Electronic Health and the Non-Digerati

Everytime we discuss something innovative and interesting to do with our lives, my friend comes up with yet another app or game we should design and market via the App Stores and live richly and happily forever. And I, true to my vaguely creative pursuits, always state that not every problem has a solution rooted in IT or mobile phones or the next iThingamajig. While this is a strange admission to make on a blog that is titled “EMR Thoughts”, bear with me. For example, there are entire classes of problems that IT cannot solve – such as whether the water in a village well is potable, or ensuring that there is enough food for a growing world populace, our collective Farmville skills notwithstanding.

Today I was reading John Moore’s report of the recent SFO Health2Con, where I felt he addressed a health version of the same discussion my friend and I have. More on that later. First the reviews.

Moore says:
– the Health2Con demos sported cleaner interfaces, better UI,
– had more realistic business models (fewer free/Freemium models).

On the not-so-great news side:
– mobile health is cheap and the “it” technology of the moment but Moore doesn’t think anyone’s figured out how to use it,
– demos rarely give enough detail to be instructive,
– And if he cannot deal with any more demos that call for gamification or Facebookization as a way to approach health (I hear him)

Then about midway through the post, he made a comment that made me sit up and take note:

“[Health IT Vendors] want to make a difference. That passion is contagious. Unfortunately, that passion appears to be confined to the digerati [digital literati]

Maybe the most disturbing part of the event was the on-stage interview with a mother of eight kids (she was white, middle age and clearly upper middle class) showing how her family is tapped into the quantified self movement with the various Apps they use to track their health and fitness. This is not representative of the broad swath of the American populace who are the ones that will drive our healthcare system off the proverbial cliff. It is that grandmother in Indiana who is caring for her diabetic, overweight husband, two grandchildren, a daughter suffering from an addiction and a son-in-law who is unemployed and has no health insurance that we need to talk to, have up on stage to tell us what they need to better manage their health and interaction with the healthcare system.”

Another post on iHealthbeat clearly examines the motivations behind our health IT thrust.

EMRs/EHRs will make healthcare efficient and reduce costs. Engaged, empowered patients will take charge of their own health and again bring down health costs. These are some assumptions we hold to be true.

The problem with these assumptions that they don’t take into account the non-IT savvy grandmother problem. How do we reach her and others like her? A particularly trenchant comment from commenter Kim Slocum on iHealthBeat says:

We know that half the US population consumes essentially all the nation’s health care resources.

I’m guessing that a large proportion of high car(sic) utilizers are also off-line and currently unreachable via this medium (e.g. dual eligibles and substantial fraction of the Medicare population). If that’s true, a lot of the “Health 2.0” buzz is misguided if it is thought to be a vehicle to bend the cost curve via “consumer engagement.”

Something to think about. John Moore’s post is here, and the iHealthbeat post is here.

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Priya Ramachandran

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

   

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