Pioneering Ideas

Leaders in Change Video Series: Part I, Our Conversation with Nicholas Christakis

Over the next few weeks, we’ll be posting a series of video interviews featuring the directors of three cutting-edge Pioneer projects explaining and highlighting the progress of their work. While the projects span multiple health care areas – and in some cases, academic disciplines – one common theme unites them: They are all born from ideas that have the potential to drive dramatic change today and may shape the future of people’s health tomorrow.

Kicking-off the series is a video from renowned Harvard internist and social scientist Nicholas Christakis. Currently, Christakis and his research partner, James Fowler, are receiving accolades for their recent book, Connected, which explores how behaviors, habits and other traits "ripple" along our social networks. Anyone familiar with the “six degrees of separation” concept (or the late 90’s viral Internet hit The Oracle of Bacon) will understand the philosophy that serves as the foundation of Christakis’ research. That being, any individual in the world is connected to another by at-most six people.

While it’s interesting that we are all somewhat closely connected, does this have any impact on us as individuals?

Christakis’ research shows that it does – to a point. He found that our behaviors are usually influenced by up to three degrees out on our social “chains.” For example, if your friend’s friend’s friend smokes, you’re more likely to smoke – even though you probably don’t know that person directly. However, any more than “three degrees of influence,” and the contagion seems to stop. So, while you may be connected to the Queen of Jordan by five or six degrees, it’s unlikely her behaviors will impact yours.

A result of this theory is that it may be possible to impact an entire social network through just a few targeted interventions. As Christakis explains, if we “seed” strategic parts of the network with certain thoughts, those thoughts – whether healthy eating choices or abstaining from tobacco – will ripple through the chain and can have a scalable affect.

 

Impact of Social Networks on Health and Behavior from Pioneer Portfolio on Vimeo.

Changing the Way a Clinician Views a Patient

Last week, Susan Promislo discussed the announcement of five new grantee teams selected in Pioneer’s Project Health Design second round of funding.  As she mentioned, the teams will be testing new ways to integrate patient-generated observations of daily living (ODLs) in the clinical care process.

 

Today, Steve Downs elaborates on the concept on The Huffington Post.  As Downs mentions, “wireless data networks, smartphones, low-cost sensors and minimal software distribution costs have created new opportunities to paint a person's health experience in vivid detail.” The teams will try different ways of analyzing, synthesizing and summarizing the data and they'll try to extract clinically significant information from all the bits and bytes. They'll share the information with the participants and pass information on to clinicians. In short, they will prototype a new approach to health care - one where trends can be spotted before they manifest themselves as problems, one where the effects of new treatment regimens can be readily observed and quickly adapted, one where the connections between behavior and health can be more easily demonstrated.”  

 

Is the ability for a clinician to access a patient’s ODLs a good thing? Will it enhance care or will any meaningful signals in that data be drowned out by the noise of information overkill? 

 

We want to hear what you think.  Are we on the verge of entering a new era? We encourage you to read the post and share your comments over at the Huffington Post.

 

The Government Wants You to Play with Your Food

In a move that underscores the potential for digital games to improve health and healthcare, the US Department of Agriculture together with Michelle Obama’s Let’s Move initiative announced yesterday a competition for apps and games “that encourage children directly or through their parents to make more nutritious food choices and be more physically active.”

The Apps for Healthy Kids competition will award $40,000 in prizes in two categories: Tools and Games.  All entries will be judged on their

• Potential impact on target audience;

• Quality, accuracy, and content of message;

• Creativity and originality;

• Potential for further development and use; and

• Potential to engage and motivate target audience. 

Judges include Aneesh Chopra, U.S. Chief Technology Officer, White House Office of Science & Technology Policy; Eric Johnston, Senior Software Engineer, LucasArts; and Steve Wozniak, Co-founder, Apple Computer, Inc.

 

When USDA was thinking about this contest, they pulled together a group of folks for advice, including Debra Lieberman, National Program Director for our Health Games Research Program; and, Ben Sawyer, who runs the Games for Health Conference, which we support. 

Kudos to the USDA for seeing the value of games and to Debra and Ben for their contributions.

New Project HealthDesign Grantees Tackle ODL Challenges

Today, Pioneer and Project HealthDesign announced the five new grantee teams 
selected in the program’s second round of funding.  They’ll be breaking new ground in testing ways that patient-generated observations of daily living (ODLs) can be collected, integrated in clinical care processes and, ultimately, organized for action to drive smarter heath decisions by both patients and providers.  Congratulations to the grantees, who rose to the top of an applicant pool numbering nearly 150 with their innovative ideas and robust approaches:

• Carnegie Mellon University
• RTI International and Virginia Commonwealth University
• San Francisco State University
• University of California, Berkeley, in partnership with Healthy Communities Foundation and University of California, San Francisco
• University of California, Irvine and Charles Drew University
  

The teams will be working with patient populations that are managing two or more chronic conditions to collect and store various health observations that arise in the course of their day to day lives.  A later technical challenge will be to figure out best ways to share meaningful signals from these ODLs with providers and integrate that data in to clinical work flows.  National Program Director Patti Brennan writes more about this on the Project HealthDesign blog.

The patient groups are compelling, and you can see how making sense of ODLs and being able to act on them can have a tremendous outcome on their health.  Patients can use technologies like smartphones and biomonitors to harness information that better equips them to manage their conditions and make decisions that hopefully allow them to experience better outcomes, day in and day out.  Providers will get a far fuller picture of the way health plays out for their patients and be able to act on more meaningful information than that typically collected in a periodic office visit conversation. 

For example, parents of low birth weight babies will use a specially designed mobile device, "FitBaby," to record ODLs such as the baby’s temperament, exercise, feeding and sleeping schedules, as well as the caregivers’ stress levels and attitude swings. Providing nearly real-time data to clinicians will help alert them to early signs of health problems, which is crucial in treating low birth weight infants.  Another team will help young adults who suffer from Chron’s disease create visual narratives of their condition and treatment to provide concrete feedback to providers about how they feel from day to day. Patients will track ODLs of physical symptoms like diarrhea, bleeding, and profound weight loss, along with more complex social and emotional observations.

The path is not entirely clear, and lots of questions will be raised along the way.  Which is why the grantees will be sharing their learnings, experiences, road blocks, questions and successes along the way, largely via the Project HealthDesign blog and Web site.  We want their progress to be an open path along which you follow and help to guide.  We’ll be sharing updates and hope you’ll check in often as well.