Wellocracy is coming!

By Joseph C. Kvedar
12:00 AM

After working at this remote patient monitoring game for about 10 years now, we are ready to bring self-care to consumers  -  couch potatoes, weekend warriors and all of us in between hoping to live a little healthier, lose a few pounds or just feel a little better.  Meet Wellocracy.

The goal of Wellocracy is at once simple and daunting  -  to get America moving, and to motivate our citizens to move to a healthier state. It turns out that the formula is straightforward:  a) track your activity, b) find your individual set of motivational tools and c) find ways to increase your activity without disrupting your life.

But let's take a quick look at how we got here. In the early days of remote monitoring, we thought the big value add would be giving a doctor or nurse a more rich data stream about your vital signs and this would enable her to make better just-in-time decisions about your care plan. Turns out, we were right. The best example of this is the 50 percent reduction in hospital readmissions we've seen by employing home telemonitoring for our heart failure patients.

But the biggest insight that I've gained in my 18+ years of working in connected health came when some of our earliest patients on that same telemonitoring program began to significantly improve their self-care. We noticed that they used their daily monitoring results (weight, blood pressure, heart rate) as a numeric yardstick for their progress, enabling them to better understand the basic pathophysiology of congestive heart failure. They began to realize that salt intake leads to fluid retention and if your heart is weak, a buildup of fluid in the lungs can be quite dangerous. As a result, they started being much more fastidious about salt and fluid balance.

As we observed this phenomenon, we broke it down into two sets of factors we could study: the use of objective data in feedback loops and the use of motivational psychology to help our patients strive to keep those data in the right range. In most cases, the motivational tool was a phone call from one of our telemonitoring nurses (highlighting our partnership with Partners HealthCare at Home). One lovable and amusing quote from a patient comes to mind: "I can't eat fudge because I can't fudge my data."

Another profound, reproducible finding over the years has been the attachment patients feel for these home-monitoring devices.  Patients almost universally plead not to be taken off a remote monitoring program. This led us to the observation that self-tracking is contagious or in Internet parlance, 'sticky.' Most people enjoy seeing how their lifestyle affects some sort of number. Self-tracking keeps health top of mind and can keep people motivated.

A sneak peak into Wellocracy...

I thought for years that if there was some way to bring this insight, this stickiness into the homes of regular folks that we would see a corresponding improvement in health and wellness in the population at large. As the quantified-self movement caught on to self-tracking and the deluge of self-tracking devices and apps that is now available came on the market, the conditions improved even further.

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