“Patients + Providers + Technology = Engagement” (Guest post by Patti Brennan)

Patti Brennan

Patricia Flatley Brennan, PhD, RN, PhD – University of Wisconsin Madison, School of Engineering

This is a real pleasure – a guest post by Patti Brennan (@PattiFBrennan), one of the people I admire most in the world of improving healthcare through patient engagement. I first met her through Project HealthDesign, one of the best programs sponsored by the Robert Wood Johnson Foundation: “Rethinking the Power and Potential of Personal Health Records.” I’ve also shared a panel or two with her at industry events – not nearly enough to suit me, though. :-)

Last year Project HealthDesign completed. One of its key subject areas was “ODLs” – observations of daily living. Here she explains the idea and lists some exemplary work she’s seen.

This guest post (I added some boldfacing) is long overdue – I’m just too busy for my own good sometimes! Thanks for this honor, Patti.


Patients + Providers + Technology = Engagement

There’s a growing group of patient advocates, people like Hugo Campos or ‘our own’ Dave deBronkart (e-Patient Dave), who are calling for patients to be active and equal partners in their health—and that’s a goal that as a nurse I wholeheartedly support. At Project HealthDesign, we have worked to encourage two-way conversations between patients and clinicians, with both parties held in equal status. Clinicians are the trained experts in health care, but patients are the experts in their own lives and their own bodies. We believe that when both parties work together, more can be done to improve health care than either can do alone.

The key to forging these relationships and creating successful partnerships between patients and providers is technology.

Over the past seven years, 14 teams supported by the Robert Wood Johnson Foundation’s Project HealthDesign demonstrated that mobile technology can be used to help both patients and providers work together to better manage health and more effectively treat illness. Our grantee teams found that when patients tracked personally relevant observations of daily living (ODLs) through mobile devices and shared that information with providers, they were often able to meet their goals such as lose weight, decrease the frequency of asthma attacks, reduce fatigue, pain or discomfort from Crohn’s disease, and remember to take medications on time.

These observations of daily living—data that are recorded by people, based on health information that is personally relevant and important to them–can provide powerful insight into a person’s life and health. The recordings can shed light on issues such as mood, weight gain or loss, energy level, sleep patterns, etc. They can be any item that the patient deems as important to them and to their health. Tracking and sharing these ODLs with clinicians can yield insight into patterns that would be impossible to discern otherwise, and directly involves the patient in the process.

During our project, each grantee team implemented a unique approach to tracking ODLs, using existing technology wherever possible. The iN Touch team, for example, developed an iPod Touch mobile application for low-income teens and young adults who were dealing with obesity. The dwellSense team developed in-home sensors to monitor performance of everyday activities as a way to detect cognitive decline in elderly populations, while the BreathEasy group used a mobile application that gathered ODLs from patients with asthma and populated a web-based dashboard for clinicians to view.

Not only did patient-to-provider communication increase during this project, but one group of patients used the technology during their appointments to share the data collected by the app with their clinicians nearly one third of the time. The data allowed patients to track and share ever-changing information with their clinicians, while the technology helped to create a personal narrative describing their health.

Technology is the key. It flips the visit—precious visit time with clinicians can be used to discuss and plan around individual’s health and health care. The time is taken to understand one’s own health in everyday living to make better choices about health and self-management. Technology allows patients and clinicians together to monitor trends in symptoms, which in turn helps both of them to make more informed decisions. It’s through technology that patient engagement can thrive.

To learn more about observations of daily living as a unique expression of patient engagement and how you can be a more active participant in your care, visit projecthealthdesign.org, or view any of the resources available on the e-Patient Dave site.

Patricia Flatley Brennan, PhD, RN, is the national program director of Project HealthDesigna groundbreaking national program of the Robert Wood Johnson Foundation’s Pioneer Portfolio, designed to spark innovation in personal health technology.


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