Technologies used by patients to manage their health issues outside of medical institutions are gaining momentum.  The explosion of the technological innovations, concerns about the cost of healthcare, shifting patient habits and the expectation for shared decision-making with their doctors, and political interests in stimulating competition among providers are some of the reasons for this surge of interest.

Self-management tools can be categorized by patient roles and the complexity of the technologies:

Subordinate: tools such as video monitoring or home surveillance sensor systems provide limited patient discretion beyond agreement to use the tools.

Structured: these are tools that provide more active self-management, but in highly defined ways. Examples include sound and text reminders from a tabletop appliance or perhaps a personal digital assistant or telephone, or devices allowing a patient to transmit data such as blood pressure readings.

Collaborative: this category includes decision support aids, online interventions, chronic disease management aids, and patient education materials.

Autonomous:  tools for autonomous roles do not require regular participation or input from professionals. Internet sites such as eDiets and home heart defibrillators are examples of this category of tools. 

Tools that support subordinate roles offer added convenience, greater precision, fewer errors, and less stress;  tools for structured roles still require  adoption by clinicians; collaborative tools are preferred and mostly used by better educated patients and the aspiration of some doctors; and tools supporting autonomous roles don’t require doctor participation and their use depends on patient preferences and personal circumstances.

Source:  California Healthcare Foundation, June 2010