy. While awareness is invaluable, it serves no purpose without the ability to properly act on it.
Wearing an Apple Watch wouldn’t really help Kobe Bryant be a better athlete. Coaches make great athletes successful by optimizing their talent, skills and abilities.
Sure, it requires hard work on the part of the individual, but behind every sports star — or for that matter, any successful professional — there is a teacher, mentor, counselor, coach… someone who established a relationship of regular communication and influence. Someone to teach, track progress and encourage the work and determination required to become successful.
That coach made the difference. Data played a role, but the relationship created the result.
So it is with health, and we need to be thoughtful in how these relationships develop through our technologies now and in the future.
All the data and feedback in the world won’t make someone healthy.
I know — I’ve treated thousands of people over the years facing serious health problems. I’ve seen patients with more tubes than orifices, and more wires attached to them than a power company. We collected A LOT of data. But someone had to distill the data to make a difference.
Today we suffer not from a lack of data, but a lack of adherence.
Apple, Samsung and Google will enable measurement and collection of an enormous amount of data — but that must be turned into contextual information and then, more importantly, action. Action is the essence of adherence.
Something must establish a relationship with the individual and help them not only understand their data, but converse with them and positively influence behaviors. That something will be a virtual health assistant (VHA).
A VHA will be an extension of a physician, nurse, dietitian, physical therapist. It will provide true information exchange, not just data collection. It will respond to emotion and help manage uncertainty, ultimately enabling patient self-management. A VHA will foster healing using proven technology based on decades of behavioral psychology research to motivate patients.
By breaking down desired behaviors into small actions, providing triggers and challenges, tracking and trending, a VHA will encourage the lifestyle changes a patient needs to become healthy. Instead of losing 50 pounds, a VHA will prompt a patient to focus on the first five.
Instead of walking the recommended 150 minutes per week, a VHA will suggest starting with five minutes per day.
But what is a VHA?
A VHA is a conversational interface that uses natural language processing to engage a patient and establish a relationship. Light-years beyond voice recognition, which can type a spoken sentence without knowing what it just typed, a VHA understands the intent of a question or statement and responds appropriately. A VHA learns over time, becoming more adept at not only knowing the domain of medicine and all the questions and concerns of a patient, but also understanding an individual.
A VHA takes all the data collected by devices and builds upon it. It will ask:
● How much energy do you have?
● Can you concentrate on your work?
● How did you sleep? Do you feel refreshed?
● How stressed do you feel? What concerns do you have?
● You walked 6,000 steps yesterday, would you like to set a new goal for today?
● Do you want me to set a reminder for your midday medication?
● Did you take all doses of your medication today?
● Are you having any side effects?
● Are you not taking your medicine for financial reasons?
…basically, a VHA will figure out why a patient is not adhering to their treatment plan.
A VHA will understand responses and engage a patient to address these issues, motivating them to take action or notify their caregiver.
A VHA will refill a prescription and schedule a flu shot. It will remind a patient about their need for a dental checkup, mammogram, or physical. It will give daily nutritional advice, suggest restaurants that match dietary needs, track the distance walked or run, among many other actions.
And perhaps even more important, just like a coach or even a mother would, it will ask: “What is the most pressing question you have today about your condition, your health, your medication?”
Even if the VHA doesn’t know the answer immediately, just knowing the major concerns of thousands of patients can offer great insight into understanding the needs of a population, in addition to the individual.
Adherence means more than just taking medication. Adherence means improving overall health, which requires a dialogue and ultimately, behavioral change.
But without a relationship there is no influence, and it takes influence to create adherence. A VHA will develop the relationship!
It will also track virtually everything, including the sensors and apps on a smartphone, incorporating all social and personal data available into the overall data set.
Yes, Google, Apple and Samsung are developing amazing medical applications and are on the cutting edge of a health revolution — but these devices must be integrated with the natural language conversational interface of a VHA for the real fun to begin!
