Today's Wired Digital Patient


Thanks to innovative mobile technology and the prevalence of broadband networks, patients are investing in their own healthcare more than ever before. From searching for a physician online to tracking fitness activities via wearable technology— patients are embracing mHealth and technologies that will help improve their well-being. In fact, the number of adults using smartphones to monitor their health grew to 75 million in 2012 — a number expected to more than triple by the end of 2018! However, as more and more patients get active through mHealth technology, security should remain top of mind for providers. According to EHR Intelligence, security was the #1 concern among individuals, so ensuring the connection, transmission and protection of patient data is imperative.


We are now at the point where it is possible to measure almost every component of human physiology and many elements of behavior. But just having data from disparate devices and apps does not alone translate to better health and prevention or improved management of disease. The data and analytics need to connect with clinical endeavors to be translated into knowledge and actionable information.

But the virtues of the digital age are not always aligned with those of psychotherapy. It takes time to change behavior and alleviate emotional pain, and for many patients constant access is more harmful than helpful. These days, as never before, therapists are struggling to recalibrate their approach to patients living in a wired world.

For some, the new technology is clearly a boon. Let’s say you have the common anxiety disorder social phobia. You avoid speaking up in class or at work, fearful you’ll embarrass yourself, and the prospect of going to a party inspires dread. You will do anything to avoid social interactions.You see a therapist who sensibly recommends cognitive-behavioral therapy, which will challenge your dysfunctional thoughts about how people see you and as a result lower your social anxiety. You find that this treatment involves a fair amount of homework. You typically have to keep a written log of your thoughts and feelings to examine them. And since you see your therapist weekly, most of the work is done on your own.

Are you struggling with major depression? Digital technology may soon have something for you, too. Depressed patients are usually lacking in motivation and pleasure; an app easily could lead patients through the day with chores and activities, like having a therapist in one’s pocket. Not just that, but the app might ask you to rate depressive symptoms like sleep, energy, appetite, sex drive and concentration in real time, so that when you next visit your psychiatrist, you can present a more accurate picture of your clinical status without having to worry about your recall.

In 2018, the data dots are starting to be connected at meaningful scale, particularly as incentives in healthcare become more aligned towards "value based care", rewarding prevention, proactive care and improved outcomes. The internet of things is rapidly coming to the "internet of the body and healthcare". With it comes the promise of leveraging these diverse mobile and connected technologies beyond common health and fitness applications to make them truly impactful for the prevention and management of acute and chronic disease, and to further bring healthcare outside of the walls of a hospital.

We are moving beyond simple wrist-based accelerometers. Smart watches regularly capture heart rate, and soon may add cuffless continuous blood pressure monitoring and glucose measures. Disposable vital-sign patches can transmit streaming ECG, posture, temperature, stress data and more. Integrated home diagnostic "medical Tricorder" platforms and connected pill bottles are coming to market. These will be paired with Amazon Echo and Your.MD and similar healthcare chatbots as interfaces. Mental health can be discerned from analyzing our speech and the "digital exhaust" from our smartphones. Breath can be analyzed for more than alcohol, to track hydration status and molecules that can indicate a metabolic or malignant disease. Sensors in our beds can readily track the quantity and quality of sleep.

Digital technology has the potential to either enhance or confound therapy, but much depends on the patient and the condition being treated. Some patients will find that the glowing screen only feeds their psychopathology. Others will find digital technology a boon to self-esteem and assertiveness. We are only beginning to figure out which patients are which. 

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