In the past decade of my clinical practice, I have encountered numerous patients brought to the hospital in life-threatening conditions. Among them were several young individuals who, despite having no prior medical history, required ICU admission due to major health issues such as heart attacks, strokes, kidney or liver dysfunction, and other serious conditions. During the assessment of their medical histories, no significant health issues were identified before hospitalization. Unfortunately, some of these young patients succumbed to their ailments. When questioned by the patients’ relatives about the preventability of these clinical conditions, doctors responded affirmatively, emphasizing that prior health check-ups might have detected abnormal parameters earlier.

The modern lifestyle, characterized by altered food habits and disrupted sleep patterns, underscores the importance of identifying minor health issues in their early stages to prevent major catastrophic events. While individuals invest significantly in health insurance to mitigate the financial impact of hospitalization, they often neglect preventive measures. Many diseases are preventable, and the progression of these conditions can be controlled or reduced with timely interventions. Therefore, preventive medicine warrants equal importance alongside therapeutic management. As the saying goes, it is better to build dams than to wait for the flood.

Preventive medicine involves promoting health measures to avert disease, a form of prophylaxis that reduces the risks of diseases, disabilities, and death. There are four levels of prevention:

1. Primordial prevention: Preventing the occurrence or development of risk factors.

2. Primary prevention: Preventing disease when a risk factor is present.

3. Secondary prevention: Preventing the complications of an existing disease.

4. Tertiary prevention: Preventing disability or death from an existing disease.

By the time individuals seek medical consultation, they often already have established diseases or risk factors. While doctors can provide medications for secondary or tertiary prevention, primordial and primary prevention are equally vital, emphasizing the proverb that prevention is better than cure.

Consider, for example, a young overweight individual presenting with persistent headaches and elevated blood pressure. Treating the high blood pressure with medications constitutes secondary prevention. However, had the same individual consulted a doctor a few years earlier when noticing weight gain, the doctor might have advised lifestyle modifications to control body weight, representing primary prevention. If attention had been given to healthy food, nutrition, and exercise before weight gain occurred, this health education would be considered primordial prevention.

Physicians can guide individuals in adopting preventive health measures, emphasizing that preventive measures extend beyond medications to include simple lifestyle modifications, exercises, nutrition, and health awareness. While abundant information on healthy living is available on the internet, individuals often struggle to discern when to consult a doctor in the absence of active health issues.

Even in the absence of symptoms, it is advisable for individuals to undergo routine health check-ups annually. Early detection of abnormal parameters is fundamental to preventive medicine. These check-ups should include blood investigations (complete blood picture, renal function test, liver function test, thyroid profile, random blood sugar, and lipid profile), ECG, 2D-ECHO, and abdominal ultrasonography. If all results fall within normal limits, primordial prevention—incorporating healthy food, nutrition, exercises, and discouraging alcohol, smoking, and drug use—is sufficient.

For individuals with deranged lipid profiles and elevated cholesterol levels, dietary and lifestyle modifications are recommended as cholesterol is a risk factor for sudden heart attacks. Similarly, individuals with higher blood sugar levels can implement lifestyle changes, exercise, and dietary modifications to maintain HbA1c below 5.7%, avoiding the need for medications.

Awareness about health-related issues can aid in identifying major health concerns early. By cultivating the habit of periodic health status checks, many diseases can be prevented. Even healthy individuals should consult a doctor annually to discuss health check- up reports, allowing for preventive measures. Further investigations may be necessary if preliminary reports are abnormal, requiring regular follow-up with a doctor.

Common preventive measures advised by doctors to healthy individuals include:

1. Periodic measurement of blood pressure.

2. Annual blood tests to identify diabetes, thyroid disorders, and dyslipidaemia.

3. Breast cancer screening for women over 40 years and colon cancer screening for men aged 50 to 75 years.
4. Smoking, alcohol, and drug cessation.

