The Future of the Health Graph (Health Social Layer) – Part 2



In Part 1 of this post I presented the argument that there is currently no true social layer in health. I think that a true health network layer (the Health Graph) will evolve that organizes users based on their health profile from multiple data points and will allow groupings based on a high degree of similarity between users (and thus relevance).

Personal health data exists today in many digital silos, and increasingly, APIs are being opened to allow app developers to provide services to users based on their personal health data.  Microsoft Healthvault and Google Health were designed as platforms from the outset, and recently, EMR vendors (such as PracticeFusion) have announced intentions to open APIs allowing development of personalized applications for physicians and patients.

While current applications built on these platforms have some degree of personalization based on an individual’s data, they are still mostly one-to-one connections between one app and one individual.  With the addition of the Health Graph, ‘social health applications’ will become possible across these platforms, greatly increasing value to users.

I know the common Health Graph API and Login are a long-shot, but it is the way things should be, so I hope it will happen someday.

 

Applications of the Health Graph

I think the most immediate application of the Health Graph is the ability to target content or questions from one user to another based on a higher degree of similarity and relevance than is possible in today’s one-dimensional “health networks”.  However, I think the real value of this Health Social Layer will come from the aggregation and sharing of personal health data and health content among personalized peer groups that are based on an individual’s health profile.  The Health Graph will allow applications to automatically segment users into meaningful peer groups, based on what the app is trying to accomplish.  Below are a few thoughts on features and applications that could be built on the Health Graph:

Q&A

Rather than posting a question to the appropriate forum or site, users will have health questions targeted to users with very similar health histories and characteristics increasing the relevance of the response.  A response will carry more weight to the user if they know what they have in common with the respondent.  For instance, a response about a potential therapy for depression is valuable.  But a response about this therapy from another user who has the same symptoms, history of depression, age, gender and sequence of therapies is much more relevant.  An analogy from standard Q&A sites is the value of Quora or Aardvark versus Yahoo! Answers.  I am an expert about my own body and health history, so if we share a very similar health history, my ‘expertise’ is relevant to you, and vice versa.

Surveys and Statistics

In addition to the type of Q&A described above, users will be able to ask simple quantitative questions that can be targeted at the appropriate audience.  Again using a depression example, if a user wants other users to rate the effectiveness of a given treatment, it is useful to have a result from a broad audience, but it is much more relevant if the answers are filtered to only users highly similar to the initial user.  Using this approach of targeted quant questions, an app could generate highly relevant data and statistics of how a given user responds relative to their peer group, and relative to the population as a whole.

Treatment Recommendations

I remember reading a series of Q&A posts about a certain drug from a popular health Q&A site.  User #1 was asking if this drug was appropriate for them, and if others had experience with the drug.  He listed a pretty detailed medical history in his initial post.  After numerous posts on whether the drug worked or did not work for respondents, but without context, another answer jumped out.  This respondent went on to describe a very similar medical history to User #1 (which was quite complex), and then gave a very detailed description of their trial with the drug (which was positive).  The relevance and weight of that post was very impressive.  The Health Graph will enable this level of relevance for all questions and recommendations.

Health Games

It seems to me that it is a lot more fun to compete with others when I know a bit about them.  I think FitBit has done a nice job on this front by allowing users to see group data on activity level, but allowing filtering by important characteristics: age, BMI, etc.  This peer group is relevant to me, but comparing my activity level to an 18 year old marathon runner probably is not.  True peer groups open many opportunities to add game mechanics into health apps.

Social Tracking – Longitudinal Data Collection by Peer Group

I think one of the most powerful outgrowths of the Health Graph and ability to define highly relevant peer groupings will be the ability to track specific pieces of data over time.  I have written previously about the rapid rise in health trackers facilitated by smart phones.  While most of these trackers are for the individual, the power of social tracking far surpasses individual tracking.  With a well defined and relevant peer group, I think the value of tracked data will grow exponentially.  In addition to seeing how you are trending relative to your peer group, the Graph makes it possible to compare two groups who are essentially equivalent, but differ on one key characteristic: drug A vs. drug B, migraine with aura vs. without aura, frequent exercise vs. infrequent, etc.  With enough data on each user, over time these could become well matched and well controlled studies.

Please let me know of your thoughts on these concepts, or other potential uses for the Health Graph …

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9 Responses to “The Future of the Health Graph (Health Social Layer) – Part 2”


  1. 1 Gary Wolf December 3, 2010 at 3:07 pm

    Thank you Chris for that extremely helpful account. It unifies a lot of
    disconnected threads of discussion from various parts of the health/social conversation, and puts them into an analytically coherent form. Every paragraph is, potentially, the beginning of an extended discussion.

