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Empowering Patients is a Robust Strategy no Matter what the Future Brings

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There is an old strategic foresight story that seems relevant for health IT planners today.  In the film Lawrence of Arabia (certainly an age dating reference even if it was before my time) there is a scene where Lawrence and a fellow traveller are in the desert and notice a small dot on the horizon. They do not know what the dot is, and continue to watch and wait. They just stand and stare at the dot, not knowing what to do. Eventually, they recognize the dot as a man riding a camel but they do not recognize his identity, so they continue to wait and stare. They stay fixed on the approaching man but do not know what to do. Lawrence’s companion finally suspects that something is about to go wrong and reaches for his revolver, but before he can lift it, he is shot by the man on the camel. It was too late to react. Had they at least begun to move before the dot got closer, they may have been ready for a greeting or a fight, rather than remaining a stationary target.

At times over the past decade it has felt as though health IT strategy has been stuck in a similar paralysis.  The overwhelming bulk of public investments have focused on implementing clinical systems and connecting them with each other to achieve clinical efficiency rather than patient empowerment.  All while the dots of aging Baby-Boomers, rising rates of chronic disease, and expensive treatments have grown larger on the horizon.

Meanwhile, in what sometimes seems to be a separate and disconnected world, technologies for patient-consumers have been exploding.  Apps for personal health and wellness management and wearable devices to quantify the self are already ubiquitous.  Yet public sector consumer health strategies typically focus on solutions that are out of step in today’s quickly evolving technology world.  One popular solution is tethered patient portals that give patients access to EMR health records.  These have some brief informational utility but limited value for supporting a patient’s self-management or significantly impacting outcomes.

Robust strategies are the ones that will help planners succeed whether the dots on the horizon are friends, foes or something not yet imagined.  One robust strategy for health IT planners is to invest significantly in consumer health tools that enable patients and their communities of support to be better educated about their health and wellness, more able to collaborate with each other and the formal health system, and more motivated to make the changes required to achieve their health and wellness goals.   A second robust strategy in the context of exponential growth of consumer health technologies is to connect all things to the patient and then connect formal health system data to the patient.  More on this in a subsequent blog.