Using Person-Centered Health Analytics to Live Longer: Leveraging Engagement, Behavior Change, and Technology for a Healthy Life

The American way of producing health is failing. It continues to rank very low among developed countries on our most vital need…to live a long and healthy life. Despite the well-intentioned actions on the part of government, life sciences, and technology, the most important resource for achieving our full health potential is ourselves. This book is about how you can do so, and how others can help you. Dwight McNeill introduces person-centered health analytics (pchA) and shows how you can use it to master five everyday behaviors that cause and perpetuate most chronic diseases.   Using Person-Centered Health Analytics to Live Longer combines deep insight, a comprehensive framework, and practical tools for living longer and healthier lives. It offers a clear path forward for both individuals and stakeholders, including providers, payers, health promotion companies, technology innovators, government, and analytics practitioners.

Table of Contents:
Introduction     1 Background     4 Solutions     7     Toolkit for People     7     Opportunities Portfolio for Stakeholders     12      Stakeholders     12     Barriers to Widespread Adoption of pchA     13     Areas of Opportunity     14     Visualize SOPrDiMoCa     14     Design for People     15     Tailor Best Fit     15     Sustain Passively and Actively     16     Discover Alien Intelligence     16     Extend...Don’t Stand Alone     17     Shape Momentum     17     Rework Hackathons     18     Assure Privacy     18 Welcome Aboard     19 PART I:  IMPROVING HEALTH OUTCOMES: THE FUSION OF HEALTH, ENGAGEMENT, DEMOCRACY, TECHNOLOGY, AND BEHAVIOR     21 Chapter 1  It’s About Health Outcomes     25 Health Care’s Veiled Purpose     25     Measuring Health Outcomes     27 The Uneasy Business of Health Outcomes     31     Missed Opportunities     31     New Pressures on the Business and Analytics     34 Occupy Health Care     36     Rebuilding the System     36     Generation Unmoored     37 Taking Off the White Coat     39 Chapter 2  More Prevention, Less Treatment     43 It Has to Be More about Health than Health Care     43     More Prevention, Less Treatment     44     More Upstream, Less Downstream     45     More Socialized, Less Medicalized     46     More Systems Thinking, Less Siloes     49     More People, Less Patients     51 Personal Behavior = 67     51     Chronic Diseases “R” Us     51     Measuring Burden and Risk     53     Learning from Finland (Maybe     56     Let’s Get Back to the 67     57 Everyone’s Eyes on Five Behaviors     58     Five Behaviors and the 20% Rule     58     Whose Responsibility Is It     62     A Culture of Health     62 Chapter 3  Driving Health through Engagement     65 Integrating Our Four Selves in Health     65     Consumer     66     Patient     67     Citizen     68     Customer     69     Our Integrated Self     69 Patient Engagement: What, Why, and Why Not     70     What Is Patient Engagement     71     Why Patient Engagement     72     Why Is Patient Engagement So Rare     73 Making Patient Engagement Work Better     76     What Health Care Organizations Can Do     76     What Patients Should Do     83 Becoming Un-Patient     84 Chapter 4  Forces of Democracy for Health     87 Data Truths     87     Whole Health Catalogue     87     Show Me the Data     88     The Case of 23andMe     90     Am I Lab Worthy     91 Superconsumers     92     A Caveat on Self-Service     94     Redirecting Our Free Time     95     Crossing the Gap     97 Relying on Me...and We     98     Health Social Networks     99     Examples of Health Social Networks     100     Observations     104 Chapter 5  High-Definition (HD) Health Data     105 Overview     105     pchA Data     105     pchA Technical Cornerstones     106     Beyond Personalized Medicine     107 Genomics     108     Consumer Genomics     110     What’s a Person to Do     113 Sensors     114     Not Ubiquitous, but Promising     116     Achieving Results with Sensors     117     Finally...Proof     121 HIT and Health Records     122     Electronic Health Records     123     Challenges     124     Kaiser Permanente     125     Personal Health Records (PHRs     125     Two Best Practices: Blue Button and My Health Manager     127     The Connection between Data Availability and Quality of Care     129 Chapter 6  The BIG Challenge of Behavior Change     131 Paternalism     132 