    One question worth asking: what qualifies as health data? There is an obviously circular answer: health data is any data that a particular social graph vendor includes in the graph; a fact that is likely to be determined by whatever rules, TOS, etc, are defined for the APIs. Are we satisfied with the notion that this will all be “worked out” by market forces, broadly defined?

    How happy are we with the formalization of the social that has been achieved by Facebook and other vendors? Are there any lessons from the good and bad effects of attempts to formalize the social so far that we would like to use in defining our hopes for the health graph?


    Gary Wolf
    @agaricus

    • 2 Chris Hogg December 4, 2010 at 10:14 am

      Hi Gary,

      Thanks a lot for your comment. This is a good question of what constitutes ‘health data’. To be honest, i had not really thought of the limits/extent of what would be included. I was more focused on the early first step of mapping ‘standard’ health data: age, weight, chronic conditions, etc. Of course it can get very complex when you add in activities, attitudes toward health and treatment, personal interests and behaviors, etc. This is a good point for further thought and discussion.

      As for the ‘Facebook Problem’, this is actually one of the things that started me thinking about, and writing, this post. I would hate to see someone, or some group, develop this new Health Graph and try to contain it. My hope was to start a discussion that this Graph will develop, and begin to think of ways to make sure this Graph is portable and free from the outset. I do think that eventually formal standards will develop for this Graph. But if we start the discussion now, we can force these standards to be open from the outset.

  2. 3 Gary Wolf December 7, 2010 at 11:25 am

    Chris – thinking more about this: there is a good “conceptual” role to be played here by people whose professional training allows them to be comfortable in the world of technical abstractions. Programmers should be thinking philosophically about these questions, because there will be a big difference between solutions that begin with the common metrics that are being tracked (weight, calories, etc.) and solutions that begin with unspecified “tracking entities” and only acquire definition “downstream.” When we think about a health graph, I’d prefer that we be thinking about something that is not walled off from the diverse tracking streams that are already in use, or may come into use. Seems innocent enough, but this preference actually presumes a radical redefinition of the concept of health.

    • 4 Chris Hogg December 14, 2010 at 6:30 am

      Hi Gary – I really like this concept that some of the items we track will ultimately become a large part of the ‘definition’ of our health profile, but that we might not know how at the outset – gaining definition “downstream”. I think i might see this as a hybrid approach. there is already defined data about our bodies and health – our current metrics, our health history, and these data points generally have structure (linked data sets). So i think these data are useful, to a point, and should not be overlooked initially. granted, these measures will change over time also, but i could see these ‘basic’ pieces forming something of a foundation, or jumping off point, for our health profile (the low hanging fruit). we will then add complexity (and richness) to our profiles, over time, through these more abstract tracking streams or tracking entities. clearly over time these streams will gain definition, but also power (through sheer amount of longitudinal data), and may begin to dwarf the ‘foundational’ data in importance.

      Thanks again for your insight.

  3. 5 Susannah Fox December 14, 2010 at 11:01 am

    Thanks so much for writing this — and opening it up for comments.

    I have a few reactions:

    1) This is not a far-fetched, futuristic idea. Pew Internet has data to show that about 1 in 5 internet users go online to find people who have similar health conditions. See: http://pewrsr.ch/Cancer20 for now and a January 2011 report which will go into detail. Some people are also tracking health indicators online. Bottom line: people are ready for this conversation.

    2) I’ve been reading & hearing about how people make health decisions not only in the context of what will work for them, but how the choice fits with their values. Research shows that many teenage girls want to get birth control advice from someone like them – not just another 15-year-old girl, but one who looks like they do, has had experiences like they’ve had. Can the Health Social Layer take that into account?

  4. 6 Chris Hall December 14, 2010 at 1:46 pm

    Loving this conversation. I see three problems to be solved, with privacy being the biggest concern:

    DATA COLLECTION – How does a system get social AND health data from individuals and put it together to create a more holistic view of the people… ultimately making it easier for them to connect? Asking people to manually enter this data is difficult. Piecing together APIs could possibly work. But it’s interesting to think about the web browser as a possible solution. An application on top of the browser can log web activity that individuals can choose to share anonymously. A person’s search strings, as well as the pages they visit tell a lot about both their social and health interests.

    DISCOVERY – How do people find other people with similar health conditions AND social interests? Data collected from individual browsers can populate an anonymous “personals” portal, that displays quantitative results around each individual and matches people who are “alike.” Interaction can remain anonymous or move to the physical world with the consent of both parties.

    CONNECTION – How do the interactions and experiences of similar individuals benefit the broader condition specific community? A combination of automated aggregation and manual curation can build searchable, condition specific knowledge centers.

    That’s how I see it, anyway… 😉

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  1. 1 The Future of the Health Graph (Health Social Layer) – Part 1 « Citizen Medicine Trackback on December 3, 2010 at 6:27 pm

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