A blog covering the health/care ecosystem and people.

Mobile and digital technologies will bend the health care cost curve, drive individual and population health, and solve the nagging challenge of health disparities. Mobile and digital technologies will increase costs to health providers, disrupt work flows and lower clinicians’ productivity, and hit a market bubble. Depending on your lens into mHealth, and what product categories and user segments you’re looking at, all of the above can be true. The plenary session of the 2014 mHeath Summit kicked off with Dr. Harry Leider, Chief Medical Information Officer of Walgreens, who spoke of the pharmacy’s evolving role across the entire continuum of care,

This post is written as part of the Disruptive Women on Health’s blog-fest celebrating the 2014 mHealth Summit taking place 7-11 December 2014 in greater Washington, DC. Women and mobile health: let’s unpack the intersection. On the supply side of the equation, Good Housekeeping covered health tracking-meets-fashion bling in the magazine a few weeks ago in article tucked between how to cook healthy Thanksgiving side dishes and tips on getting red wine stains out of tablecloths. This ad appeared in a major sporting goods chain’s 2014 Black Friday pre-print in my city’s newspaper last week. And along with consumer electronics brand faves like

Dr. Joseph Kvedar has led the Center for Connected Health for as long as I’ve used the word “telehealth” in my work – over 20 years. After two decades, the Center and other pioneers in connected health have evidence proving the benefits, ROI (“hard” in terms of dollars, and “soft” in terms of patient and physician satisfaction), and technology efficacy for connecting health. The 11th Annual Connected Health Symposium is taking place as I write this post at the Seaport Hotel in Boston, bringing health providers, payers, plans and researchers together to share best practices, learnings and evidence supporting the

With the goal of driving a digital health platform for well-informed, effective self-care, the nation’s largest retail pharmacy chain and prominent consumer-facing health information portal are allying to move from serving up pills and information to health “care.” Walgreens and WebMD launched their joint effort on 2nd October 2014, a few weeks after CVS/pharmacy re-branded as CVS Health. Welcome to the reinvention of the retail pharmacy. I spoke for a few minutes with David Schlanger, CEO, WebMD, and Alex Gourlay, President, Customer Experience and Daily Living, Walgreens, the day of the launch, to get early insights into the vision for

More than twice as many patients than physicians are embracing consumers’ use of new digital technologies to self-diagnose medical conditions on their own. On the other hand, 91% of doctors are concerned about giving patients access to their detailed electronic health records, anticipating patients will feel anxious about the results; only 34% of consumers are concerned about anxiety-due-to-EHR-exposure. Welcome to the digital health chasm, that gap between what consumers want out of digital health, and what doctors believe patients can handle at this stage in EHR adoption in doctors’ offices and in patients’ lives. I have the video of Jack

National health spending will comprise 19.3% of U.S. gross domestic product in 2023, nearly $1 in $5 of all American spending. This statistic includes the expenditure categories for health spending as defined by the Centers for Medicare and Medicaid Services (CMS), Office of the Actuary. The number includes hospital care, personal health care, professional services (physicians and other professionals), home health, long term care, retail sales of prescription drugs and durable medical equipment, and investment in capital equipment, among other line items. The forecast was published in Health Affairs article, National Health Expenditure Projections, 2013-23: Faster Growth Expected With Expanded

The supply side of telehealth has been readying itself for nearly a decade. The demand side appears to be aligning in 2014 for adoption to grow and sustain (some) solid business models. On the demand side, Towers Watson’s 2014 survey of large employers forecasts growth among companies that will offer telemedicine in 2015. Towers found that 37% of employers planned to offer telemedicine to workers as a lower-cost site of care; 34% more employers were considering telemedicine in 2016 or 2017.  The health benefits adviser calculates that employers could save over $6 billion if industry replaces virtual health consultations with

Nations throughout the world are challenged by the cost of health care: from Brazil to China, India to the Philippines, and especially in the U.S., people are morphing into health care consumers. Three categories of health spending in the bulls-eye of countries’ Departments of Health are prescription drugs, and the costs of care in hospitals and doctors’ offices. In the U.S., one tactic for cost containment in health is “switching” certain prescription drugs to over-the-counter products – those deemed to be efficacious and safe for patients to take without seeking treatment from a doctor. Over-the-counter drugs (OTCs) are available every

