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Carolinas HealthCare Links Portal, Health Tracker Data

January 19, 2015
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Carolinas Tracker app seeks to provide clinical context for patient-generated data

If conference meetings are an indicator of a topic’s current relevance, then patient engagement is red hot in 2015. There is a summit meeting on patient engagement in Orlando in February and another in September in Boston. Last week I had the chance to interview one of the presenters at the upcoming Orlando meeting, Pamela Landis, assistant vice president, information services, at the 42-hospital Carolinas HealthCare System.

Carolinas is working to bridge the gap between all the new health trackers in the consumer space and the clinical data people access through their patient portal.

“We have been working for the past year or so on what to do with patient-generated data,” Landis said. “How to manage it to make sure it is meaningful for those patients and our clinicians is something we are trying to figure out. I don’t think anybody has it figured out soup to nuts.”

Landis said the information you get from apps such as Fitbit, Runkeeper, and MyFitness Pal needs more context. She said having an app tell her she ran three miles is not enough. “I know I ran three miles. I was there. But is that good? I don't know,” she said. “Is my pace good for someone my age and my condition? How does it all matter? From talking to patients, we think that is where the gap is. What do I do with all this information I am gathering about myself? Do I take the advice of an app, or do I really care what my clinician thinks?”

Carolinas, an $8 billion integrated delivery network, is rolling out a new Carolinas Tracker app that can pull data from more than 40 different connected health devices to allow patients to track steps, sleep, mood, exercise, blood pressure, weight, BMI, body fat, heart rate, oxygen saturation, glucose, cholesterol, and other biometrics.

Carolinas will seek to provide context for this patient-generated data by connecting the app to its  “My Carolinas” patient portal, and by allowing for a cloud-based data sharing dashboard (Carolinas MGR) to facilitate health coaching and care management. (Carolinas will make a consumer version of the app available in app stores for anyone to use. But a second version, coming out in February, will tie the tracker data to clinical data for patients in the Carolinas system.

Landis said Carolinas also had to look at the issue from the clinician’s perspective.  “They ask what do I do with the onslaught of all this patient-generated data? How do I handle it? How do I make sure when data is coming to me it doesn’t dilute the vetted clinical data?” she explained. “We had to figure out how to collate all the data from those apps and bring it into one app for patients and then put it into clinical context.”

Carolinas’ first foray into using the data proactively will be to identify diabetic patients and connect them with health coaches online. “The coaches could see how the person is doing every day,” she said. “We will start to see daily glucose values. Our health coaches are excited about it because their patients are already using some of these tools and the coaches currently don’t have access or insight into it. Now they could say, ‘Use this one, and I can start to help you.’ That is a win-win.”

Another question Carolinas will study in the first year is whether the use of trackers might be “stickier” when tied to clinical data. Surveys have suggested that about 40 percent of people quit using fitness trackers in the first six months.

“We have to study whether they are more actively engaged,” Landis said. “I think too often we focus on meaningful use measures and the patient portal. Those are important, but we want to figure out how to build tools that engage people so much in their healthcare that they check their health app as much as they check Facebook. By marrying clinical with patient-generated data, can we create a full picture that they start to care about? That is the nut we are really trying to crack.”