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Should You Encourage Your Patients to Explore "The Quantified Self?

By Craig Mellow for America's Backbone Weekly
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In 2007 San Francisco-based Wired magazine writer Gary Wolf coined the term "quantified self" to encompass the emerging technologies that enabled individuals to monitor various states of physiology and behavior in real time. The field has gathered momentum since the smartphone revolution with an increasing wealth of wearable devices and mobile apps available to track everything from asthma to REM sleep to heart-rate and blood-sugar levels.

The quantified self's potential for improving health care is obvious, or at least should be so to any health entrepreneur. Instead of a patient laboriously recording blood pressure or insulin levels on paper, then reviewing them with a physician during monthly or semi-annual check-ups, a transmitting sensor can now, or soon will be able to, feed continuous data streams, which can be correlated with related factors like altitude or when the patient ate his/her last meal. "Over the next few years, vast new pools of data will create amazing new possibilities for both patients and care providers," raves enthusiast John Haughom, MD, writing on The Health Care Blog

A study by consultants Frost & Sullivan predicts that 27 million consumers in North America will have bought a wearable data device by the end of this year, and most of those will be used to monitor bodily function in one way or another.

"Quantified-self facilitates the tracking of diet, sleep, heart rate, activity, exercise, and moods and allows individuals to gain better insights on physiological parameters that were never examined earlier," writes Sumit Kumar Pal, the senior analyst on the study.

Yet all that knowledge will not automatically translate to the power to keep patients healthier with less hassle and cost, other experts warn. Silicon Valley ? from start-ups like Fitbit and Jawbone to giants like Apple ? may be sprinting ahead with ingenious new ways to generate and manipulate live health information. But small business medical professionals, already stretched to digest a world of clinical and business innovation, may struggle for practical ways to make use of it all.

"Many physicians are still challenged on how best to respond to patients who arrive in their office with a list of symptoms and a stack of 'research' they have downloaded from Dr. Google, let alone a USB flash drive of data downloaded from their running shoes," observes Joseph Coughlin, director of MIT's AgeLab, writing in the Huffington Post.

Patricia Brennan, director of the Robert Wood Johnson Foundation's Project HealthDesign, lists five thorny, unanswered questions about the quantified self from a practitioner's point of view, from "How will all this data be received and stored?" to "How will clinicians be compensated for reviewing the data?" She concludes: "Technology is the easy part ? institutional policies are hard to change, and clinicians' time is precious."

Not that these skeptics advise physicians to turn their backs on the quantified self altogether. Brennan offers some salient guidelines on avoiding a "data tsunami" and establishing manageable information protocols jointly with patients. Successful strategies back away from entirely passive collection of data via "a USB drive on the running shoes," instead engaging patients to track symptoms but share them continuously with the caregiver via a simple tablet- or phone-based interface, she writes.

The most promising pilot programs using the quantified self all have two factors in common according to Brennan: highly motivated patient populations and user-friendly technology designed to meet their specific needs. One study outfitted parents of "very high-risk babies" with a "fussy-ometer" to chart disturbed interludes and diaper-based sensors to monitor fluid levels. These data points were downloaded to a smart phone to create a seamless, and if necessary interactive, picture of key infant indicators. Other projects have brought sufferers from asthma to Crohn's disease into a new information environment using quantified self technology.

Coughlin of MIT underlines another, so-far embryonic element of quantified self-style innovations: their potential to integrate with video gaming technology to change the emotional nature of medical care from dreaded to entertaining. "The real potential of the quantified self movement is to bring fun, friends, and even fashion to health," he writes. He contrasts this with the leaps in financial information that have revolutionized bank and portfolio statements around the world, but not by and large made it financially healthier. "Few have been able to make financial planning fun," he observes. Will health care have any better luck?

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Craig Mellow is a freelance journalist in New York City, specializing in financialmarkets and energy.
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