You want to achieve wellness, a cure, or to manage a health condition.
As a consumer, how do you interact with a guide or expert; where (doctor's office, your home, at work, traveling); and how do you get feedback, rewards, and a sense of value in what you do to maintain or improve your health or wellness?
For the person living with a chronic condition or a wellness concern, there are several contexts that need to be considered: wellness; medical treatment; and management of chronic conditions. Aside from procedures that are done to or for you (a medical exam, an operation, a prescription for medicine), for you to benefit, you need to change or maintain lifestyle behaviors, i.e., take your medicines, exercise, have a suitable diet, do stress management. Although you are the focus, the systems for providing wellness, medicine, and chronic care are separate, uncoordinated, and not always available to you when you need them.
Using the internet, cell phones, and other technologies, you now are able to have access to convenient, low-cost or free help. Some of this help can be completely outside the medical system; some may be an extension of your medical care.
You can now have anytime-anyplace access to wellness and treatment guides using a computer, a dedicated hardware system, or smart phone. There are easy to use sensors to collect information about you in real time, and even smart medicines: the bottles and pills are wired, when you take your medicine it broadcasts to the system! So access by a landline, cable modem, or cell phone system can provide you with a choice of services tailored to your specific needs. Are you trying to lose weight? Get the information and recommendations you want for deciding what to eat for lunch immediately on your cell phone. Are you managing your diabetes? Record your blood sugar levels, exercise, food intake and more--here and now.
Wellness
For better wellness there are many choices available free or at low cost, designed to provide you with information, support, and a sense of achievement or financial reward when you modify your behavior. The greatest advances and changes are taking place in the arena of wellness. Doctors haven't claimed this area, it is not protected by a legal monopoly, and emerging technologies can efficiently and inexpensively provide information, support, and rewards to help you.
You can do much to improve your wellness and sense of well being through lifestyle changes. You don't need, and can't get, much help from your doctor for these efforts.
Problems in getting help from medical providers
It may be more prudent for you to have professional input when making lifestyle changes for your health, but it is hard to get and the medical system just isn't set up to deal with achieving wellness. Medicine is designed for dealing with a disease or condition now, on an "acute" basis. Prevention, wellness, chronic care: they all cost money and require a different sort of intervention, and no one in the current medical system stands to benefit.
For a variety of reasons, medicine has been highly conservative and unable or unwilling to adopt modern technologies of communication and data management. Medical people have enjoyed a monopoly of delivery of health care. Just as GM has prospered selling large, inefficient vehicles and been able to ignore competitors offering small, fuel-efficient and hybrid vehicles--up to the point of imminent collapse because now GM lacks the time and money to adapt...so the medical system has lagged.
People with a need for medical care are "patients," not "consumers." Patients have to go to a doctor's office, wait for an appointment, wait for tests, and wait to find out what to do. Doctors are very aware of how difficult it is to have their patients "comply with treatment." Patients don't get help with wellness behaviors; if they get support and feedback for a treatment plan it is at best by phone on a schedule, not when they need it. Consumers of banking services get convenience (credit cards, debit cards, ATMs everywhere) and reliability.
Competing new models in lifestyle, wellness, and chronic care
But the result of the slow adoption of new consumer modalities in medicine has created challenges which are being met by entrepreneurs. Efforts to achieve wellness can improve health and well being and drastically change the need for medical intervention. And wellness does not fall under the umbrella of medical care, so the field is open to innovation.
There is a broad spectrum in efforts to use distant interaction over phones, internet, wireless devices...with a diversity of methods and philosophies. One medical model, exemplified by DPS Health seems designed to capture research findings and to create a robust replica of an effective medical model for managing diabetes and overweight. Another example is Alere providing disease management programs to people with chronic conditions including heart failure, coronary artery disease, diabetes, asthma and COPD to manage their health through at-home monitoring, patient information, and nurse-patient relationships. Delivering services through a medical context, so that clinicians buy the service for their patients, may assure integration of medical and lifestyle issues. However, I suspect this will lead to a fairly slow rate of adoption because you will need to sign up the doctors and their organizations.
Others in the marketplace are going directly to the consumer. This might help them grow rapidly and enable them to do much more "fun" things that appeal to their customers, engage them in social networks, and more. One example is KEAS.com; their business model is a massmarket approach with a low price to join; it would create a user-friendly environment to provide targeted lifestyle (not medical) information, feedback, and support.
I asked Neal Kaufman, M.D., M.P.H., the founder of DPS Health this question: Will this lifestyle model integrate with medical concerns of the individual? Which approach will succeed, and for whom?
Kaufman replied "I think that is the key question. My belief is that diferent people at different stages in their lives or disease/predisease state will need different approaches. The more these approaches can be integrated into a cohesive and unified approach the better the outcomes. Direct to consumer approach have an important place. No doubt about it...I would hope that it can be complementary and integrated into other approaches to maximize the outcomes."