PERSONAL HEALTH INFORMATION MANAGEMENT

Personal health information management (PHIM) refers to activities that support consumers’ access, integration, organization, and use of their personal health information. We investigated PHIM in the health consumer population using a focus group and participatory design. In collaboration with health consumers, we identified PHIM activities and explored the design of new supportive technology. Our findings describe prominent PHIM activities such as monitoring and assessing health, as well as health-related decision making, planning, and action. We describe design principles our participants used during the participatory design of a PHIM tool. These include individual control, sharing, integration, security and flexibility. These findings provide new insights into emerging ideas in consumer health informatics research and technology design. Understanding health consumers’ PHIM needs is an important step in creating technology to support these needs.

INDIVIDUAL HEALTH MANAGEMENT

The health management system (HMS) is an evolutionary medicine regulative process proposed by Nicholas Humphrey^[1][2] in which actuarial assessment of fitness and economic-type cost-benefit analysis determines the body’s regulation of its physiology and health. This incorporation of cost-benefit calculations into body regulation provides a science grounded approach to mind-body phenomena such as placebos that are otherwise not explainable by low level, noneconomic, and purely feedback based homeostatic or allostatictheories.

• Many medical symptoms such as inflammation, fever, pain, sickness behavior, or morning sickness have an evolutionary medicinefunction of enabling the body to protect, heal or restore itself from injury, infection or other physiological disruption.
• The deployment of self-treatments have costs as well as benefits with the result that evolution has selected management processes in the brain such that self-treatments are used only when they provide an overall cost benefit advantage. The brain controls such physiological process through top down regulation.
• External treatment and the availability of support is factored into the health management system’s cost benefit assessment as to whether to deploy or not an evolved self-treatment.

Placebos are explained as the result of false information about the availability of external treatment and support that mislead the health management system into not deploying evolved self-treatments. This results in the placebo suppression of medical symptoms.