5. Avoidance of a sedentary lifestyle and maintenance of a healthy body weight.

6. Regular vaccination and immunization.

7. Hand and oral hygiene.

Preventive care investigations or tests may vary by age group, with cancer screening and bone density screening becoming more relevant to elderly people. Despite the absence of apparent health issues, everyone should prioritize preventive healthcare for several reasons:

• Preventive healthcare identifies problems before symptoms manifest, facilitating early disease detection.
• It prevents the progression of diseases, averting complications.
• Regular health check-ups provide peace of mind, allowing individuals to discuss concerns with doctors and receive necessary support.
• While health insurance covers treatment costs, preventive healthcare identifies major health issues before they become severe, potentially avoiding costly advanced treatments.
• Those who care for others must prioritize their health to fulfill their role effectively.

Individuals are the heart and soul of their families, and it is crucial for them to prioritize their health through timely preventive care.

Author’s biography

Dr. Chandreshkumar Sudani has been working in the department of critical care as senior Intensivist. He has shown great contribution in public health by spreading awareness about preventive medicine.

The post Preventive Medicine: An Urgent Imperative appeared first on InnoHEALTH magazine.

Traditional healthcare has always been patient-centric. What does that mean? A patient is defined as “a person receiving or registered to receive medical treatment.” While the patient-centric functioning may have been perfect for a fee-for-service economic model, the world is rapidly moving towards a value-based model that focuses on preventive medicine.

This value-based model shall see a majority of healthcare providers being rewarded not for the number of procedures performed or patient appointments, but the health outcomes of the people under their care. Thus, the ultimate goal is to shift from just treating conditions to ensuring overall wellness. This value-based preventive medicine model is pushing for a reduction in the need for care and making that a measure of success.

UX design: Empowering proactive healthcare

User experience (UX) design has been driving the healthcare technology sector towards bold changes in the past few years. This has happened in conjunction with the rapid spread of technology that outlines how, when and where healthcare services should be delivered. This healthcare delivery approach is more consumer-centric than ever, with people asking for care that works best for them, and pushing for personalized plans. Here’s an overview of how people are making use of digital healthcare tools to manage their basic tasks –

What is proactive healthcare?

In 2017, Stanford Medicine partnered with Apple to launch the digital health study. This study made use of the Apple Watch to screen for irregular heart rhythms in 400,000 participants. Its goal was to learn if the watch could detect atrial fibrillation, a heart condition causing 130,000 deaths and 750,000 hospitalizations in the United States each year. It often remained undiagnosed because many people never experience symptoms; it can increase the risk of stroke and heart failure.

The algorithm in the Apple Watch was revealed to successfully identify atrial fibrillation. Additionally, it also showcased user engagement that can be enhanced with the use of digital health alerts. A survey of participants who received an irregular-pulse notification showed that 76% contacted either the telehealth provider or a non-study provider, suggesting that many actively sought medical attention as a result of an irregularity identified by their Apple Watch

This is a fine example of a person-first healthcare system, also called a proactive healthcare system. It proactively analyzes data to identify people at risk and takes the right steps to intervene and provide support and sustain wellness.

Health management devices such as fitness trackers or blood sugar monitors help people become active partners in managing their condition, rather than remain passive recipients of treatment.

How can UX contribute to designing proactive healthcare?

A people-first healthcare system is one that mindfully engages them to identify the best care based on their personal health status. For a healthcare system to transform into a people-enabled system, the key motivations and expectations of users must be at the forefront of its design. People are now proactively asking for healthcare tools that work best for them, creating an intensive demand for personalized options.

Here are three ways in which UX design can take things forward –

1. Designing personalized tools that put users in charge

Most healthcare apps until now were centered on solving an explicit problem.

A user complains of symptoms?

Help them book a doctor’s appointment.

A user’s insurance premium is due?

Provide easy payment options.

However preventive healthcare primarily focuses on wellness, dealing with situations wherein the user is yet to encounter a problem. Therefore, proactive healthcare tools have to be designed in a way to get users interested in activities that would prevent them from having the explicit problems mentioned before. 

