The State of Health Tracking 1/30/13

It’s sometimes hard to get a sense of the real world beyond your own bubble. The challenge with this is that you have a tendency to think of and see value in solutions that are applicable to those around you. It’s why Silicon Valley and SF make tons of cool tech tools that don’t see widespread adoption. At the same time, being surrounded by early adopters — as long as it doesn’t mean your product is too early — is a good thing for testing.

Most of my friends track runs or meals or activity or weight using apps or devices. Most have smartphones. I think all my friends use some form of social networking and text messaging. Outside of my own skewed circles it’s sometimes hard to know what the majority of people are doing in health and with technology. That’s why I love Pew Internet research and Susannah Fox, because they have great data on smartphone adoption, mobile service usage, and health and technology metrics.

Earlier this week Pew released a new report on health trackers, analyzing how 3,000 US adults track various health indicators. This is really important stuff. It’s invaluable to understand where we are today so we can better understand what needs to be done to move connected health and health technology and patient engagement to the next level. The entire report is here. You can watch the 12-minute video interview of Susannah Fox below if you want to hear her summary and interpretations.

I’ve pulled out what I think are the most important data points.

  • Seven in 10 adults track a health indicator, either for themselves or for a loved on. I was a little surprised that only 12 percent of those surveyed track a health indicator for a loved one. Based on the very good report from AT&T a couple years ago that found 25 percent of US households are acting as caregivers for loved ones (usually elderly parents), I expected this number to be close to 25 or even 30 percent.
  • Fifty percent of trackers are only tracking in their heads. As Susannah Fox says in the video above, for her this is assessing whether or not she fits in her skinny jeans. This stat is really the kicker to me. I can’t really call it tracking if you say it’s only in your head. If that counted for tracking anything, then I must be simultaneously tracking about 1 million data points right now. I firmly believe the process of recording — whether manual or passive — and storing is essential to having an impact. So basically around 35 percent of adults are tracking a health indicator.
  • Sicker track more – 62 percent of those with two or more conditions track. This one isn’t surprising to me. Chances are this group is also the one that is more likely to be sharing the indicators they are tracking.
  • Fifty percent don’t track regularly. Just like healthcare, we should be shooting for continuous and not episodic. Interestingly, caregivers are more likely to be regular trackers. This relates to tracking in your head and again points to around 35 percent of adults tracking a health indicator.
  • Two out of three do not share data they track. Of the one-third of those trackers who do share data, only 50 percent of them share with clinicians. Part of that is probably not recording the data, but another part of that is probably feeling like it makes not difference in health to share.
  • Most adults that track say tracking has some impact on health. Respondents are said that keeping notes had more impact.
  • Looking specifically at smartphone owners and mobile apps for tracking, only 19 percent have apps for tracking or managing health. Overwhelmingly those mobile apps are for tracking exercise and diet. Those more likely to use app are female, young, and wealthy. Most apps are for fitness. Pew asked specifically about WebMD and found that four percent of health app users have the WebMD app, a percentage higher than apps for tracking glucose, mood, medication management, and sleep.

Overall I think this is depressing data on the current state of the engaged patient. I interpret the report to mean that only about one in three adults in the US tracks a health indicator. Most of those who track data do not share it. I’m also betting a decent number of those one in three who track a health indicator regularly are people that are relatively healthy — tracking runs, carbs, etc.

If you’re like me, you’re on the side of technology to help solve some of the problems of the engaged patient. I don’t think this data bodes well for our camp. If adults aren’t tracking — and I take that to mean they don’t see health as a problem and/or tracking as a solution — then getting them to adopt technology to track is going to be a struggle.

I know people out there are saying that new technology can make tracking incredibly easy and even passive, meaning people don’t have to do anything more than they do now. That’s true of certain technologies, like the Telcare connected glucometer or Wi-Fi scales or activity trackers, but that certainly isn’t the case for all types of tracking, especially nutritional. Then we can talk about gaming and socializing these health tracking tools, but I think these features will increase ongoing engagement, not initial adoption.

Adoption is the problem. How do you get people to track health data? Technology is not the answer, as I’ve written about before. You really need to fundamentally change the way people think about wellness, health, and healthcare.

Like keeping up with friends on Facebook or weekly with favorite TV shows, consumers need health to be a part of the day to day, not purely an annual or acute event. That’s really, really hard. In part it’s hard because our health system is not set up and our providers are trained or paid to operate this way. It’s also hard because consumers don’t directly associate a financial pain point with healthcare, even though many bankruptcies are the result of healthcare costs.

The answer lies in how we offer health benefits, as these seem to shape how people think about and access health. Payers and employers can (maybe) shape this view of health by forcing continual engagement in health as part of benefits packages. I’m not even really sure payers and employers can do that, but it seems like the only way to me. I’m all for voluntary participation, but I’m also a fan of seeing some change before I retire.

Of course providers need to fit into all this, but again, the payers and employers can take care of that. I just don’t see any other way around overcoming the hurdle of adoption of health tracking.


Travis Good is an MD/MBA involved with health IT startups. More about me.

  • Elise Singer MD MBA

    In my experience patients, families, caregivers, even physicians and ancillary staff (on the healthcare side) tend to be very engaged when, and only when, they need to be engaged.

    I, for one, have a lot going on in my life as a professional women with a family who likes to exercise and really only want to be involved or doing something extra when I really need to. Like when my Dad got sick.

    When we focus on the right patients for engagement, it turns out not to be a problem – they have the problem of not being able to be as engaged as they want to be. Who are the right patients? More advanced, high morbidity multiple chronic illnesses, cancer, elderly, sick children.

    Prevention engagement is another problem and more normative-based or related to incentives and the lens of healthcare in the US today.

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