March 18, 2013 Back to All Blogs

Not Your Grandmother’s Patient Engagement – the Public Health Graph

It is perhaps the most important public health challenge today – how to influence the thousands of personal health decisions made every day in ways that add up to big improvements in public health.opengraphappsnet

Like it or not, when it comes to health we humans respond to the personal over the professional. The explosion in personal fitness and other mobile health apps show signs of working against some of our most intractable public health challenges – taking medications on time, eating better, moving more. But collectively they could add up to so much more.

Last week the Case Foundation proposed “The Giving Graph” – a brilliant idea to tap online networks to connect us to the social causes we care about. If retailers, marketers and social networks like Facebook and Twitter can capture our preferences and practices to serve up tailored advertising and movie and book recommendations, we can put the “graph” to work to inform and engage around a multitude of health challenges.

It got us thinking – what about a “Public Health Graph” that makes connections to people and information based on unique health conditions?

The Network Effect
Imagine the alarm and heartbreak of your child being diagnosed with Type 1 Diabetes. Now imagine a “Health Graph” connecting you to millions of other parents with advice and “been there” experiences in everything from finding specialists, to managing daily multiple finger pricks and getting through airport security with an insulin-pump dependent child.

On a collective level, organizations like the Juvenile Diabetes Research Foundation could not only share important news about advances in research and new treatments, they can learn what’s on the mind of their constituents, which treatment centers are doing the best job and even tap new donors and advocates for increased federal cures funds. At a public health level, parents who are better equipped to manage this relentless chronic disease affecting three million children make fewer emergency room visits and deal with fewer complications – saving lives and dollars.

Now imagine the network effect of this “Public Health Graph” for countless other public health issues. Oh the places we could go: real progress in reducing gun violence, chronic disease and obesity and increasing affordable, quality health care.

“Population” Health
After all, increasing the “population” in population health efforts is what it’s all about. By mapping health and fitness activity in a Public Health Graph we expand the World Health Organization and Center for Disease Control definition of social determinants of health beyond the static “conditions in which people are born, grow, live and age” to something much more dynamic and personal. The current Facebook “Like, Listen, Watch, Fitness” can include “Eat and Healthcare (a verb!).” Suddenly social determinants of health become actionable, not despairing destiny. This is particularly true when combined with health care’s “big data” sets like the EPA and CDC’s surveillance of things like air quality, the flu, obesity and HIV/AIDS rates in specific geographies. The statistical becomes seamlessly integrated in your page view and presto – personally relevant.

Power to the Patient = Better Care
Health IT expert Fred Trotter recently unveiled DocGraph – a huge open data set showing a pattern of referrals to and from doctors.  If referrals are a proxy for quality, the doctors who get more referrals from their peers should be higher quality and a better choice. But the data set goes beyond referrals. Trotter describes how combining referral data with Hospital Compare data can reveal things like which cardiologists are referring to hospitals with poor central line infection rates.

And let’s not underestimate the powerful feedback loop to shape better care. We’ve already seen a correlation in Facebook likes and hospital quality. A Health Graph would be patient engagement on steroids. Instead of banging the gong to get health care to listen to and include patients and their families in care decisions, health care will clamor to listen to patients and measure up in public healthcare performance ratings embedded in the “graph.” Talk about “meaningful use” of electronic health information.

“Want to” Meet “How to”
Facebook’s Open Graph currently allows any developer to create custom apps. For example, last week Pantheon helped launch the Robert Wood Johnson Foundation’s (RWJF) Aligning Forces for Quality “AF4Q Heath Care Quality Wire” app for Facebook, which allows users to share what 16 AF4Q communities are learning about how to improve health care. The makers of the RunKeeper app recently invited developers to connect multiple aspects of diet and fitness into a personal Health Graph. These custom apps are fantastic plug ins, but the vision for a truly breakthrough Public Health Graph requires seamlessly integrating a universal set of core actions shared among all users that connects to the other big data sets in health care.

While no other network has the one billion users required to raise the public health roof, there are obvious privacy concerns to address with Facebook. Doing it right will require collaboration among social networks, the health care, nonprofit and technology sectors.

Whether it’s through current social networks or an alternative network, the Health Graph is a moon shot worth taking – forever changing the center of gravity for health information and engagement. Do you agree? Have ideas for making it happen? Share them using #PublicHealthGraph. We’ll definitely be revisiting the topic here at Panthink.

* Also check out:
It is your damn data. Use if for personal and public good.
What Turbotax and online dating can teach health care
What do we know about health care public reporting? Not enough.
Health care data’s tipping point
Five trends that show the digital health revolution’s potential to improve quality and cost
Red carpet premieres and animated reviews for health care public reporting
Designing for Behavior Change in Health

Mark Tobias (@PanthTech) is president of Pantheon, which combines technology expertise and a deep knowledge of health care, education, and social impact markets to provide online technology solutions for nonprofits, associations, and government.