The World Health Organization estimates that 50% of the global burden of disease is chronic illness. Health management devices such as fitness trackers or blood sugar monitors help people become active partners in managing their condition, rather than remain passive recipients of treatment. Fitbit’s achievement badges are among the best examples of technology in healthcare, which rewards the user for having accomplished a set of fitness goal, encouraging them to keep working on their health.

Regular and timely communication between health systems and patients is a standout feature of proactive healthcare design and is prominent among healthcare technology trends. It is a feature that has transformed the patient experience. For instance, cancer patients who completed treatment over a year ago and are overdue for screening can be reminded of the same via a highly targeted outreach. This early intervention plays an important role in identifying any relapses and ensuring timely treatment.

• Tracking population and individual health trends

Preventing the onset of illness is the holy grail of sustainable healthcare transformation and UX design plays an important role in its facilitation. There are 2 primary types of healthcare tools –

i.) Proactive solutions, which identify at-risk people by running known algorithms to track social determinants of health (SDOH) such as tobacco or alcohol consumption, sedentary lifestyle, or lack of nutrition, etc. Preventive action is then applied before the manifestation of symptoms, let alone illness. By integrating non-clinical factors and incorporating SDOH data into workflows, the gaps in patient management can be closed. For example, care providers can are the patients residing in remote food deserts and have the ability to provide them with a nutritional food delivery service.

ii.) Predictive solutions, which make use of healthcare AI technology or machine learning data algorithms for not only predicting and classifying risks, but also intervene at the right stage. For predictive healthcare solutions to work requires data from across the healthcare system. It also has to be aggregated, centralized, and analyzed to provide care managers with a 360-degree view of the population’s health and suggest actionable insights. In the recent pandemic, predictive solutions were deployed to virtually screen and identify people at risk of COVID-19 to determine the most urgent set of vaccine recipients. Another example of upcoming healthcare technology companies is Benevolent AI, which uses the deep learning to produce a better target selection and provide previously undiscovered insights, thus getting the right treatment to the right patients at the right time.

Well-designed apps are those that reinforce the concepts of privacy and security through functionality, navigation, and content.

• Giving users confidence with managing their health data

Privacy and security have always been considered as important concerns in digital experiences across any industry, more so in the case of healthcare. According to a survey conducted for Cyber crime and privacy breach, only 25% of consumers surveyed believe most companies handle their sensitive personal data responsibly but 85% of them say cyber security and privacy breach are among the biggest risks facing society. Well-designed apps are those that reinforce the concepts of privacy and security through functionality, navigation, and content. Two-factor authentication and end-to-end encryption work well, but users should also be made aware of background details such as cookies and data capturing to reinforce trust in privacy and security.

Conversely, there are also times where users may want to share access with other trusted members among their family, friends, or caregivers. A great user experience around privacy and security is one that enables users to let in the right people along with keeping out the wrong ones; and letting users make that choice themselves.

Today, virtually every sector has gone the digital way, curating well-designed experiences to better engage and be more responsive and responsible towards their customers. The impact of technology on healthcare is undeniable. Flyers get a text in advance informing them of flight delays, and next-day delivery at a preferred time and location is commonplace among eCommerce giants. A common thread running through these strategies is the focus on user-centric design, engaging their consumers proactively, and keeping them at the centre of their decision-making.

While the healthcare technology industry has been lagging on this front, it is now taking steps in the right direction, designing proactive systems to diagnose diseases in early stages to optimize treatment outcomes, helping people stay fit, and deploy digital tools to encourage self-management of health and lifestyle behaviours to prevent disease and illness.

Composed by: “Bansi Mehta believes that UX for workforces should be tailored to meet the needs of employees, managers, and business owners. She has led the design of many healthcare products, applications, and tools with respect to user-centric design. She has pioneered the need for research-led design within organizations.”

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