Personally collected health data is predicted to outgrow all other sources of health data by 2020. People are increasingly tracking and collecting data on their health, fitness, wellness, and lifestyle, using wearable or portable connected sensors and devices. Almost universally, those devices come connected with an app that users install on a mobile phone or tablet, and a portal where the data is stored. They are marketed as consumer products and are bought by would-be athletes, the “worried well”, and many people in between who want to change and improve their lifestyles and become more active.

Increasingly, medical devices also come connected. For example, people with diabetes tracking their blood sugar levels can now routinely send their data to an app and a portal (often hosted by the device vendor), rather than writing it down. These data might be shared with health professionals on an as-needed basis or as part of a shared care or continuous monitoring programme. Personal health systems may be relatively passive tools for collecting data, or may be smart in some way: offering feedback, depicting trends or giving advice, generating alerts to the user or remotely signalling a concern to a monitoring service or care professional.

In fact, the worlds of consumer devices and medical devices are merging. There is significant industry investment in more portable and wearable sophisticated monitoring technologies, in apps that are becoming more intuitive to use and deliver valuable feedback to users. Device vendors are developing or buying portals and apps that help them build patient and user loyalty. There is also investment on the part of healthcare providers and authorities to enable their healthcare information systems to receive data collected by personal health systems. Advocates of “big data” hope that this wealth of data and information that can be used for data analytics, medical evidence, population health management, and precision medicine.

However, there are many challenges to realising a richer connected world in which patients and healthy citizens co-operate in information, knowledge and decision sharing with health professionals. These include:
• worries about privacy protection and the misuse of personally collected data;
• concerns amongst professionals about the quality of patient generated data and their legal accountability as they devolve more monitoring and care decisions to patients;
• the limited availability of evidence of healthcare value (including cost savings) through the smarter use of personal health solutions;
• the challenges in changing professional culture towards a more equal collaboration and empowering relationship with patients and families;
• the slowness of healthcare providers and health authorities to build systems that can receive and process patient generated data; and
• the lack of interoperability and the persistence of data silos, with many commercial vendors reluctant to facilitate data sharing with health providers by adopting interoperability standards.

Cumulatively, these barriers have prevented a “break out” of personal connected health: only in few parts of the world have we seen innovative ideas and initiatives taken to scale. “Pilotitis” is a well recognised problem.

This Research Topic wishes to showcase state of the art initiatives that help to demonstrate:
• how innovative health systems and providers are developing the conditions for people to use personal health systems to deliver innovative prevention, monitoring and treatment scenarios;
• how they tackle challenges of interoperability and connectivity, privacy protection and usability,
• how clinician-patient relationships can successfully evolve towards greater empowerment and shared decision making through the use of digital health, and
• what value demonstration can be established from the use of connected personal health solutions.

This Research Topic is inviting submissions reporting empirical projects and initiatives that have demonstrated successful innovations in the design, deployment, use and evaluation of personal health solutions, that have put interoperability and connectedness into practice, that have tackled some of the challenges listed above, and/or demonstrated a health impact. We are especially interested to receive reports of formal evaluations including health outcomes, business modelling and cost benefit assessments, and any work that has succeeded in demonstrating sustainability beyond an initial research grant or period of pilot funding.

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Frontiers in Medicine

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Impact