By Dennis Robbins
Chief Clinical and Business Intelligence Officer
Today’s literature is filled with articles reminding us how unhealthy lifestyles are making us sicker. Technology is held out as a potential panacea to help us out of this quagmire. While I trust that technology can make a huge difference, if we truly wish to improve the life of the person, a multifaceted approach employing diverse yet complementary devices and solutions is optimal.
For example, a device monitoring A1C's for diabetes, while important, becomes even more powerful when that information can be seamlessly leveraged for improvement by engaging and activating the person towards a healthier life and lifestyle. We will never achieve that by becoming a patient. Patients are passive, wounded, sick, vulnerable, subservient and on unequal footing. Yet we label patients as non-adherent, non-compliant, and non-accountable. If the patient is passive why would we expect them to be anything else? As a patient, things are “done to me.” Accountability compliance and adherence are all passive demands made by others yet only I as an active agent can make a difference.
It is the “person” not the patient who can change but only when they find something to be sufficiently meaningful to stimulate, promote or sustain change. The central pivot or regulating fulcrum is the degree of meaning and value to the person. That is the foundation for true and effective engagement, activation and positive change. Each person is different; it is not a one size fits all enterprise. In fact, despite the most sophisticated trends, robust metrics, and past experience we are frequently surprised if not astonished by disparities regarding what we thought someone wanted and what they really wanted. Furthermore, no one knows the person better than the person him/or herself. Each of us knows our hot buttons as what is truly most important and meaningful to us.
Perhaps the very agnosticism of devices and technologies that impose no attitudes or admonishments makes them so attractive. They can inform us, warn us, and help us achieve meaningful goals. Augmenting artificial intelligence technology in the form of avatars such as that employed by the Spokane based company NEXT IT or virtual coaching and supportive technologies of NOOM out of NYC and various forms of behavioral economics based nudging can be a great source of knowledge, guidance, support and inspiration. These can help shape the value equation for the person, essentially, what value or meaning a person assigns to a bit of information that motivates him/or to take that extra step towards positive outcomes. It is of utmost importance to be sure that we design for the goal at hand and make it achievable and not daunting or overwhelming. Moreover, we must take care and be vigilant to clearly articulate the value equation and the reminder that small changes can make huge differences.
The fact the technology and devices are agnostic with no attitude is quite attractive. They just tell me what I need to know to help shape my decision-making and help me define an action plan.
They don't force me to become passive, subservient, or helpless rather, they serve as the substrate or foundation for decision-making and behavioral change. It is ultimately me who must choose and change for the better. It’s not about my relinquishing my control or responsibility to someone external or alien to me. And I do whatever I do as a freethinking person consistent with my personal choices, values and preferences. I can choose to be a vanguard or victim since I am the only one ultimately who can make a difference in my life and future.
Thus, if we can only make and activate changes in our lives as persons, then empowering the person through information, technologies, devices. support systems, and mobile solutions is a great way to initiate the process of behavioral change that is self-directed, self-driven and personally meaningful. Patients don’t change, take ownership or self-determine their futures and destinies; people do! The prescription for health centers on meaningful changes in behavior in concert with person-centric solutions. Person-centricity™ moves beyond models of consumer/patient empowerment, centeredness, engagement, and activation, and is reflective of how individuals make decisions within the broader context of their lives. This fresh paradigm accounts for the complexity and comprehensiveness of who we are and what we can become.
The relationship between the notion of person-centricity and the transition from healthcare to health is symbiotic and functions both as the missing link and the common thread that weaves together the needs, choices and aspirations of people throughout their health and lives. This shift is critical and a necessary part of every aspect of our transition from healthcare to health and to bending the sickness curve to better curb and control avoidable costs, promote and sustain health while reducing unwanted lifestyle-related diseases and illnesses.
Dennis Robbins is prominent health care steward, innovator, thought leader, entrepreneur and health activist. and is Chief Clinical and Business Intelligence Officer at KPN in Dallas and an advisor to Sanovas in the San Francisco Bay area.