Nebeker Camille, Weisberg Bethany, Hekler Eric, Kurisu Michael
Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, La Jolla, CA, United States.
Center for Wireless and Population Health Systems, UC San Diego, La Jolla, CA, United States.
Front Digit Health. 2020 Jun 4;2:2. doi: 10.3389/fdgth.2020.00002. eCollection 2020.
Access to digital health technologies is contributing to a paradigm shift where care may become authentic care. Individuals can now access personal health data through wearable sensors, affordable lab screenings, genetic and genomic sequencing, and real-time health tracking apps. Personal health data access creates opportunities to study health indicators 24/7 and in real time. This is especially useful for patients with hard-to-diagnose or treat diseases, which led to a self-formed patient group called Project Apollo. Project Apollo is composed of highly motivated patients with common experiences of undiagnosed conditions, a lack of clear treatment options, and shared frustrations with navigating the U.S. healthcare system. These experiences have led the Apollo cohort to supplement their health knowledge through self-study research. To qualify the experience and expectations of patients affiliated with Project Apollo. A qualitative approach involved record review and semi-structured interviews. One-hour semi-structured interviews were conducted to solicit motivations, expectations, and potential barriers and facilitators to self-study followed by a brief survey on digital tool use. Interviews were digitally recorded, transcribed, and analyzed to identify themes and patterns. Participants included six females and three males ranging in age from 30 to 70+ years. Responses were organized under five key themes including: frustration with healthcare system; community support; self-study/N-of-1 research; access to experts; moving from sick to healthcare. Facilitators include motivation, albeit stemming from frustration, a safe community where patients derive support, and access to experts for guidance. Increasing awareness of clinicians about the potential value of partnering with patients who are advancing health knowledge through self-study is critical. N-of-1 self-study research, coupled with community support and digital health tools, appears to be one plausible pathway to shifting the paradigm from care toward patient-partnered care.
数字健康技术的应用正在推动一种范式转变,即医疗可能会成为真正的关怀。现在,个人可以通过可穿戴传感器、价格亲民的实验室检查、基因和基因组测序以及实时健康追踪应用程序来获取个人健康数据。获取个人健康数据为全天候实时研究健康指标创造了机会。这对于患有难以诊断或治疗疾病的患者尤其有用,由此形成了一个名为“阿波罗计划”的患者自发组织。“阿波罗计划”由积极性很高的患者组成,他们有着未确诊疾病的共同经历、缺乏明确的治疗选择,并且在应对美国医疗体系时有着共同的挫折感。这些经历促使阿波罗群体通过自主研究来补充他们的健康知识。为了了解与“阿波罗计划”相关患者的经历和期望,采用了定性研究方法,包括记录审查和半结构化访谈。进行了一小时的半结构化访谈,以了解自主研究的动机、期望以及潜在障碍和促进因素,随后进行了一项关于数字工具使用的简短调查。访谈进行了数字录音、转录和分析,以确定主题和模式。参与者包括6名女性和3名男性,年龄在30岁至70多岁之间。回答归纳为五个关键主题,包括:对医疗体系的不满;社区支持;自主研究/N-of-1研究;接触专家;从患病到医疗保健。促进因素包括尽管源于挫折但仍有的动力、患者能够获得支持的安全社区以及有专家提供指导。提高临床医生对与通过自主研究增进健康知识的患者合作的潜在价值的认识至关重要。N-of-1自主研究,再加上社区支持和数字健康工具,似乎是将范式从医疗转向患者合作医疗的一条可行途径。