The Role Of Big Data In Personalizing The Healthcare Experience: Mobile

This article was written in collaboration with Ellen M. Martin and Tobi Skotnes. Dr. Feldman delivered a webinar on this topic on September 18, 2013 and spoke about it at the Strata Rx conference.

Sensors, games, and social networking all create change in health and fitness

Cheaper, faster, better technology is enabling nearly one in four people around the world to connect with each other anytime, anywhere, as online social networks have changed the way we live, work and play. In healthcare, the data generated by mobile phones and sensors can give us new information about ourselves, extend the reach of our healers and help to accelerate a societal shift towards greater personal engagement in healthcare.

Mobile, Gamification and Sensors

A wealth of intersecting movements (Figure 1) intertwine to create this shift.

Figure 1. Major factors in mobile health

Mobile is increasingly ubiquitous. With 6.8 billion mobile subscriptions worldwidw, access anytime, anywhere through smart gadgets is now putting cheap and connected, mobile computing power in the hands of millions of consumers and healthcare practitioners.

Gaming is popular too: 121.3 million Americans (Figure 2) play mobile games at least occasionally. Now health apps are using games to improve health and wellness. Gaming elements are bringing deeper engagement, to improve compliance and make managing chronic conditions and complicated regimens easier.

Figure 2. One hundred twenty million Americans now play mobile games

Sensors–accelerometers, location detection, wireless connectivity and cameras–offer another big step towards closing the feedback loop in personalized medicine. There is no more personal data than on-the-body or in-the-body sensors such as those pictured in Figure 3. Sensors used to be exclusive to the laboratory (polysomnography) or hospital (EEG, EKG). Now, body area network applications can be used not only for fitness/wellness, but also to identify, diagnose and manage acute and chronic disease.

Figure 3. Popular fitness and medical sensors

Online social networks (such as Facebook, Twitter, and other social media apps), which offer peer-to-peer support, are another useful tool enabling this societal shift in healthcare. Nearly a quarter, 23%, of people with chronic illnesses, go online to find others with related conditions.

We see online social tools as a means to gather motivation and support health-related activities, similar in concept to Weight Watchers and Alcoholics Anonymous. As we all know, changing routines is hard. For some of us, adding the support of online social networks may help nudge our behaviors in a more positive direction.

Bigger Picture: Who Cares and Why?

In terms of Big Data, mobile health is a new frontier, contributing new streams of data such as behavioral, biometric, and environmental in real time.  Combining these new data streams with EMR/ EHR data and giving patients/consumers access may enable us to make better-informed decisions and lead healthier lifestyles.

Mobile is extending the reach of our healers: healthcare providers, fitness coaches, and other supporters. Providers are in desperate need of better educational tools to improve efficiency and lower costs. Physical therapists, fitness coaches, home aides, occupational therapists, discharge planners, doctors, nurses, public health and other health educators are all interested in employing new ways to help patients understand their diseases and take better care of themselves.

Mobile health is enabling experimentation across the disease spectrum

Today there are over 96,000 health apps for mobile phones that use sensors, social networking, and gaming to improve health. This explosion includes mobile fitness tracking, support networks, and brain games. Part of the app explosion can be credited to the government, celebrity endorsements, and the growth of corporate wellness plans, such as Keas, Redbrick Health, Limeade, and ShapeUp, which are encouraging Americans to improve their health.

In chronic disease, according to a Misfit graphic, mobile health apps could help over 124 million people with hypertension, 105 million obese adults, 21 million people with sleep apnea, 79 million pre-diabetics, and 81 million adults with cardiovascular disease.
The data generated by body sensors and mobile phones can provide a rich new source of insights for patients, providers, and researchers. With their online social communities, companies such as Patients Like Me are using their data to support not only their members, but also new research initiatives in multiple sclerosis and other diseases.

Active and passive data collection can provide new insights into human behavior.

In behavioral health:

• Ginger.io, using passive data collection, is developing algorithms that detect when behavior patterns are abnormal, initially to help people better cope with depression.
• OneHealth, using active data collection, is gathering real-time behavioral data that may help us better understand how to cope with multiple conditions such as addiction, obesity and diabetes.

In cognitive health and wellness:

• Lumosity’s database of 40 million users through the Human Cognition Project is looking for correlations between lifestyle, age and cognitive performance.
• Brain Resource is using its 20 year-old standardized brain database to better understand brain health, wellness and disease.
• Lark is using the world’s largest sleep database to tweak its automated coaching algorithm to better address the needs of its customers.
• AchieveMint, a motivation tool, is aggregating health data from apps as well as data from other components of the social graph. The goal is to make customized health suggestions similar to what we now get on Amazon for books or Zappos for shoes.

Just as developers and providers try to better fit the treatment to the patient, patients are increasingly likely to be engaged and involved in their own care. Furthermore, an increasing number of healthy people are taking proactive personal responsibility for their own fitness and preventive care. Mobile health tools are enabling us to take better care of ourselves to accelerate a wider adoption of healthier lifestyles and preventive care.

This article was first published in O'Reilly's Strata and it is reprinted here under the terms of the Creative Commons license.