In a post a couple of weeks ago (Part I), I talked about the participatory nature of the internet and related platforms. OK, I agree that “Web 2.0″ is already becoming a somewhat empty concept, as some of my colleagues have noted on this very site. No matter your opinion of that catchphrase, the point is that many commercial proponents of Web 2.0 have become aware of e-Patients. Here is an example.


A couple years ago a group of technology companies formed a collaboration called Continua Health Alliance. The stated mission is “ Fostering independence through establishing a system of interoperable personal telehealth solutions that empower people and organizations to better manage health and wellness.” The participants in this alliance include giants like Cisco and Intel but also Polar, Tanita and other companies that make personal health and training devices. A full list can be found here. The members of the alliance are working together to help create technical standards so that data can be easily exchanged. But the driver behind this initiative is somewhat unique: that individuals (e-patients?) will pay out of pocket for gadgets and gizmos that can be used to improve their health and collaborate with their doctors. Over time, as the value of these devices and the behaviors they engender become evident, the hope is that payers will finally join in.

A good example of this business strategy comes from the related world of sports and fitness. The health value of staying fit is pretty obvious. Unfortunately, jobs that allow for daily, strenuous physical activity became pretty scarce decades ago. In response, people started jogging, cycling and engaging in other sports. Health clubs appeared to fill a year round need, and to offer a variety of exercise options. Formal studies of the benefits of exercise followed, and today, some health insurers actually support and pay for health club membership. Thus, out of pocket payments by early adopters powered the development of a service that is on the verge of becoming mainstream health care for all. Part of the hope at Continua Health Alliance, as I understand it, is that a similar process may promote new health electronics and networking. Why not use that heart rate monitor that you bought to train for the marathon to also engage your cardiologist? And, what about that new scale that also measures your body fat content? Can it talk to the heart monitor and compare notes on the internet, combine data and display it for you and your health professionals? In the next few years, a whole collection of sports and fitness gadgets will be available to monitor your physiology and an era of networked health and fitness will begin. Runners may share heart rate data, body fat content, even glucose and other blood chemistry data with each other, and with their “team doctor(s)”.

While the fitness enthusiast may make up one part of this market, another sector has already been identified. They are caregivers of those who are infirm. In this age of smaller families and increased mobility, the care of the elderly and cognitively challenged has become increasingly difficult. We turn to institutions earlier than ever before. Can technology help us live independently, longer and better? This market has already been opened with the cry “I’ve fallen and can’t get up”. But, home monitors that help the elderly when disaster strikes are only the tip of this iceberg. With the Internet as the common platform, there are remote devices that can remind you that you’ve forgotten to take your medication and scales can monitor your fluid accumulation and help manage your congestive heart failure. Imagine display devices in the home that can be used to present orienting reminders and visual cues to someone with early Alzheimer’s disease. A network of sensors could also allow concerned family members to know that an aging parent is safe at home. If she became confused and left the home unexpectedly, a neighbor who may be part of the extended caregiver network could be alerted to help. All of these are also under active development by one or a combination of companies joining in the Continua Alliance.

Monitors for fitness and sensors that can extend independent living require communications and data standards if they are to be useful. I admit there is a “big brother” component to these products and privacy and respect for autonomy must be considered as they develop. Nevertheless, these developments will lead to some very exciting opportunities for e-patients. But, one thing is certain, as in many of the examples offered by Tom Ferguson, e-Patients will use these products in innovative and unexpected ways.

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