Your blood pressure is spiking and you don’t know why or what to do. You forgot to take your meds. A new diet to lower cholesterol isn’t working. When healthcare issues like these arise we’re often on our own when out of a doctor’s care. But what if we, as patients, were actually managing our healthcare? What if we had the power to connect the dots between medical providers and a caring social network?
CCS puts the patient first. With its end-to-end architecture, CCS enables the patient to manage a Cloud-based Personal Area Network of healthcare devices and exchange data and messages with medical practitioners while also sharing information about activities and achievements on social networks.
“CCS puts the patient at the center of holistically managing their healthcare situation,” says Thomas Sutton, executive creative director at frog’s Milan studio.
An urgent need for innovation
Reforming healthcare is an urgent yet complex challenge. Faced with growing and aging populations and progress in medicine and healthcare technology, politicians and policymakers—along with healthcare professionals and patient advocacy organizations—are exploring ways to maximize healthcare delivery, improve outcomes, and lower costs.
For the most part, though, healthcare systems are mostly structured around an outdated model of hospital and primary care delivery. Got the flu? Go to the doctor. If it’s an acute illness or an emergency, go to the hospital. Yet these models overlook long-term chronic disease management, self-determined behavioral change and the need for better and more frequent communications between the patient and healthcare providers.
In that sense, CCS’s core concept is inherently different from established practices. “It puts the focus on what you as a patient can do,” says Matteo Penzo, technology director at frog.
Portable and wearable measuring devices, and an array of smartphone embedded sensors—such as accelerometers and GPS—help Charles monitor and record data on his blood pressure, glucose, and electrocardiograph. Information is gathered and displayed in real time, enabling the patient—and the caregiver, via an iPad optimized web application—to review past data points and progress toward a nutrition, exercise or activity goal.
The patient is never out of reach or sight: Dr. Rossi can check up on Charles anytime—and without an appointment—to detect the onset of a problem or the deterioration of a condition. The application recognizes correlations and trends, highlighting outliers so they are instantly recognizable to the medical professional.
Meet Charles Green
To find out how it works, let’s check in with Charles Green, a 48-year-old who just visited his physician, Dr. Sara Rossi. She diagnoses hypertension and mild chest discomfort, and prescribes Lipitor and aspirin cardio, as well as an exercise regime. At this point a patient like Charles would be solely responsible for his healthcare.
But Dr. Rossi gives Charles a printout of his care plan with a QR code to download the CCS app to his smartphone. What he will see is an app with a calming visual design that suggests a continuation of his visit to the doctor’s office. Flashy tech touches are played down in favor of a reassuring approach. “We wanted to avoid any kind of visual fireworks and keep the design very low key,” Sutton explains.
The value of data
To be effective, the data collected by CCS must be transformed into actionable information. CCS’s connectivity allows the information gathered from the patient to be part of a larger conversation between the patient and the doctor as well as the patient and loved to impact and change the routines of daily life.
If Charles forgets to check in or take a medication, he will be reminded to do so. He can set progressive targets for physical activity.
Helping out is a special feature on CCS called Virtual Coach that interprets data and provides in-context solutions. Is your blood pressure too high compared to average readings? The Virtual Coach will suggest ways to lower the rate, like cutting down on coffee or listening to soothing music that will be automatically played, thanks to the auto-relaxation feature. Real time and historical data is displayed on a LifeLog, which unfolds as a calendar-like story enabling patients to review past actions and progress toward goals, and see subtle trends in their overall health. Healthcare professionals can access the same data to monitor progress and optimize care.
You are not alone
CCS opens the way for an intimate, shared care network to form around the patient to help change behavior through accountability and encouragement on Facebook and other social media.
Achieving an activity goal is a celebratory moment that receives praise from a circle of friends and family who can also nudge the patient to stick to the plan if they falter.
“This provides a social layer on top of a care plan, because you can tell the world you are taking this action,” says Penzo.
In broader sense, a CCS Community is created that reinforces social support as well as educates people about health and wellness. While cheering on a friend or family member, the cheerleader is brought into a circle of awareness about a particular illness and treatment, and is emboldened to participate in their own health improvement plan.
Scale, technology, and challenges
CCS leverages existing technology, standards, and protocols. It can therefore be easily scaled and extended to fit either state-run healthcare systems or privately managed healthcare models, as long as there is broad and continuous connectivity.
A key role is played by wireless devices certified by the Continua Health Alliance—a non-profit organization made up of healthcare and technology companies—that is collaborating to establish a compatible network of connected personal health solutions. For example, Continua-certified devices can seamlessly link to the user's mobile phone over a Bluetooth connection to perform continuous or periodic monitoring.
The phone synchronizes with a remote system via a secure connection over the web. A resource-oriented service layer on the back-end allows for data exchange with external systems and development of third-party applications.
frog originally developed CCS with cardiovascular patients in mind. But the platform is applicable for a wide range of health issues that require longer-term support and motivation, such as diabetes care or post-transplant recovery.
One challenge might be changing the mindset of patients and healthcare providers. Concepts like remote monitoring and sharing data on social networks raise questions about public and private boundaries for sensitive information and data, both for patients and healthcare organizations.
Yet the design and user experience of CCS reinforces the principal that it is a companion to help the patient improve their health “and not an intrusive guardian or Big Brother,” explains Alex Conconi, a software architect at frog’s Milan studio. Clear safeguards between private information and public availability are built into the system, while access to the social network via Facebook is determined and controlled entirely by the patient as a motivational factor.