I have no problem with concentrating on wellness.
Melissa Yuan-Innes


First of all, thank you for being an emergency physician. I hold a special place in my heart for those who work in EMS and the ED. Early in my career I occasionally worked in the ED (not as an attending) and it takes a certain kind of person to thrive there and the work brings such tremendous value to the community.

Thank you as well for your thoughtful response. I think we are mostly on the same page here; I would not want anyone to know the ins and outs of all of my activities unless I grant them access and had to ability to revoke it at any time. This is why the consent controls that could be enabled through blockchain technology are keys component of “health record” management.

One thing you mention that I will respectively disagree with is the following. One of the rubber-meets-the-road problems with understanding how daily behaviors affect health is that even when someone really wants to gather the data it is hard to track some of these mundane things and it’s human nature to selectively track what is perceived as “good behavior” over “bad behavior.” I myself tried, for two weeks, to track all of my food intake and even with a firm mental commitment to do so it was not easy. This can be a huge barrier to even starting the process of improving health (as opposed to becoming unsick) mediated through a physician. I see the convenience factor of being able to opt into some level of automated tracking is a big, big deal. These technologies are on the horizon and I could see it as ubiquitous as cell phone ownership (maybe even tools to do so will be enabled through some kind of phone integration in the near future). The ability to track always, opt in/out as desired, and possibly have a physician give a patient some low-cost tracking hardware will come sooner than people think. It seem to me a natural extension of telemedicine and the savings of getting it right earlier in a disease progression should outweigh the cost of the tech.

Money and convenience — as the money moves to disease avoidance and shared risk between the players in healthcare, wellness has an opportunity if looking into one’s life is convenient enough that people are willing to opt in.

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