Next week is HISA's national conference (HIC09) in Canberra and it's time for reflection on some of the big issues in e-health.  In consumer e-health this has got to include how consumers are going to take advantage of the significant planned invest in the "professional" e-health systems.

First, what do I mean by professional e-health system.  Well, these are the technologies that link our hospitals/clinics,  pharmacy, diagnostic and care planing operations.  They will enable the health consumer to get safer and more cost effective care.  This is all about how we treat patients when they are in care.

Ok, these are pretty significant benefits, BUT....they don't reflect what could be some even larger benefits generated through our e-health investment.  These are the benefits driven from actually keeping patients out of care and they are realised through engaging consumers more effectively in their own health mangement. 

While there is a strong recognition of the need for a personal health record for consumers, that system, by itself, is not going to entice consumers to take better care of themselves.  Health consumers require high value experiences to better engage themselves in managing their own care. 

Some of these experiences are now being partialy delivered (albeit in a relatively disjointed fashion) with highly engaging online systems that support all types of health and fitness needs, with well qualified information resources, online therapy, training and social networking processes.  These are supported with an exciting range of sensors and devices which often use game technology to make information input and tracking an enjoyable and a higher value experience.  What they often lack (except in the case of some excellent mental health examples) is the linkage with care providers and the provision of high quality coaching and feedback to guide the consumer.

The ability to link these consumer e-health systems, perhaps through the Personal Health Record, to the professional health systems will allow a crucial link between the consumer and the care provider to be forged.  This will enable the consumer to experience highly relevant and context specific professional feedback that will drive more effective everyday decisions about their health.  It could also deliver an accurate and rich source of valuable patient information to improve the care process when the consumer does find themselves in the health system.

So what REALLY excites me about consumer e-health is its this ability to cost effectively link the care professional and the consumer with information and tools which enable long term better personal health decisions.

I have written a presentation on this issue for the Nursing Informatics Conference next week.  It has a more extensive discussion of this issue with lots of links to sites of interest.  You can download a copy by clicking here

This may sound a pretty dry topic...but it is not.

Continua is an organisation which develops specifications for uniform communications interfaces in consumer health devices and certifies products compliant with these specifications. 

Ok, I can now see the yawns and eyes drifting shut, but this is important. 

For consumers to really embrace e-health requires that the input of information be as simple as possible.  In fact, ideally it should be totally transparent to the user.  This is the sort of future that Continua looks to enable.  The availability of standard interfaces opens up the apllication of these devices to all the small and innovative software development companies that can integrate the devices into home based health products. 

So a potential scenario is that a person on a weight management program can hop on the scales in the bathroom and their weight can be recorded on their electronic health record...a scary thought for some, but very helpful for many.

So the latest products announced by Continua are an A&D blue tooth weight scale, and a blood pressure monitor, plus a Roche blood glucose meter (see http://www.continuaalliance.org/products/certified-products.html ).

Continua are only just starting to announce the products that are passing through their certification process, so look out for more announcements in the future.  These are the products which will be defining in the next generation of consumer e-health systems.

Just a quick note to let everyone know that The Journal Of Virtual Worlds Research has just released a dedicated edition on "Virtual Worlds for Health and Healthcare"  see http://daneelariantho.wordpress.com/2009/08/03/3d-virtual-worlds-for-health-and-healthcare-a-special-issue-of-jvwr/ .  It has some interesting articles for those seriously involved in health applications using virtual world technology.

I thought the release last week by Bayer Health of their new blood glucose measuring device (Diget) was an interesting one.  Not so much because the device neatly integrates with the Nintendo DS gaming system and provides game rewards (new powers, access to new levels, etc) but because the eHealth Europe ( http://www.ehealtheurope.net/news/5051/nintendo_ds_to_offer_diabetes_care ) has reported that the device will also will also upload data to the DIGET website and integrate with their diabetes management system designed for children between the ages 5 and 14.

The big issue with personal health records is not so much the technology (both Global Health and Healthe have been providing consumer focused personal health records for years), the real issue is making it worthwhile for consumers to enter the data.

It is always a balance of weighing up the time spent in the boring task of inputting data against the benefit derived from better managing your health.  The problem is the downside of data input always has to come first, it is an immediate issue, while the benefit of a healthier lifestyle can take months before a positive feedback is realised.  This is of course separate from the difficulties healthcare practitioners have in inputting information...but that is an issue for a separate discussion.

So anything that makes health data input easier has got to be an important step in the broader use of personal health records and the better management of our lifestyle.  As a consequence the DIGET product announcement is important.  But this is only one of many such announcement you may be seeing in the near future.  Lifescan have announced a blood glucose device for the the Apple iphone (http://www.diabetesmine.com/2009/03/lifescans-new-diabetes-iphone-app.html )  and there will be announcements for other smart phones coming out soon.

The application of gaming technology is one of the most promising areas for making the input of of health data a higher value experience.  This, combined with the spread of the high power mobile computing platforms (read smart phones) integrated with all sorts of sensors, means that the objective of convenient health information data entry that is linked with our healthcare providers care plan that allows us to make more effective lifestyle decisions, is getting closer.