There’s an App for That — Dr. Linda Li from CHÉOS at St. Paul’s discusses e-health and the future of her field

September 21st, 2017

With over 165,000 health and wellness apps available, technology’s permeation into health care has earned the name “e-health”, and offers to help patients track and manage their conditions with some digital help, ranging from pop-up notifications about exercise goals to an AI therapist.

Dr. Li, Senior Scientist at Arthritis Research Canada, first engaged with e-health when she began doing research on how patients make decisions regarding different treatment options.
“We started looking at options to help people make better treatment decisions and recognize that they need to go to a doctor in a timely manner,” said Dr. Li. “So, we started to develop patient decision aids.”

In a collaboration with students from the Centre for Digital Media in Vancouver, Dr. Li’s team developed an interactive patient decision aid to present the latest evidence about a common arthritis medication. “We tested it and found that it actually helped people to make better decisions and feel less conflicted,” said Dr. Li, pointing to results from a proof-of-concept study of ANSWER-2, which CHÉOS’ Dr. Nick Bansback co-authored.

Prior research Dr. Li has been involved in showed that when patients used the internet to learn more about their conditions, their interactions with health care providers changed—patients were more likely to engage in a discussion with their doctor, rather than have the treatment plan dictated to them. She believes wearable devices and health apps could further empower patients.

“Knowing your own body gives you a lot of power when you go to see your doctor, in terms of knowing exactly what to convey about what you feel is out of the ordinary, and to engage in a discussion,” said Dr. Li. “Some of the patients we’ve interviewed talk about a more level playing field.”

Investigating the use of digital media to help patients make decisions spring-boarded Dr. Li into projects that examine how to incorporate technology and digital media into knowledge translation and arthritis care, such as how to leverage the use of wearable devices, like a Fitbit, in physical therapy and exercise promotion. For example, Dr. Li served as the medical consultant and scientific lead for the development of Walk10Blocks, an iOS app that encourages sedentary people to walk at least 10 blocks a day.

Screenshot via

On the surface, the app is an incentive to move, with motivational pop-up notifications and badges that can be unlocked with various levels of activity. However, research questions built into the app are collecting data on how users interact with the app—how often they open it, whether they complete the surveys, and more—that can be useful for improving the app and building more digital tools to prompt people to alter their behavior and assume healthier habits.

Moreover, at the BC Support Unit, an organization for patient-centred research, Dr. Li leads a group responsible for advancing the science in knowledge translation and implementation. Her team collaborates with the Unit’s Data Sciences and Health Informatics Cluster to develop an infrastructure for large databases, which can combine patient-reported data (such as Fitbit data) with administrative health care data. Such a data set could further knowledge of disease progression and management, as well as identify gaps in care and opportunities for intervention.

“When you incorporate patients’ experiences, which are collected on a day-to-day basis or over a long period of time, in a big database, you may actually see trends that nobody has thought of,” said Dr. Li. “That’s where I see e-health research going, not only improving care for patients—faster and more accurate screening, diagnosis, better management, better access to care—but also asking better research questions in a way that is truly meaningful.”

Dr. Li is currently testing a fitness tracking web app FitViz in clinical trials and recruiting patients for studies involving wearable devices.

This article has been republished from CHÉOS’ e-newsletter, click here to read the original.