Wellocracy is coming! Watch for it

Joseph Kvedar

(Reprinted with permission from the cHealth Blog)

After working at this remote patient monitoring game for about 10 years now, we are ready to bring self-care to consumers  -  couch potatoes, weekend warriors and all of us in between hoping to live a little healthier, lose a few pounds or just feel a little better. Meet Wellocracy!

The goal of Wellocracy is at once simple and daunting  -  to get America moving, and to motivate our citizens to move to a healthier state. It turns out that the formula is straightforward:  

1. a) track your activity; 
2. b) find your individual set of motivational tools; and 
3. c) find ways to increase your activity without disrupting your life.

But let's take a quick look at how we got here. In the early days of remote monitoring, we thought the big value add would be giving a doctor or nurse a more rich data stream about your vital signs and this would enable her to make better just-in-time decisions about your care plan. Turns out, we were right. The best example of this is the 50 percent reduction in hospital readmissions we've seen by employing home telemonitoring for our heart failure patients.

But the biggest insight that I've gained in my 18+ years of working in connected health came when some of our earliest patients on that same telemonitoring program began to significantly improve their self-care. We noticed that they used their daily monitoring results (weight, blood pressure, heart rate) as a numeric yardstick for their progress, enabling them to better understand the basic pathophysiology of congestive heart failure. They began to realize that salt intake leads to fluid retention and if your heart is weak, a build up of fluid in the lungs can be quite dangerous. As a result, they started being much more fastidious about salt and fluid balance.

As we observed this phenomenon, we broke it down into two sets of factors we could study:  the use of objective data in feedback loops and the use of motivational psychology to help our patients strive to keep those data in the right range. In most cases, the motivational tool was a phone call from one of our telemonitoring nurses (highlighting our partnership with Partners Healthcare at Home). One lovable and amusing quote from a patient come to mind:  "I can't eat fudge because I can't fudge my data."

Another profound, reproducible finding over the years has been the attachment patients feel for these home-monitoring devices. Patients almost universally plead not to be taken off a remote monitoring program. This led us to the observation that self-tracking is contagious or, in Internet parlance, 'sticky.' Most people enjoy seeing how their lifestyle affects some sort of number. Self-tracking keeps health top of mind and can keep people motivated.

A sneak peak into Wellocracy...

I thought for years that if there was some way to bring this insight, this stickiness into the homes of regular folks that we would see a corresponding improvement in health and wellness in the population at large. As the quantified-self movement caught on to self-tracking and the deluge of self-tracking devices and apps that is now available came on the market, the conditions improved even further.

Then I met two impressive colleagues who share this vision for bringing connected health into the living room: Carol Colman, an accomplished author specializing in the self-help genre, and Justin Mager, personal trainer turned physician and expert in lifestyle interventions. Soon we were joined by media relations maven extraordinaire Gina Cella, and Wellocracy was born. Along the way, we picked up some awesome advisors, including Andy Donner, James Fowler, Emily Hackel, David Rose and Charlotte Yeh.

How will we achieve our goal to motivate individuals to move to a healthier state? We start with the premise that the self-tracking market is crowded, confusing and oriented toward techies. We will simplify the language and drive home the value through a series of books (short e-books, to be followed by a traditional book later). These books will be tightly coupled to a website, where we can build community around Wellocracy and continue to update our members' knowledge about the fast changing field of self-tracking and behavior change.

We're excited to have the opportunity to launch our first e-book and our website at the Consumer Electronics Show, on Jan. 8, 2013. There, at the Silvers Summit, I'll have the pleasure of moderating a panel on health apps for the 50+ crowd. I hope we see you there. 

In the meantime, we're looking for early adopters to join the Wellocracy community and share their own stories about how the combination of self-tracking, motivational tools and steps and bursts can lead to improved health. If you are interested in learning more, please comment on this blog or email me at jkvedar@partners.org

I'm excited to be working with Carol, Justin, Gina and our advisors as we launch this effort to improve the health of our nation. More to come on Wellocracy, as we ready for the official launch in January.

Joseph C. Kvedar, MD is the director of the Center for Connected Health (www.connected-health.org), a division of Partners HealthCare in Boston. Connected Health is focused on developing new methods of delivering quality patient care outside traditional medical settings. This post appeared at The cHealth Blog.