The Race Is On: To the victor go the spoils (of 21st century medicine)

In the past, the medical profession was aware of groundbreaking technologies and applications well in advance of patients. Their first experience with EKG’s and genetic testing was mediated by their doctor from the beginning. Today however, patients can get their hands on mountains of genetic data through the mail at the price of a fancy meal. As these tools are made ever cheaper and more sophisticated, as inexpensive and inobtrusive devices are networked with smartphones and mobile health apps, and as patients increasingly adopt these tools in an effort to define themselves as empowered members of the doctor-patient relationship, the traditional medical world will be trying to catch-up. Today’s doctors will have to learn how to adopt these advances into their practice on their own, and it’s hard to think of a better time to start than now. The challenge of a patient armed with a dossier of Google searches pales in comparison to an empowered patient who has the motivation and time to enlist several features of 21^st century medicine: direct-to-consumer genomics, mobile health apps, personalized medicine, social media tools, personalized health records, and more.

While the current medical education curriculum still labors under an educationally conservative structure, medical students might paradoxically see great opportunity. Today’s medical students are largely digital natives who, importantly, have not been shaped by what has been described as a bygone era of medicine. They are uniquely suited to learning about these breakthroughs, experimenting with the devices and tools, and innovating their application. In the teaching hospital, the medical student can familiarize his or her superiors with the tools while gaining insight into effective uses. Thereafter, medical graduates so informed would be highly sought after to shape the clinical and commercial future of these initiatives. There is a wealth of opportunities for the student who buys a BodyMedia armband and talks about it with clinical faculty while on the wards, or, by comparing their experiences interviewing patients in the clinic with the dialog at PatientsLikeMe.com, becomes proficient at distinguishing what patients want to know from what is helpful to know. Precisely because medical schools struggle to incorporate this material into a curriculum means that students who take the initiative to become proficient in 21^st century medicine stand to be particularly valuable to many stakeholders in the healthcare field.

Why the FitBit is FanTastic.

                                                                                            Photo: www.FitBit.com

Being healthier means a lot of different things, but one commonality to almost any health improvement is that, at some point, it will be hurt a little to run a mile, forego an ice cream, or down some cabbage. And that's why the FitBit is the best health tracking tool there is:

It's painless.

You put this tiny clip on your person and then forget it's there. It can go a week between charges, all the while recording your steps and calculating your total calories burned. And when you're within 15 feet of your computer, it uploads your data wirelessly (provided the hub is attached by USB). And. That's. It.

Even the fee schedule for the fitbit is painless. The device costs $100, and the basic web analytics are free--if you want, you can upgrade to more web features for a fee. Again, painless.* I've been using it for 7 months and haven't had a day go unmeasured.

This is a point too easily lost: people don't necessarily want more features, they want less pain. (David Pogue engagingly demonstrates this truth here.) The makers of health apps and health games and tracking tools and health devices need to understand that most people want less tasks to do, and less to think about, rather than more. (See my post about apportioning our cognitive resources.)

Bells and whistles often become work, and living healthy is already a full time job.

*Compare FitBit to the BodyMedia armband. It's accuracy is unparalleled, and it's able to measure your calories burned even while watching TV and sleeping. The web profile is flashy, and there's a great smartphone app that enables you to watch your data in real time. And... it's a little painful. 

The armband is bulky (how do you wear it at work?), you have to take it off and physically plug it into your computer every day, and there's an unavoidable monthly fee. It's painful.

Note: I have no affiliation with FitBit and no axe to grind with BodyMedia. 

Dirk Nowitzki gave me mad props today, and it was awesome.

My Nike+GPS app had a message for me at the end of my run today, and it was from Dirk Nowitzki: "Hey, this is Dirk Nowitzki, and I just wanted to give you mad props for making it out there today."

I couldn't be much more of a cynic, and I HATE patronizing flattery, and what could be more baldly obvious than that a corporate behemoth was shamelessly using a celebrity to make me feel good about buying and using its products? By all rights, I should be sick.

But if I don't get bummed some canned words of encouragement at the end of a run, I'm a little bummed.

The tiny fraction I know about Dirk NowitzkiI is that he's well regarded as a dedicated player and a stand-up guy. When I imagine Mr. Nowitzki sitting in a sound booth somewhere recording his stock accolades, I'm pretty sure he is, in no small degree, genuinely happy for me. I bet he's happy to be encouraging legions of minor athletes out there, and genuinely wants us to keep at it. And it works.

Imagine if it was stock commentary from my doctor?

Getting Played: 3 design thoughts for improving buy-in for mobile health apps.

Just because it's a game doesn't mean it's fun.* With angry birds, you simply fire up the app and start poking at the screen, but in health games you have to do something you'd rather not- eat a vegetable or run a mile or climb some stairs. To overcome this....

It would be simple.
In any game, there's a gap between input of time, energy, and focus, and the output of points earned, leveling up, or saving the princess. While some games thrive on a wide gap that's filled with a rich story line, engaging graphics, or intricate maneuvers, my health app would have a strict minimum of futzing around. This is because, by the time I reach for the health app icon, I've already crossed much of my gap, and I'm ready for my reward. Now.

It would be social.
Yes, social is all the rage, and rightly so. A less obvious feature of the value of social is that it enables healthy people to encourage close friends and family to be healthy, without precipitating an intervention. Motivating loved ones to eat better and exercise is tricky if you don't want to bring anxiety, guilt, and tension into a relationship. A social game is a perfect way for healthy people to casually encourage others, as well to stay motivated themselves.

It would include your doctor.
A family doc I worked with had some success with his own personal diet brochure. It was especially successful because he had personally lost much weight with it. What if he could point patients to a social game app that he himself played too? Consider the ramifications: The doctor's advice about eating better and exercising doesn't end at the office door. The app is good branding for the physician's practice. Buy-in soars because the virtual presence of patients' doctor connects healthy lifestyle choices with significant disease. Hospitals can adopt it as well, and there are lots of hospitals with lots of money. Local businesses can support it too by advertising their healthy offerings of food, gyms, or exercise equipment. I dare say this is only scratching the surface....

*Check out Jane McGonigal's TEDTalk on solving problems, including obesity, with games.