Patient engagement on a smartphone

Technology forum

Imagine playing a game where you track down clues and data and have to make key decisions to stop a threatening disease outbreak. Now imagine that the strategies you devise could actually help patients and health professionals in the real world.

The first part of that scenario has been possible since February, when CDC released Solve the Outbreak, an iPad app that lets users play detectives like those in the agency’s prestigious Epidemic Intelligence Service, popularized by Kate Winslet’s character in the 2011 movie Contagion. The app (www.cdc.gov/features/solvetheoutbreak/) challenges users to resolve public health outbreaks based on real events.

What about the second half of that hypothetical? Could scientists and gamers come together to solve problems while also contributing to strategies for future real-life situations? That is exactly what Jane McGonigal, game designer and Director of Games Research and Development at the Institute for the Future, strives for in her work. In McGonigal’s world, gamers from across the globe collaborate on real issues, such as depression, chronic pain, and anxiety.

Pharmacists on the frontlines, especially in community pharmacies, unknowingly gather rich troves of data seldom used outside of conversations with patients. Can we use our patient interactions to help improve the quality of care by communicating our valuable insights back to patients, other providers, and the rest of the health care system? Perhaps pharmacists, too, can harness our power through apps that engage patients and create a truly patient-centered approach to treatment and care.

Patient-driven change

In today’s world of widespread smartphone apps, patients are looking to their phones for simple, easy ways to manage their chronic conditions. Brett Shamosh, who has ulcerative colitis, decided to merge his digital media skills with his desire to improve his quality of life, creating a means for tracking his own symptoms and providing this information to health care providers in a concise, comprehensible format.

The result was GI Monitor, an app designed to help patients suffering from gastrointestinal illnesses. Shamosh partnered with a former colleague and gathered input from stakeholders, including physicians and researchers, to develop the program. It began as a simple digital diary for patients but became a more developed platform providing feedback on patients’ progress.

Patient-reported outcomes

The passage of the Affordable Care Act, changes in payment models, and an increased focus on quality improvement have led to the emergence of patient engagement for health plans and institutions. To improve quality of care while reducing costs in the U.S. health care system, patients will need to become actively involved in their care.

Pharmacists know that many patients are not proactive in their care and do not know what questions to ask or information to relay to health care providers. As a result, both patients and providers are often in the dark about key factors affecting patient treatment options and quality of life. A self-described “terrible patient,” Shamosh told Pharmacy Today that he never realized that his treatment was almost entirely dictated by what he told his physician.

Part of the impetus behind GI Monitor was Shamosh’s belief that existing clinical indices for disease activity and quality of life could be improved. “Today’s patient ODLs [observations of daily living] are being collected and analyzed in real time,” he told Today. “What can be learned from this data, especially when married to objective clinical data, could change the course of human health and wellness. And that excites me.”

Shamosh predicted that what we know of diseases and how they affect quality of life and adverse effects may change drastically over the next 5 years because of patient-reported outcomes. The key will be getting patients to report these data and change their behaviors.

Capturing pharmacist–patient interactions

Shamosh may not be a pharmacist, but he is a consumer and a patient—just like all pharmacists. Pharmacists have a unique advantage when it comes to gathering patient information. With medication adherence in the limelight, pharmacists can partner with developers, IT professionals, and other health care providers to create of tools that engage patients, optimize medication use, and improve adherence.

Pharmacists should leverage their unique relationships with patients to provide insights in building health IT tools, including smartphone apps, and in developing innovative ways to use existing technology to help patients.