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Keynote David Bates on developing “sticky” technology for patient engagement

By Rebecca Weintraub, MD | 15 Dec, 2014

We are delighted to welcome David Bates, MD, MSc. as a Keynote Speaker for this Breakthrough Opportunities event with the Commonwealth Fund.

David is the Chief Quality Officer and Senior Vice President at Brigham and Women’s Hospital, Chief of the Division of General Internal Medicine at Brigham and Women’s Hospital, and Medical Director of Clinical and Quality Analysis at Partners Healthcare.

An internationally renowned expert in patient safety, David uses information technology to improve care, quality-of-care, cost-effectiveness, and outcomes assessment in medical practice. He is a Professor of Medicine at Harvard Medical School, and a Professor of Health Policy and Management at the Harvard School of Public Health, where he co-directs the Program in Clinical Effectiveness. He directs the Center for Patient Safety Research and Practice at Brigham and Women’s Hospital, and serves as external program lead for research in the World Health Organization’s Global Alliance for Patient Safety.

In this short video, David discusses current opportunities to support patient engagement through personal health records and mobile apps, as well as strategies for making these technologies “stickier” in the future.

We look forward to hearing your thoughts on David’s video below, and encourage you to submit ideas sparked by his closing comments:

(Note for those viewing this update via email, please click through to view David's video on


A/Prof. Terry HANNAN Advisor Replied at 3:48 PM, 15 Dec 2014

David, what a great terminology to describe what we are aiming to do-"stickiness".
Your short presentation reminded me of two earlier scenarios from out Kenyan campaign on "stickiness" where the patients become the users of the clinical information to improve care.
Graphic 1. An HIV patient capturing data (with alerts/reminders) in another patient's home.
Graphic 2. patients sharing their computer-generated summary record to educate each other and share their illnesses.

Attached resources:

Jordan Harmon Advisor Replied at 4:05 PM, 18 Dec 2014

Thanks David- really thought this interview was great. I'd love to hear more on allowing open notes from physicians to be viewed by patients, etc. What were some of the outcomes from this research? Do you think that by providing open access to notes and clinical info that patients would be more engaged in their care?

A/Prof. Terry HANNAN Advisor Replied at 4:31 PM, 18 Dec 2014

Jordan, I have attached two documents produced by Prof Danny Sands (who works in David Bates) backyard in Boston. I would also look up more of his work.
Also the work by the Californian Health Care Foundation on this topic. I will post some publications from there later today.

Attached resources:

Madhuri Gandikota Replied at 5:39 PM, 18 Dec 2014

I agree with Prof. Bates, that development of a “sticky site” which is synonymouos to patient engagement is the key for any tool that is developed with health IT.

Though there are no methodological approaches to do this, but , I feel
one of the way to achieve this is to follow the “Design thinking” approach developed by Stanford and embraced by the technology companies like IMB and SAP.

In nutshell, this involves, thinking, :

• User Experience IS NOT JUST User Interface:
- It should convey the interaction between organization and end-user eg. Patient, provider, clinic etc
• Infact, it is more than interaction, but have
- Empathy for all users, their needs, login & security
• Have a consistent with look and feel
- navigation controls, visuals, graphs, preferably interactive
• Focus on user value by
-engaging the patients, providers for their target roles

Most importantly have a collaborative review and participation of all the stake holders in the development of the final product.

Once we achieve this, the next most impratant thing is how to achieve the final (first) conversation with our pristine data. To me, a great soft ware which has LOW LATENCY, so that the end use will get quick answers will finally end the gap. !!


Hisham Yousif Advisor Replied at 5:40 PM, 18 Dec 2014

How do we make apps stick? Beyond clever marketing that appeals to younger generations how do we get people with chronic conditions to use technologic advances to monitor/manage their chronic conditions? As Dr. Bates pointed out, there is some promise in terms of app but the market is flooded with 40,000+ apps that most people do not use. I think part of the issue is that there is no standardization and there are so many different apps/versions that different health providers advocate that it is difficult to get any sort of traction. In addition, a lot of these apps are tacky and have too many features (most of which aren't used) that take away from the main functionality and make it confusing to use. One example that is taking flight is that of creating an app that can administer a self-eye exam that is being developed at (most probably) every ophthalmology program in the US. It has a single functionality and is easy to use, and now there is a race to see which developer can gain the most traction. In summary, it would be great to see an app that delivers functional data that is useful and promotes better health, is easy to use, and isn't crowded by dozens of other 'me too' apps.

A/Prof. Terry HANNAN Advisor Replied at 7:07 PM, 18 Dec 2014

Here are three documents that I believe are relevant to this topic but can be applied other aspects of this forum.

Attached resources:

A/Prof. Terry HANNAN Advisor Replied at 7:14 PM, 18 Dec 2014

Hisham, "As Dr. Bates pointed out, there is some promise in terms of app but the market is flooded with 40,000+ apps that most people do not use". When David mentioned this and as you have documented it brings us all back to the Gartner Hype Cycle. Therefore we must continually "measure what we do".

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