Make-over your medicine cabinet. That’s a key headline for International Self-Care Day (ISD) on July 24, 2014, an initiative promoting the opportunity for people to take a greater role in their own health care and wellness. Sponsored by the Consumer Healthcare Products Association (CHPA), consumer products companies, health advocacy organizations, and legislators including John Barrow (D-GA), a co-sponsor of H.R. 2835 (aka the Restoring Access to Medications Act), the Day talked about the $102 billion savings opportunity generated through people in the U.S. taking on more self-care through using over-the-counter medicines. After the 2008 Recession hit the U.S. economy, industry analysts

“Reality is the leading cause of stress among those in touch with it,” Lily Tomlin once quipped. Perhaps in 2014, America is the land of stress because we’re all so in touch with reality. THINK: reality TV, social networks as the new confessional, news channeling 24×7, and a world of too much TMI. So no surprise, then, that one-half of the people in the U.S. have had a major stressful event or experience in the last year. And health tops the list of stressful events in This American Life in the forms of illness and disease (among 27% of people)

Smarter homes can conserve energy, do dirty jobs, and remind you to take your medicine. In doing all these things, smart homes can also collect data about what you do inside every single room of that home. The fast convergence of Wi-Fi and sensors are laying the foundation for the Internet of Things, where objects embedded with sensors do things they’re specially designed to do, and collect information while doing them. This begs the questions: what do you want to know about yourself and your family? How much do you want to know? And, with whom do you want to

Expanding its wireless footprint in health care, Verizon, the telecommunications company, announced the start of Verizon Virtual Visits today. The program will be marketed to employers and health plans to enable patients to see doctors at home or when traveling, via Verizon’s wireless network. I spoke with Christine Izui, Verizon’s quality officer, mobile health solution, earlier this week about Virtual Visits. We discussed the market forces that support the growth of telehealth and, in particular, physician visits “anywhere:” There is an under-supply and poor distribution of primary care doctors and certain specialties around the U.S. Employers and health plan sponsors are

Tomorrow is World No Tobacco Day. The use of tobacco is one of the most preventable public health issues on the planet. And the global tobacco epidemic contributed to 100 million deaths around the world in the 20th century. 6 million people die every year due to tobacco use — including 600,000 deaths due to exposure to secondhand smoke. About 500 million people living today will be dead from the use of tobacco products if current smoking habits continue, the World Health Organization (WHO) expects. WHO sponsors the World No Tobacco Day every year on May 31. For this year’s

People managing chronic diseases are more likely to have accessed information in their electronic medical records — and are also less likely to worry about the privacy risks of their personal electronic health information compared with people who are healthy. Over 2,000 people, both those who say they’re healthy and those with chronic conditions, were surveyed by Accenture in February-March 2014, and their responses are summarized in the report, Consumers with Chronic Conditions Believe the Ability to Access Electronic Medical Records Outweighs Concern of Privacy Invasion. Slight more consumers are concerned about privacy risks related to online banking, online shopping,

I have seen the future of food and it is in Italy at a grocery chain called Conad, which launched a locavore-focused brand called Sapori & Dintorni. Here in Florence, Italy, where I’m spending a week’s holiday with my family, we stay in an apartment in the Oltrarno – just south of the Arno River, up a short hill from the southern tip of the Ponte Vecchio, the old bridge known for its gold and silver jewelry. But the real gem in this neighborhood is that grocery store, whose Sapori & Dintorni label represents food sourced from Italy’s great food

In 2014, we are digital omnivores. Most people “consume” information and entertainment on more than one screen: 7 hours’ worth over a 5-hour period. You read that right: most people who watch TV, use a laptop or PC, smartphone or tablet are multitasking use of these devices in parallel. And above all, people are using smartphones as their primary screen. The AdReaction: Marketing in a multiscreen world report from Millward Brown paints a picture of global consumers who are cobbling together multiscreen experiences. The smartphone has become the “do it all” device if you don’t carry a laptop or tablet around, especially favored

