Headline
Healthcare in the US is broken in reversible ways for stupid reasons. Doctors offices are overwhelmed with administrative tasks and workflows that eat into the limited time they have to deliver actual care, and patients increasingly report negative experiences that include a lack of transparency and feeling ignored. One solution is for us as individuals to capture as much personal health data as we can on ourselves, so that we can live healthier and more informed.
An opaque and irrational market
The American health care market is unlike any other. We rarely have any idea what we have been charged or what our insurer has actually paid. Much of the system is predicated on a fee-for-service model rather than rewards for health preservation. Whatever the market will bear is the prevailing business model. The cost of American healthcare is an astonishing 18% of GDP. Even so, there is profound waste that is the result of incomplete information and fractured customer service.
- $55 billion of waste is attributed to missed prevention opportunities
- $210 billion of waste is attributed to unnecessary services
- $130 billion of waste is attributed to inefficiently delivered services
- $105 billion of waste is attributed to prices that are too high
- $190 billion of waste is attributed to excess administrative costs
One way that we can improve our interactions with the healthcare system (as well as generally be in better health) is to build a more complete information profile on ourselves. We should collect as much data about ourselves as we can. The goal is to build a preventive medicine apparatus so that we can receive personalized care at the right time.
An individual patient produces an extraordinary amount of data exhaust through their various “omes.” These include:
- Exposome
- Includes environmental data like exposure to radiation, air pollution, pollen count, and overall air quality
- Epigenome
- A record of the chemical changes to DNA
- Microbiome
- Gut microbiome that can be measured to indicate the presence of various bacteria, viruses, and fungi
- Matabolome and Proteome
- A window into an individual’s protein biology
- Genome
- DNA sequencing
- Anatome
- Referring to one’s anatomy, measurements include magnetic resonance imaging, CT, and nuclear scanning
- Physiome
- Biosensors that can measure a wide array of physiological markers
In-person office visits can take on a whole new look by capturing this information. Highly enriched by data that is patient-generated, but also visualized and processed by the patient. This sets up an opportunity to strengthen the bond between patient and physician. The data can be sent ahead of the visit or even preempt the need for a visit which end up becoming informative, data-driven discussions.
Eventually, a considerable percentage of in-person office visits could be replaced with virtual check-ins that are informed by the individual patient data records which would further help improve physician productivity and customer satisfaction.
Our approach
I set out to create a way to put myself in control of capturing and controlling my health data. As I saw it, there were three main considerations I needed to address to make it successful:
- Capture as much data as possible; [completeness]
- That is as scientifically meaningful as possible; [correctness]
- That requires as little measurement time as possible [compliance]
This foundation will enable capabilities like applying machine learning to the data, understanding the multiplicity of interactions, and open the window to predictive analytics. This will fully transform the rudimentary electronic record that exists today.
Better outcomes have been demonstrated for engaged, activated patients as compared with usual care for a wide variety of conditions, including hypertension, diabetes, obesity, multiple sclerosis, hyperlipidemia, and many types of mental health disorders.
Action
Below is a table that has a collection of what I have been measuring that has markedly improved my personal health and my interaction with the healthcare system (saving money, time, and frustration). The daily measurements take no more than 3-5 minutes out of my day, and everything listed is available to the masses. I’ve been measuring many of these for years so I haven’t included all of my data, but if you click into an individual ome, I have provided some examples of data outputs and how I use them.
I have also included:
- What I measure
- Why it’s important to measure it
- What device/app/test I use to measure
- How often I measure it