TEDMED Breakaway Forum 2013 Talk

The Patient Portal Conundrum Ashwin Ram, PhD, Innovation Fellow

"Software is eating the world. Over the next 10 years, I expect many more industries to be disrupted by software. Healthcare and education are next up for fundamental software-based transformation.”

—Marc Andreessen, WSJ Essay

[email protected]

PARC | Ashwin Ram | 1

The Business of Breakthroughs®

laser printing Ethernet PC workstation Alto

WYSIWYG, GUI

corporate ethnography

multi-beam laser diodes

ubiquitous computing

collaborative filtering

AI/ model-based systems

content-centric networking

socio-cognitive computing cleantech printed & flexible

electronics content-centric

networking incorporated 2002

founded 1970


“What people say

Margaret Mead

what people do and what people say they do are entirely different things.”

New models for business

Human behavior and context

Leading technology

and know-how

Breakthroughs aren’t (just) about technology


Healthcare Crisis Obesity Rates


Where’s the problem?


The healthcare challenge of our generation: Chronic conditions

7 out of 10 deaths among Americans each year are from chronic diseases Source: CDC

More than 75% of health care costs are due to chronic conditions Source: CDC

Employers’ spending on health coverage for workers rose 9% in 2011, tripling the growth in 2010 Source: Kaiser Family Foundation and the Health Research & Educational Trust


Opportunity

50% of factors related to personal health are due to lifestyle.*

Sources: *CDC **Hartman PARC | Ashwin Ram | 7

68% of adults are actively trying to prevent at least 1 major chronic illness.**

Well People

(68% adults)

Personal Lifestyle

(food, exercise)

Active Prevention

(behavior change)

How do people get healthcare info?


Healthcare Information

Internet is the leading source of health and wellness information.


“Meaningful Use”

Stage 1 • EHR

Stage 2 • Portals

Stickiness • Quality of Care


Health 1.0 à Health 2.0


A recent survey from health-care research firm National Research found that 96% of the nearly 23,000 consumers it surveyed use Facebook to gather information about health care, with 28% using YouTube and 22% using Twitter. Hospitals, health-care providers and private insurers also are seeing social media as a tool to engage consumers.

NPR Marketplace calls it “the biggest threat to healthcare portals like WebMD”.

The Patient Portal Conundrum

Stage 1 • EHR

Stage 2 • Portals

Stickiness • Quality of Care

Engagement?


Healthcare Goes Social

relevant info

game rewards

social graph

“Behavior is social. When someone loses weight, quits smoking, or increases exercise, the people in their trusted social network are 34% more likely to do so.”

—Dr. N. Christakis, Harvard School of Medicine

72% of consumers rely on the Internet for health information 100s of millions of consumers interact and share health experiences online 100s of hospitals use social media 1000s of health communities $100M investment in gamification of health

People require health information that is timely, relevant, reliable, and easy to understand.

— Picker Institute Europe

Con

sum

eris

m


Tren

ds


“The consumer is the CEO of their own health.”


“Meaningful Use”, revisited

Information

Engagement

Behavior Change


Stage 1: EHR

Stage 2: Portals

Stage 3: Quality

Concept


A team social network with personal coach to engage consumers and change behaviors… …to improve health outcomes and reduce healthcare costs… …at scale (millions of people).

personal model

mobile coach

social team

Sensors + Analytics + Context + Social

Data aggregation

Goal setting

Personalized Coaching

Social support

Source: Healthrageous.com

= sustainable engagement and behavioral change


Why Mobile?

For the first time in history… more smartphones and tablets will be sold than PCs worldwide Source: Deloitte Canada, 2011

A smartphone in 2011 has as much compute power as a laptop in 2001 Source: C. Arthur, Guardian UK, 2011


Why Social? (Christakis & Fowler, 2009)

•  Entire clusters quit in concert

•  25% more likely to quit if your sibling quit

•  67% more likely to quit if your spouse quit

•  34% more likely to quit if your co-worker quit

•  36% more likely to quit if your friend quits


Improved Outcomes & Lifestyle Adoption

Achievable Goals

Fun

Peer Support

In The Moment

Easy, Natural

Proper Goal Setting

Social Sciences Ethnography

Underlying Science


Goal

Outcome-goal Behavior-goal

Food-goal Activity-goal Lose 40 lbs

Path-goal

Duration-goal Eat breakfast Every day

Exercise 5 days/week for 5 weeks

(+H <habit-name> goal: <what it achieves> cues: <location, time, people,

preceding-action, thoughts/mood> knowledge: <relevant knowledge/ability> actions: <behavior-spec>)

(+H-parameters <habit-name> difficulty: δ expectancy: <P> cost: <C> successes: s failures: f)

(BG <goal-name> supergoal: <super> subgoals: <subs> habits: <habits> spec: <what it achieves> duration: <over what period>)

log(odds(success(Habiti ,Personj )))

= match(c, j)c∑ + θikwjk + rikwjk

k∑ +α log(t) + vf s fi

f∑ + pf s fi

f∑

k∑

f (θi,w j ,ρij ) = θ0ρij +θi1wi1 ++θiTwjT

Consumer Engagement

Social Network

Just-In-Time Information

Personalization

Behavior Change

Gamification

Platform

Modeling & Analytics Platform

Decision Support

Cognitive Modeling

Social Analytics

Semantic Analysis

Behavior Modeling

Monitoring Platform

Context/Activity

Web/Social Network

Ethnography/Field Studies


Wellness Application


fittle.org

Team social network with personal coach to engage consumers and change behaviors…

Vision

Consumer •  Engagement

Relevant Information •  Behavior Change

Dashboard Dashboard

Ethnography Analytics/Social Media Context/Activity Tracking

Company Portal

Provider Portal

Modeling & Analytics Platform

Food / Nutrition

Alternative Medicine

Medicine / Supplements

Exercise / Activity

Apps

Wellness Drivers

PARC Competitive Edge


Contact

linkedin.com/in/ashwinram

www.parc.com/ashwinram


[email protected]

TEDMED Breakaway Forum 2013 Talk

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