• by Prodeep Bose , Elizabeth Elfenbein , February 18, 2011

Why is it that the average teenager has a clearer recognition of Kim Kardashian's wardrobe than the colors that comprise a healthy meal? This reflects a critical insight about health and wellness: people lack an understanding of why an illness occurs in the first place and what could have been done to prevent it. In general, people aren't very accountable when it comes to their health. They treat their health topically or incidentally. And until something goes wrong, most people take their health for granted. Many only choose a healthy lifestyle as a result of having been jolted into reality by a health issue. Even then, there is no guarantee they will continue to do what they need to do in order to improve their health.

Understanding that mind-set affects behaviors.

Why is this a universal problem? Perhaps because people aren't educated enough about the simple things they can do to be and live healthier. They don't realize that the preventive piece of the equation is actually the more manageable and easier piece. They also don't understand that the physical behaviors that manifest from an unhealthy lifestyle affect one's emotional/mental health, which tends to result in a self-perpetuating downward spiral. Once you get a condition, be it chronic, terminal, symptomatic, or asymptomatic, educating gets a lot more complicated. Add to that the concept of compliance and persistence, and you have patients feeling overwhelmed and confused, which leads to emotional gridlock.

Prevention, prevention, prevention.

Perhaps if people were made to understand, in a bite-sized way, what prevention could do for them, they would be inclined to change their behavior even in modest ways. Prochaska and DiClemente studied behavior extensively and looked at what it takes to change. They came up with the Stages of Change Model. This model has been used a lot in the last few years for driving healthier outcomes through behavior modification in everything from weight loss to quitting smoking and drinking -- all lifestyle-related issues that can result in chronic and terminal conditions. Like anything, though, you can't force people to take better care of themselves. They need to see what simple lifestyle changes can mean to their lives.

At what point does a patient's health education begin and where?

Patients need health education before they become patients -- in schools, at food courts, bus shelters, and concerts. These are not the usual channels a pharma company considers when connecting with their customers -- since the assumption is that the customers of a pill must be on it. Let's imagine for a not-so-utopian moment that oil companies invest in alternate energy sources and pharma companies invest in health education that prevents expensive critical care. The information needed to prevent most complex health conditions is fairly simple -- the earlier the education, the simpler it is -- which is where food, lifestyle, and healthcare brands must find an obvious intersection. If Total cereal is going to talk about cholesterol, there's no reason why cholesterol drugs shouldn't educate on food.

Targeting education at different stages of a patient's journey.

Patients need information that is specific to, unbiased about, and relevant to where they are in a disease progression continuum. And the role of the physician is crucial -- not just as a primary source of patient education, but also as the one who recommends and guides how and where patients educate themselves. There is a common belief -- probably a sound one -- that an educated patient is a compliant patient and a compliant patient has better outcomes. There lies the dichotomy -- while physicians are the most reliable conduit for patient education, they happen to have the least amount of time to educate, especially in the primary care setting. This is why 50% of all physicians recommend Web sites to their patients for self-education. But patients often find themselves randomly navigating information that rises to the top of search results, or viewing sponsored articles that are highlighted on medical Web sites, which might or might not be relevant or specific to what they really need. This is one of the reasons why the other 50% of physicians don't recommend sites to their patients. But perhaps there is an opportunity for organizations to use customizable portals to serve the specific needs of patient education through the physician's practice.

One of the great innovations that Web2.0 has offered is the ability to combine fragments of content from multiple sources -- much like iGoogle. The notion of content aggregation allows time-crunched physicians and information-hungry patients to meet their needs of support and education both before and on therapy. This type of service offering creates real value for a patient-education process without blustering into that sacrosanct relationship between a physician and patient with a brand platform. Patients are far more likely to connect with information and tools from their physicians than from any pharma brand.

Cleveland Clinic has online programs that empower their physicians and patients with education and tracking tools that use innovative technologies, especially in chronic areas like diabetes and cardiovascular health (www.360-5.com). Some of them include wirelessly uploaded logs of glucose levels that are used for tracking progression, management, and outcomes. They also reduce the burden on the physician while improving the transparency and continuity of patient support beyond the physician's office. It's only logical that products would evolve their pill-plus programs with such offerings.

Education that's relevant and accessible.

There's a huge opportunity to provide health education at large by targeting education at the different stages in a patient's journey, e.g., preventive education to teens and young adults to engender the right behavior while they are young, as well as simple and specific disease-management education that makes science more accessible and the implications of their behavior easier to understand as they get older. What's key to all of this education is that it must be centered on the appropriate stage of their journey and, at the same time, be user-friendly. This type of education will almost always be welcomed and may provide a fundamental vehicle for positive change.