With health costs increase increasing at 4.4% in 2014, a slightly higher rate of growth than the 4.1% seen in 2013. While this is lower than the double-digit increases U.S. employers faced in 2001-2004, it’s still twice the rate of general consumer price inflation. That’s what the first graph shows, based on the The 19th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care.  Employers generally want to continue to provide health insurance…for the time being. 92% of companies expect to make changes in health plan provisions in 2014, with 1 in 2 anticipating “significant

Today, Valentine’s Day, is full of the signs of love. I’ve gotten several hugs and “I love you’s” from my daughter (a teenager – how fortunate am I?!); my husband returned home from a business trip in inclement weather, in time to share a romantic evening; my Facebook page has countless hugs and loving messages from friends near and far; and, I received real paper Valentine cards, old school style. But the best healthy Valentine gift I got was that my husband went for a check-up with his doctor, my daughter ate a great big breakfast before she went to

While the prescription drug bill makes up about 10% of U.S. national health spending, the fastest-growing component of pharmacy spending is specialty medications. These are categorized as “specialty” drugs because they rarely have generic equivalents, and treat serious or life-threatening diseases (such as cancer, MS, and rheumatoid arthritis). They are also “special” because specialty pharmaceuticals average $3,000 per patient per month and can surpass $100,000 a year for certain products. As a result, the top two goals for managing specialty medications among employers are #1, to reduce inappropriate utilization, and #2, to reduce drug acquisition costs, based on a survey

Americans have been eating more healthfully in the past couple of years, according to the USDA which examined eating patterns among working-age adults in the U.S. between 2005 and 2010. And most people do believe they are indeed healthy eaters: three-quarters of people in the U.S. say they eat healthfully. On the other hand, it’s difficult to do that consistently. Why? Lack of motivation (37%), busy schedules (33%), lots of stress (30%), and money (29%).  Underneath these numbers are differences between women and men. When it comes to food and healthy eating, it seems men are from Mars and women,

Millions of health citizens, consumers, patients and caregivers flock to Facebook, Twitter and Wikipedia every day the world over to seek health information, advocate for patients’ access to a cancer therapy on a health blog, engage in peer-to-peer health care in a social network, and bolster each others’ management of chronic medical conditions in a chat community. Yet the pharmaceutical and medical device industries rank well behind other industries vis-à-vis the use of social media, asserts Engaging patients through social media, with the punchline question: is healthcare ready for empowered and digitally demanding patients? from the IMS Institute for Healthcare Informatics, published on

When the head of the Consumer Electronics Association gives a shout-out to the growth of health products in his annual mega-show, attention must be paid. The #2014CES featured over 300 companies devoted to “digital health” as the CEA defines the term. But if you believe that health is where we live, work, play, and pray, then you can see health is almost everywhere at the CES, from connected home tech and smart refrigerators to autos that sense ‘sick’ air and headphones that amplify phone messages for people with hearing aids, along with pet activity tracking devices like the Petbit. If

Wearable technology is the new fashion accessory, Accenture observes in its 2014 survey report, Racing Toward a Complete Digital Lifestyle: Digital Consumers Crave More. In parallel with the supply-side growth of wearable technology that is seen this week at the 2014 Consumer Electronics Show, Accenture brings a sanguine story to the supply side of the equation, finding consumers “craving more” than one function from a digital device. Over one-half of consumers surveyed in six countries favored vehicle navigation, home safety/security monitors, health monitor, home comfort and control, fitness monitors, and personal safety monitors. Nearly one half (46%) liked smartwatches, and

We who are charged with forecasting the future of health and health care live in a world of scenario planning, placing bets on certainties (what we know we know), uncertainties (what we know we don’t know), and wild cards — those phenomena that, if they happen in the real world, blow our forecasts to smithereens, forcing a tabula rasa for a new-and-improved forecast. There are many more uncertainties than certainties challenging the tea leaves for the new year, including the changing role of health insurance companies and how they will respond to the Affordable Care Act implementation and changing mandates

At the Venture+ Forum at the 2013 Mobile Health Summit yesterday, Lisa Suennen, Managing Director of Psilos Ventures was asked what she and her venture capital fund look for in choosing new investments for their health care portfolio. She succinctly said, “technologies that lower costs.” With nearly $1 in $5 of the U.S. economy attributable to health spending, Lisa’s got a point. Technology in U.S. health care has been mostly additive and expense-inducing, not reducing: fax machines and printers, for example, continue to proliferate in health care settings as part of “networking,” and once you add a new clinical technology

