Role of Technology in Preventative Healthcare - Insights from REAN Webinar

The REAN Foundation recently hosted a webinar to discuss the Role of Technology in Preventative Healthcare. We were joined by Patrick Dunn, Program Director at the Center for Health Technology and Innovation at the American Heart Association and Anil Joshi, Founder and CEO of IntelliH along with Sri Vasireddy, Founder and CEO the REAN Foundation, who are also working on creating a mobile technology platform to help people to manage their health at home.

The panel discussed how healthcare technology is being used to prevent and reduce the emergence of diseases while helping to identify risk factors to detect and control the illness before it spreads. The focus of the discussion was to understand how technology could help promote good behaviors and limit or eliminate bad behaviors. Good behavior could also include taking medication, avoiding tobacco use or controlling the urge to overeat.

Que 1: What is preventative medicine? Why is it in focus now?

As the old saying goes - An ounce of prevention is much better than a pound of cure. So, we are trying to reach this goal from the public health and population health perspective. Making people aware of good behavior to prevent diseases that could promote health. Adopting these behavioral changes can bring about a big change in our lives that can help communities on a large scale.

As everyone is looking for value-based care that improves the outcomes for the patients, thereby resulting in less hospitalizations and lesser number of ER visits; an element of prevention and early intervention can help attain that goal.

Que 2: What is the role of technology in preventative healthcare?

Healthcare has always been rooted in technology and innovation, from developing an electrocardiogram to researching a new vaccine to discovering new imaging technology. With the internet and the ability to reach more people outside of the healthcare setting adds a lot of promise. There are a lot of people around the world that don't have access to the same type of healthcare services and technology has the ability to improve access of basic healthcare to populations in remote areas.

Another very important aspect of prevention is education. If you don't have the knowledge, you lack the understanding of how a particular behaviour impacts your health in short and long term. Technology bridges that gap and provides a way to educate and also provides a way for patients and community members to connect and share your challenges.

Que 3: How is the technology adapting to focus on the preventative side of healthcare?

Technology is the key to personalize the information and make it easy enough to send into the hands of the common man. It is essential to share educational insights as easy and useful tips, without complicating the content to ensure better adoption. There are many gadgets available now that help in monitoring vitals ranging from blood pressure, blood oxygen saturation level and heart rate as well as help in detecting medical emergencies like seizures or falls. All this data can be easily tracked daily that is much more effective than going for a yearly checkup with the doctor as it allows us to monitor our bodies every day and act on the information swiftly, avoiding any delays that might cost us our health.

Que 4: What is the continuum of prevention-primordial prevention to tertiary prevention

There are different forms of prevention. Primordial Prevention involves managing our personal risk factors. For example, to prevent a heart attack, we need to control our blood pressure. It starts early in life and helps to eliminate personal health risk factors by adopting healthy habits. The next level is Primary Prevention involves preventing risk factors like avoiding tobacco and keeping optimum level of cholesterol.

Secondary prevention comes into play when you need to manage the existing risk factors after they occur. It involves treating your blood pressure, treating your diabetes or cholesterol. The primordial prevention applies to adoption of a wider scope of preventive habits to manage your health.

Que 5: Please share the basics of how medicine and technology can work together.

It is difficult to disseminate information in a way that people can understand, coming from a trusted source and that is designed to achieve overall health impact. Though most information is available on the internet, how does one know what's a good and what's not? A trusted source like the American Heart Association along with our technology partners is trying to achieve positive outcomes with advanced, far-reaching research and measuring evidence.

We go by life's simple seven - these are seven factors that are well-documented and related directly to cardiovascular health. So there's three that are in the behavior categories, the physical activity, nutrition and tobacco cessation, and then four that are basically biometrics i.e. weight, blood pressure, cholesterol, and glucose, which leads can lead to diabetes. Another important factor that needs to be addressed is the mental health of the individual, which involves not just if they have any depression or anxiety, but their level of engagement and motivation, their ability to, to adopt behavior change. The mental health aspect is embedded into all seven of the other categories.

Que 6: What medical conditions/risk factors can be detected and prevented through technology as highlighted in various studies?

The technology is focused on scale and precision. For example, the ability that allows the doctors to monitor blood pressure of thousand patients using a common dashboard and planning what kind of medication is most optimal for a given patient as well as planning its dosage combination of medicine. This becomes much easier and precise if data is available on a daily basis.

In another use case, a robot goes from room to room in patient's home, take the readings, and the physicians can actually have a telehealth call with the patient if they see some unusual readings coming from that particular patient.

Que 7: What is the level of acceptance and adoption from the patients? What do they think about these innovative solutions?

A lot of people think that technology is kind of going to take away the personal touch, but it can also be generous with the personal touch, the interaction with the patients. And that's a fascinating point. Technological interventions make medical care available to a low resource setting where people may not be able to pay to travel far or afford a doctor’s visit. Technology provides free, low fidelity, easily accessible solutions for activities like medication management, wider management, symptom management, nutrition management, physical activity management, and mental stress management.

Que 8: How does open source technology improve the access for the global population?

Some use cases that we are working on include: 1. As medication adherence is a challenge, we're trying to design a water bottle with a pill compartment so that somebody will just consume a medicine and drink water. This will allow the mobile platform to keep track of medications. When they go to their doctors, they're able to show a report. 2. Another example includes when a doctor had to physically examine someone to check if a patient was anemic or not. So we have built a machine learning model to figure if someone may or may not have anemia. It prompts the individual to get a test done if there seems to be a likelihood of him/her being anemic. Our goal is to build machine learning models on open source so its freely available and improve access.

Que 9: What is the premise of prevention?

The whole premise of prevention is to promote positive behaviors and to manage or eliminate negative behaviors. So how do we do that? So there is also kind of a process there and it begins with knowledge and education. The next level then is numeracy, which is applying the number to that and understanding your stats. The next level is communication. So do I know what information to share with my doctor and what questions to ask. And then the final level is decision-making which involves deciding what do I do if I am faced with a medical situation.

Que 10: How should individuals track and change their habits and why is it important?

Our health is governed in a large way by our personal behavior. As per a study in Australia, three key behaviour traits impeded obese people from going for physical exercise or physical activity. The three main reasons were:

• They're not motivated or enough
• They're not disciplined enough
• Lack of time

Other studies discuss that if there was a short-term reward, then people are more likely to adopt positive behaviour.

At times, the individuals first have to address the mental health aspect, which creates a lot of those barriers. Once people have addressed the mental health, they have to alter the behavioral approach and use something that is motivating. After these steps, continued information and education proves helpful.

Que 11: Do you think that this need to collect data add another strain on the patients or individuals?

There is a virtual cycle or there is a vicious cycle. If you start to improve, you will be taking more and more readings and be, feel good about it. And you will continue to improve upon that because you got success and successful spiral up. But if you're not making much progress and it is actually not making a difference in your blood pressure or glucose level or your something or weight, you might get anxious about it. But in either direction, if you seek help at the right place with the doctors, eventually it will help. Only if you can measure something you can improve.