Person Centered Analytics for Health.

In my previous blog, Who Am I…for Health’s Sake, I suggested that we are possessed by different selves that behave in unique ways as we navigate healthcare and our health future.  These distinct selves include that of consumer, patient, citizen and customer.  Each of the four selves is well intentioned but does not live up to its potential to improve health.  They fragment our attention, limit our power, put their own needs above the rest, and derail us from taking control of our own health destiny.  In order to achieve our optimal health potential, we must be, in the words of cummings, “nobody but ourselves” and fight against the forces all around us to “make you everybody else.”

This blogs outlines a way forward that that informs, supports, and strengthens people to improve their health through analytics.

The emerging reality is that the American way of producing health is failing because of its fixation on health care, its denial that people are the active ingredient for change, and its slow uptake of technologies. The new reality is that prevention is more important than treatment, behavior change is the reliable pathway to improved outcomes, and information technologies are shifting power to people to become the primary agents of change. 

It’s about health, stupid!

There is greater appreciation that the health of Americans, ranked the lowest among wealthy nations on most measures, will not improve by spending more on health care.  Compelling evidence on the determinants of health show that personal behavior is most important in reducing premature mortality.  In fact it is about three times as important as health care.  Breakthroughs in health will happen by attending to what is obvious to prevent chronic illnesses…diet, exercise, weight, smoking and doing what the doctor says…rather than through advances in new research and clinical care.  But what is obvious has not been easy.

The science of behavior change is improving…dramatically

People need to change their behavior to achieve better health, but our track record has not been good.  We are “just human” and do not always do the rational thing, can be lazy, have other priorities, stick with our habits, and want to fit in.  And despite the best intentions of those who care for us, including providers, payers, and policy makers, we have not cracked the code.  Until now.

Behavioral economics is all the rage.  It puts together what we know about social psychology and economics to come up with powerful solutions that are working.  It digs deep into what drives behavior change and intervenes at key points.  For example, it understands that people have biases for maintaining the status quo, for the present rather than the future, and about “loss aversion”.  It knows that we have difficulty evaluating risk because we exaggerate small probabilities, we respond to positive rewards that are frequent and fun and that sometimes play on regret, and we tend to follow through with things if we make a contract to do so.   Marketers know these things and use it in advertising to make us to buy things.  It’s time for people and their advocates to embrace these tools to improve health.

Technologies put people in control

People are making more decisions for themselves rather than relying on experts because there is more information available, translated just for them, and constantly available through devices such as smartphones.  People do their banking, airline reservations, and stock trading on their own, 24/7, and they can do the same in managing their own health.  In the near future they will be aided by passive sensors that will monitor their health and have their own Siri-like advisor formulate their daily health agenda.  People stay engaged, supported, and challenged through social media and depend on the wisdom of their peers for product reviews rather than relying on marketers.  And the expanding availability of information and its democratization provide a personal analytics platform for behavior change that is more people centric, self-managed, and delivered outside of the usual healthcare structures in the living room, over the phone, and at the coffee shop.

Know me and work with me…or get lost

As the integrated self takes more control of behaviors to improve health, it will need support, but of a different kind.  People will expect everything to be customized to their needs.  They will demand accountability for products and services to work.  They will be an active participant in key decisions.  And with the convergent forces of a new priority on health outcomes and a focus on behavior change, along with enabling behavior sciences and information technologies, they will assume a central and responsible role to improve their health future.  

Stay tuned for my forthcoming book, Person Centered Analytics for Health .