Doctor says crowdsourcing tools can make people healthier

November 1, 2011

In his seminal book Here Comes Everybody: The Power of Organizing without Organizations, Clay Shirky explores how new technology and social media can foster democracy, stop crime, even build a better kite.

But can social media and crowdsourcing make people healthier?

Dr. Brigitte Piniewski, chief medical officer of PeaceHealth Laboratories in Springfield, Ore., is convinced they can. One of her main tasks at PeaceHealth is developing ways to use the Internet and emerging technologies to improve the health of communities.

"We're being exposed to solid examples of how we can do so much more together than we can do alone, and that is irresistible to most of us," said Piniewski. Crowdsourced tools include Wikipedia, CouchSurf and TaskRabbit to name a few.

In health care, crowdsourced projects might someday include social media sites that reward exercise, engage groups in weight loss competitions, and provide identity-masked health data for use in detecting patterns, forecasting trends and shaping public health policy.

"What we are already seeing is a future where we don't walk around in isolation but choose to walk around with a (smartphone-enabled) crowd in our pocket and have access to ever better information on the web," said Piniewski. "My colleagues refer to this as high-definition living."

Young people who live plugged-in lives expect to be constantly connected to friends and information via the Internet and mobile technology. "Our youth will be essential to teaching us how to best design our new tomorrow," Piniewski said.

To Piniewski, the U.S. health care system is completely out of date when it comes to health promotion and disease prevention in part because it has yet to harness the potential of information age communication.

"Our health system is a failure detection system," she said. "Therefore we remain impotent at either defining optimal health or enabling communities to proactively coproduce optimal health futures."

She envisions a not-so-distant future where, for instance, an adult will place a drop of blood on a disposable, low-cost sensor card, place it next to a cell phone and, almost immediately, receive a reading on his or her triglyceride levels. Like popular banking apps for smartphones that offer real-time analysis of an account holder's fiscal health — information that can prevent an unintended overdraft — low-cost, easy-to-use health technologies will deliver information that the recipient can use to make decisions that promote good health.

Such data is powerful not only to individuals, but also to the community as a whole. No man is an island, in Piniewski's view. She sees an individual's health status as part and parcel of broader trends in society.

"In health we tend to separate noncommunicable diseases and communicable diseases. Today, many still view obesity and diabetes as noncommunicable. Social network analysis suggests that they totally cluster," Piniewski said. "Even pregnancy is communicable. If you have one pregnancy in a high school, the incidences of a second and third are much greater than without the first pregnancy. The whole idea that my health is somehow my own and devoid of impact beyond my own is outdated in our increasingly socially connected modern time."

Data collected with such group interconnectivity in mind, can be used by health policy makers to develop approaches that better public health.

In her published work and in a recent report for the European Commission, Joint Research Centre, Piniewski argues that crowds can and do get sick together, therefore they likely can also get well together. She organized a six-month trial in which individuals communicated and competed online while trying to lose weight. The results showed that individuals who engaged more socially with fellow participants lost more weight and sustained more optimal health behaviors.

"Social media allows people to participate and be there for each other in ways we would all like to be there for each other but can't because life is so busy," she explained.

Piniewski believes the popularity of online games proves people will compete for prizes other than money, and positive motivators could contribute to improved fitness and health. For instance, a mother can be rewarded for losing weight or climbing stairs with free parking at the office or with funding for a climbing wall at her children's school.

"The prevalence of gaming and the connecting in ways that we never did before means we're no longer locked into a single central currency model," said Piniewski. "Technology can build a flexible mechanism so when someone does the right thing the data doesn't go into a vacuum. With a simple platform, this mother can contribute her (count of climbed stairs) to her daughter's school, which is building a climbing wall or to her state total, which may be driving a federal health bonus. Within this lightly instrumented environment, this mother eventually is unable to bypass stairs anymore because too much is at stake."

Learn more about Piniewski's work:

Nudging lifestyles for better health outcomes: crowdsourced data and persuasive technologies for behavioral change (.pdf)

Campus led, crowd-based approaches to community health improvement (.pdf)


Copyright © 2011 by the Catholic Health Association of the United States
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