Making Behavioral Changes Happen     134     An Example: CAD     134     Approaches to Behavior Change     135 Comprehensive Modulate Programs     138     Integrative Lifestyle Medicine     138     Stages of Change     139     Trusted Peers     141     Common Features     143 New Wave: Behavioral Economics     144     Connected Devices and Apps     146     Social Networks     147     Gamification     148     Overall: Promise and Pitfalls     149 Analytics to Support Behavioral Change     150     Opportunities/Challenges     151 PART II:  BUILDING THE TOOLKIT FOR PERSON-CENTERED HEALTH ANALYTICS     155 Chapter 7  Getting Started with the Toolkit     159 Driving Directions     160 Knowing Me     160 Protecting Health     160 Minding Illness     161 Managing Data     161 Rules for the Road: A Top-Ten List     162 Chapter 8  Driving Directions     165 The Five Stages of Change     165 Chapter 9  Knowing Me     171 Health Status and Risks     172     Annual Physical Exam     172     Health Risk Assessment (HRAs     174     Well-Being Measurement     177     Genomic Health Risks (Optional     180 Engagement and Self-Care     182     Patient Activation     182     Social Risks     185     Personality     188 Analytics Capabilities     189     Health Literacy     191     eHealth Literacy     192     Digital Competencies     193 Summary of Knowing Me Toolkit     195 Chapter 10  Protecting Health     197 Self-Monitoring     200     Sitting     201     Eating     204     Smoking     206     Drinking     207 Information     208 Summary of Protecting Health Toolkit     210 Chapter 11  Minding Illness     213 Self-Monitoring     216     Diabetes     216     Ischemic Heart Disease     220     Taking Medications     222 Self-Triage and Peer Communities     224     Self-Triage     224     Peer Communities     228 Summary of Minding Illness Toolkit     230 Chapter 12  Managing Data     233 Get Data     234     Portals     236     Services     238     Choosing Providers     241 Store Data     244     What Needs to Be Stored     246     How to Store It     248 Protect Data     251     Computer Hygiene     253     Social Media     254     pchA     255 Summary of Managing Data Toolkit     259 PART III:  STAKEHOLDERS SUPPORTING PERSON-CENTERED HEALTH ANALYTICS     261 Chapter 13  Stakeholders: Influencing the Adoption of pchA     263 Roles of Key Stakeholders     264     Health Care Providers     265     Health Companies     266     Health Insurers     267     Government     268     Technology     269 Working Together     270 Chapter 14  Barriers to Widespread Adoption of pchA     271 Physician Practice     272     Value for the Patient     272     Help or Hinder Practice     273     Organizational Integration and Approval     273 Payment and Cost     274     Reimbursement     275     Payment System     276     Cost     276 Proof     277     Tools Ordered by Doctors     277     Tools That Substitute for Doctors     278     Nonmedical Tools     278     Proof Summary     279 Pleasing the Customer     279     The Fizz in Digital Health Product Development     279     The Fizzle in Consumer Demand     280     From Slick and Click...to Tick and Stick     282     The Job Consumers Are Trying to Do     283 Privacy     284 Obfuscation     284     The Feds Taking Notice     285 Chapter 15  Opportunities for Stakeholders to Advance pchA     287 Visualize SOPrDiMoCa     287 Design for People     289         Understanding the Customer     290 Multiple Methods for Designing for People     290 Tailor Best Fit     291     Learning from Radical Personalization     292     All the Data That’s Fit for Modeling     293 Sustain Passively and Actively     294     Sustain Passively     294     Sustain Actively     295 Discover Alien Intelligence     296     AI Maturity, Finally     296     AI for Health     297 Extend...Don’t Stand Alone     298     Integrated Systems     298     Health Management Programs     299     Medicare and the ACA     300 Shape Momentum     300     Government Actions     301     Multisector Partnerships     302     Profuse Funding     302 Rework Hackathons     303     Hack This     303     Swimming with the Sharks     305 Assure Privacy     306     Regulation     306     Industry Code of Conduct     308 Epilogue     311 Wrapping Up     311 Looking Forward     312 Staying Current     314 References     315 Index     353   How to dramatically improve health outcomes by using data, technology, and behavioral science to empower individuals as agents of change.