Wednesday, May 04, 2011

Evidence-based Medicine gives way to Evidence-based Health but what we need is Evidence-based Choices via #mHealth

Dr. Pauline Chen writes a great article in the Health Section of the New York Times: "When Doctor's Advice Is Ignored At Home. "  I read this immediately after reading a LinkedIn Innovations In Health Group Post that asked the question: "What is the future of telehealth? Do you think the initial cost justifies potential future savings?"

I added my own thoughts to Korstiaan's question:

Mark Scrimshire • I am seeing fascinating developments in body-worn and proximity sensors. When these are introduced in to the TeleHealth/mHealth portfolio there is a massive opportunity to deliver a great return on Investment for both families and health systems. The ROI will occur in two principal areas: 

- Hospital Re-admissions: Equipping a discharged patient with a device to enable remote assessment and feedback can help patients and care givers to comply with their care instructions. 

- Aging In Place: As the population ages there will be a growing demand for tools and solutions that help seniors stay independent. This will allow family caregivers to monitor a senior remotely without being intrusive. This should prove to be very attractive to families if it puts off the day when a senior either moves in to their home, or moves to an assisted living community. 

The caveat to all this is that the solutions being developed have to be consumer centric, easy to use or better still invisible in use. 

Health Care needs to learn lessons from companies like Apple. The iPod was a transformative device. Not because it was using new technologies but because it packaged hardware and software together in an innovative way that was easy for consumers to use.

My thoughts then turned to Pauline's article and the issue of the breakdown of Evidence-based Medicine and the emergence of Evidence-based Health. From my perspective the limited success of Evidence-based Medicine is not surprising. The re-focusing towards Evidence-based Health is logical and appears to yield more successful.

However, It is still not enough. I believe that we won't see real success from Evidence-based practices until we actually include the patient in the Evidence loop. We need to move towards a practice of what I call "Evidence-based Choices."

The idea behind Evidence-based Medicine was to provide doctors and other medical professionals the data that would lead to improvements in the practice of medicine. That is an admirable goal but it only goes part of the way to the solution. Real progress comes from engaging the Patient in the loop.

Successful medicine is accomplished WITH the patient, not TO the patient.

The Evidence-based Health Initiative puts medical professionals in to the community to help remove barriers to good care for the patient. But with Primary Care Doctors becoming a scarce commodity we need to develop new practices. We need to leverage the potential of mHealth to put tools, devices and sensors in to the reach of patients and present information in a simple, concise manner that can influence real-life choices that lead to better care for patients. This is the true potential of mHealth - Evidence-based Choices.

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