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

by Dwight McNeill

Overview

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.

Product Details

ISBN-13:	9780133890143
Publisher:	Pearson Education
Publication date:	03/19/2015
Series:	FT Press Analytics
Sold by:	Barnes & Noble
Format:	eBook
Pages:	384
File size:	4 MB
Age Range:	18 Years

About the Author

Dwight McNeill, PhD, MPH, is a teacher, writer, and consultant. He is a Lecturer at Suffolk University where he teaches courses in population health and health policy.
     Dwight has published two previous books on health analytics, including A Framework for Applying Analytics in Healthcare: What Can Be Learned from the Best Practices in Retail, Banking, Politics, and Sports and (editor) Analytics in Healthcare and the Life Sciences: Strategies, Implementation Methods, and Best Practices. He has also published many journal articles, including “Building Organizational Capacity: A Cornerstone of Health System Reform” (with Janet Corrigan) in Health Affairs.
     Over his 30-year career, he has worked in corporate settings, most recently as Global Leader for Business Analytics and Optimization for the Healthcare Industry for IBM, and previously at GTE; government settings at the federal (Agency for Healthcare Research and Quality) and state (Commonwealth of MA) levels; analytics companies; and provider settings. He consults on analytics innovations to improve population health management and person-centered health.
     Dwight earned his PhD from Brandeis University in Health and Social Policy and his MPH from Yale University in Public Health and Epidemiology.

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.

Editorial Reviews

This book helps readers understand the brave new world of digital health improvement tools and then use that understanding to improve their own lives. Its focused guidance constitutes a bold new entry into the traditional health improvement literature.”
—Michael L. Millenson, author, Demanding Medical Excellence: Doctors and Accountability in the Information Age

“This book helped me realize what all the hype about person-centered health analytics means for me. McNeil has blended academic analysis and practical instruction, ensuring that readers can both understand the new technology landscape and take meaningful advantage of it. The result is an important text for anyone looking to take an active role in managing their own health at a reasonable cost in the twenty-first century.”
—Lauren A. Taylor, co-author, The American Health Care Paradox: Why Spending More Is Getting Us Less

“Dwight McNeill has integrated a variety of streams of thought and research to make a compelling case that person-centered health technologies and strategies can make a real difference in improving health outcomes.”
—Stuart Altman, Sol C. Chaikin Professor of National Health Policy at the Heller School for Social Policy and Management at Brandeis University

“Dwight McNeill’s book marks a new step in our collective understanding of the relationship between health and the vastly complex health care system that consumes so much of our national attention and wealth. Health care purchasers are looking for a way to link together their efforts to promote wellness and personal engagement with their investment in the hugely expensive medical care system. This book shows that we can focus on the emerging ways to manage our personal well-being while leveraging the health care system for its particular strengths. It is valuable to all of us as patients, consumers, and families—and will outline a new direction for purchasers, payers, and policymakers trying to set a fresh course for U.S. health care.”
—David Lansky, Chief Executive Officer, Pacific Business Group on Health

“The possibilities of data and analytics to change how we live are only understood when translated into human applications. Empowering individuals to participate in, and even shape, their own medical outcomes is among the most compelling and feasible ways that analytics is affecting us all. McNeil has developed the owner’s manual for living a better life, powered by analytics.”
—Jack Phillips, CEO, International Institute for Analytics

“Using Person-Centered Health Analytics to Live Longer emphasizes the importance of providing tools to people to equip them to be successfully engaged in improving their own health. It provides these tools and recognizes that people cannot do it alone and that others can make important contributions. Dr. McNeill provides innovative guidance to stakeholders on ways to overcome barriers to make personal analytics more accessible and effective for prevention and treatment.”
—Chris Gibbons, MD, MPH, Chair of the Board of the Center for the Advancement of Health and Professor at Johns Hopkins Schools of Medicine and Public Health

“Fixing today’s issues with health care requires both individual behavior change and a unity of purpose among all stakeholders—payers, providers, analytics, and regulators. ‘Person-centered’ must progress from its status as a buzzword to an organizing principle for real solutions with data at the core. Using Person-Centered Analytics to Live Longer provides important insights for improving population health in the twenty-first century.”
—David Wiggin, Direct of Industry Marketing, Teradata

“Dr. McNeil provides a thought-provoking and timely contribution to the field of health analytics. His approach is novel and pays attention to the important issues surrounding person-centered data and its potential to promote positive changes for the health of populations. A wealthy read for students of analytics and health alike.”
—Robert J. McGrath, Ph.D., Everett B. Sackett Assoc. Professor & Chair, Director of Graduate Programs in Analytics, Department of Health Management & Policy, University of New Hampshire

From the Publisher