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Dr. Kvedar tells us that some people touch their phones up to 150 times a day, which, as an addictive behavior, results in the release of a small amount of dopamine. On the other hand, some devices require patients to push just one button a day, but are plagued with low compliance. Why is this?

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Joaquin Blaya, PhD
Replied at 11:18 AM, 18 Oct 2013

Hi Jennifer,
That is a multi-million dollar question. :-) If someone could answer that
in a succinct way they would be a millionaire because there are so many
organizations and companies looking to do exactly what you mentioned at the
end, to have their patients just click once a day on their system.

I'll give a first shot at what I think are some of the factors and would
love to hear from others about their experience.

I think the first big key is person motivation, and there are the
incentives that the application provides. So if I'm a very social person,
the incentive for me to be updated in twitter and facebook is a lot of
personal fulfillment, however, if that same person is diabetic, but doesn't
really feel bad, then entering even one piece of personal data isn't
interesting. On top of that, if it's a piece of data, say weight, so that a
nurse can call me to tell me that I'm getting fatter, I'm even less
inclined to do it. So I believe I've heard of programs that are trying to
connect the social with health. There's a program called Social Diabetes
which is for Diabetes Mellitus Type 1 which has individual data input, but
also a social component to see how your peers and friends are doing.

Gerente de Desarrollo, eHealth Systems <
Research Fellow, Escuela de Medicina de Harvard @@
Moderador, @@>

Jennifer Joe
Replied at 1:13 AM, 22 Oct 2013

Hi Joaquin,

Thank you for your incredibly thoughtful response. The interview with Dr. Kvedar wasn't long enough for me to truly dive into what Dr. Kvedar is proposing. And perhaps I'll hear more at the Connected Health Symposium.

I agree with the focus on personal motivation. Twitter and Facebook appeal to our long-standing ingrained human need to feel connected, feel supported, and to feel loved. This is also why religion is so powerful. This is why our parents have so much control over us even into adulthood.

It will be a very imaginative and creative person who will be able to make good health a religion--with or without our new amazing technology. So I will be very interested in what the Connected Health Symposium will propose.

Today, I met with Jeremy Balboni, one of the founders of Brooklyn Boulders, which is a huge rock wall/community space/work space with internet/yoga/interconnected space. His brick and mortar business has taken off like crazy. I've met BWH medicine residents who describe his rock climbing space like a cult, but in a good way.

And I remembered. Jeremy's greatest asset is that people see his space as a comfortable, open, friendly bonding space where they can perform a sport that makes them more confident in who they are, allows them to work with others and build problem solving skills, build strength, and makes them fit. That's a psychiatrist visit, physical therapist visit, and diabetic educator visit right in one place! Wow!

Are we so focused on making an addictive app that we forgot that technology is only the grease for the machine? Really? Do we think we can make a video game for obese kids that will motivate them to take more steps in order to advance to the next level in the game? Have we forgotten to just take the kids out for a hike? And use the app to find others to hike with us?!

I welcome these important discussions.

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