Customer empowerment, patient-physician relationship, and sociotechnical issues

1:30-3:00pm MaRS CR2, Medicine 2.0 Congress, Toronto (Sept17, 2009)


"Social Healthcare Networks- Leveraging Social Networking Technologies and Approaches to Connect Patients and Clinicians"


Presenters: Paula Hucko (HSAGlobal, Mississauga, Canada), Mark Smith (HSAGlobal, Auckland, New Zealand)



Paula started off with a disclaimer that she is representing a vendor for a piece of software that is commercially available. Another colleage co-represented Telus Canada.
The talk was not research- focused but business focused. The speaker discussed rising costs and shrinking market accessibility and coined an interesting term ‘prosumers’ implying that users of healthcare service are being proactive and informed consumers thus making a huge difference in the provision of services.

Furthermore, the notion of the “silver tsunami” was raised indicating that key market trends are creating a perfect storm. In essence there is a sheer dearth healthcare workers. The average age of nurses in Canada today 47.5 years. With the family members also being involved in caregiving these days there is a critical need to self-advocate for ourselves. Alarming statistics were mentioned with regards to the huge financial burden- healthcare spending in US is 4 times that of defense, 46% of the population are uninsured. The presenter suggests technology as one way of addressing the burning issues encompassing healthcare.

Growth of internet has enabled many changes- social networking, twitter, blogging are ingredients of a huge turning point in healthcare and IT. I appreciated the speaker delving into some trends to compare today’s state of healthcare with regards to technology where healthcare and IT are both exploding at a faster pace.

Talking about the core subject matter, “text messaging as a clinical intervention” was discussed. According to Paula most commercially based devices available do not use true clinically proven intervention to manage the ‘well at risk’ patients. HSAGlobal’s product package entails the Health Messaging Engine (HME) stop- layered on the HME platform used for smoking cessation for a certain audience not normally addressed. The company is hopeful that this application will eventually be used for mental health, fitness mgt, etc. perhaps even gambling! It started off as a clinical trial in New Zealand, and the company proved in both NZ and Canada that their product can help the ‘well at risk’ category to quit smoking before they need to seek any institutionalized care. I would say this is quite a challenge and appreciate that the software uses a dynamic two way messaging programme. It is based on the architecture whereby the patient (user) is given the impression that s/he has a coach who can help and monitor their progress in smoking cessation. There is a total of 551 different messages embedded in the system. Having been originated in New Zealand, this product was brought to North America about a year ago by translating NZ terminologies into the Canadian context; also targeted Quebec version of French. Additional capabilities of the database invlude administrative functions that can be targeted to specific interest groups such as those smoking more than 2 packs a day (for e.g.)
In 2008 this application also won an award in NZ. It is now live and funded by the Ministry of Health in New Zealand with approximately 4,000 users on a 6-month quit program. The target was initially 3,000 users, so they actually exceeded the target. Most surprising is the fact that Telus in Canada introduced this piece as a free service to its employees. This brings us to the notion of incentives- consumers do have an appetite for self-managed involvements in healthy lifestyles but there needs to be incentives in order to trigger action on their (consumers) part.
Food for thought- Are we talking about quitting smoking over mobile phones? Why not! Need to consider the challenges associate with such initiatives with regards to market forces and technological interoperability.

Audiences also raised concerns “How can the sector adapt fast enough to understand the potential of technology?”

Overall it was a good presentation providing insights from another continent and how it translates into the Canadian market and its future potentials.