Technology in the Patients' Hands




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Mar 17, 2017
by Oscar Tollast
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Technology in the Patients' Hands

Fellows consider the relationship between transparency and technology and how it can aid the patient-clinician relationship  Participants of Session 553 Toward a Shared Culture of Health contributing during a plenary session

Developments in technology afford new methods of treatment, new methods of recording data, and new methods to share information with more people than ever before. With that in mind, participants at Salzburg Global’s session on Toward a Shared Culture of Health: Enriching and Charting the Patient-Clinician Relationship, have been asking themselves how this technology can be better used. Technology can be used to empower patients, physicians and other health professionals. The question is how to make this technology work for all invested parties in the patient-clinician relationship.

In the past few days at Schloss Leopoldskron, participants have considered how patients have recorded their medical data as a form of empowerment, and as a method of seeking positive change through better treatment. They’ve also heard from speakers who have looked at the relationship between technology and transparency. These talks have been designed to enable fruitful thinking as to how create and enable new ways of recording a patient’s journey.

Make health care easy

On Monday morning, participants heard about what could occur if the right tools were placed in the right hands. The speaker behind the talk outlined the future of health lies in the optimum use of technology for primary health. In his presentation, he promoted the view that a multidisciplinary expertise could enable a comprehensive understanding of the needs of the health care system.

After describing health care as “one of the most stress inducing topics,” the speaker highlighted work taking place in India to make the patient treatment workflow better. He cited work taking place at Mohalla Clinics. In between April and December 2016, 110 clinics in Delhi treated 1.5 million people. The clinics are praised for treating minor ailments outside hospitals, which in turn free up doctors to focus on complicated diseases and surgeries. The speaker said these clinics provided a paperless clinic workflow, where the average time for patients end to end hovered around four minutes. Participants heard the clinics were easy to use, accessible, instant, and patients were co-designers of health.

The clinic is an example of a greater push in how the future of primary health care can be reimagined. The speaker suggested there was existing technology in place which could be used to a better advantage. He said, “It’s time for us to reformulate the role of the local clinic.”

Ending his presentation, he outlined four points: make health care easy; share data but have mediators to help patients understand it; get data automatically; and address human needs through community contact, as well as personal contact.

In response to this presentation, one participant outlined activities which were already in practice in the US. In one area, something similar to DNA biobanking is taking place except the data being used is people’s past and present social media posts. Around 5,000 patients have agreed to this, which allows them to “passively” contribute to their medical records just by going about their day-to-day lives. The participant said that because personal behaviors are digital and more accessible, patient engagement now means something entirely different.

Good over evil

This talk was followed by a presentation on learning from patients. Prior to starting, the speaker said the theme of the conference was “good over evil.” He highlighted presentations participants had heard from on Sunday to highlight the role of the patient. The end game is improving the way people work together, respect and honor, and the use of technology. As much as people want a good relationship with their clinician, the speaker said they would also like effective treatment and to be in a better situation.

The speaker referred to the “kingdom of research,” a land where “subjects” exist under the rule of a sovereign (researcher). In scenarios like this, the subject often doesn’t receive results, doesn’t feel part of the team, and doesn’t receive thanks.The speaker said he didn’t like using the word “patient.” Rather than learning from patients, he said he prefers learning with people, suggesting each party brings something new to the table to be considered. While citing related research, the speaker suggested patients should be seen as partners to achieve better results, not just participants. He later elaborated on this, suggesting nothing should be

hidden behind people’s backs. Participants heard legislation in the US allows people the right to information but there is a need for tools to make that information more accessible. He advocated for technology in medicine to be highly “permission-based.” This presentation drew several responses. Participants said most people were happy to give over their data, but the challenge was to inform people.

Let health care help patients help themselves

On Sunday, participants learned about one participant with Parkinson’s disease. She explained how she increased “feel-well time” as a result of self-tracking. The patient used this data to see progress or changes, rather than relying on one hour a year with a doctor. The data collected led to a change in her prescribed medication. She called for health care to help patients help themselves, and proposed the idea of a “lead patient,” who patients are encouraged to become. In the presentation which followed, the

speaker spoke about herself and her son dealing with separate illnesses. She shared how health care quantifies both her and her son, tracking changes over years, and medications needed. She suggested many doctors tend to attribute symptoms to generalized demographics, rather than treat cases individually. As a carer of her son, she was treated as an enemy, not an ally. She said patients can help other patients through peer support, and this form of support can actually give more help and strength than what doctors provide.

The Salzburg Global program Toward a Shared Culture of Health: Enriching and Charting the Patient-Clinician Relationship is part of the multi-year series Health and Health Care Innovation in the 21st Century. The session is being supported by OpenNotes. More information on the session can be found here: You can follow all the discussions on Twitter by following the hashtag #SGShealth