People who are diagnosed with at least one chronic medical condition are more likely to seek information online, use social media to understand peer patients’ reviews on drugs and treatments, and learn from other patients about their personal health experiences. While that’s encouraging news for a health empowerment headline, the underlying challenge that should prevent congratulatory fist-bumps among patient-engagement proponents is that people living with chronic disease are less likely to have internet access. Why? Because chronically ill people tend to be older and less educated, and they’re also less likely to be working. Simply put, “People living with chronic

Coast-to-coast, stress is the modus vivendi for most Americans: 55% of people feel stressed in every day life, according to a study from Televox. A Stressful Nation: Americans Search for a Healthy Balance paints a picture of a nation of physically inactive people working too hard and playing too little. And far more women feel the stress than men do. 64% of people say they’re stressed during a typical workday. 52% of people see stress negatively impacting their lives. And nearly one-half of people believe they could better manage their stress. As a result, physicians say that Americans are experiencing negative

Patient and health engagement is the flavor du jour in health circles these days, from the corridors of hospitals to the caffeinated marketing meetings in Big Pharma’s east coast meet-ups. But there’s no standard agreement on what we mean by peoples’ health engagement, whether by patient or well consumer. In Market Insights: The Evolution of Consumer Engagement in Health Care, Porter Research endeavors to deepen our understanding of this important concept. In the introductory section of the paper, “Understanding Engagement,” Porter proffers that industry – providers, payers and employers – consider engagement as “changing consumer behavior through increased participation in consumers’ own health

The “O” word drives health costs in America ever-upward. Without bending the obesity curve downward toward healthy BMIs, America won’t be able to bend that stubborn cost curve, either. The Economic Impacts of Obesity report from Alere Wellbeing accounts for the costs of chronic diseases and how high obesity rates play out in the forms of absenteeism, presenteeism, and direct health care costs to employers, workers and society-at-large. Among the 10 costliest physical health conditions, the top 3 are angina, hypertension and diabetes — all related to obesity and amenable to lifestyle behavior change. The top-line numbers set the context:

Where can you shop the health and beauty aisles, pick up some groceries and a prescription, get a flu vaccine, and weigh in on Obamacare and what digital health tools you like? Why, at one of several thousand retail stores where you can find a SoloHealth kiosk. As of yesterday afternoon, over 32 million encounters were recorded on SoloHealth kiosks, based on an app I saw on the company CEO Bart Foster’s smartphone. Kiosks are locatted around the United States in retailers including Walmart and Sam’s Clubs, along with major grocery chains like Schnuck’s and Publix, and the CVS pharmacy

When certain people use certain dietary supplements, they can  save money, according to a report from the Council for Responsible Nutrition and Frost and Sullivan, the analysts. The report is aptly titled, Smart Prevention – Health Care Cost Savings Resulting from the Targeted Use of Dietary Supplements. Its subtitle emphasizes the role of dietary supplements as a way to “combat unsustainable health care cost growth in the United States.” Specifically, the use of eight supplements in targeted individuals who can most benefit from them can save individuals and health systems billions of dollars. The eight money-saving supplements are: > Omega-3 > B

The FDA has spoken: there are 2 statutory definitions for a mobile health tool as a “medical device” that the Agency says it has regulatory oversight: To be used as an accessory to a regulated medical device, or To transform a mobile platform into a regulated medical device. On page 8 of the Guidance for Industry and Food and Drug Administration Staff, you can read the FDA’s expanded definition of a mobile health app as being: “…intended for use in performing a medical device function (i.e. for diagnosis of disease or other conditions, or the cure, mitigation, treatment, or prevention

Mobilising Healthcare, a new report from Juniper Research, segments the mobile health sector into “healthcare” and “health & fitness” segments. The research summary notes that fitness is a relatively new market compared with health “care,” which has been around for eons. Fitness, the analysts say, “is exempt from government intervention.” Mobile healthcare (“mHealth”) applications explored include SMS health messaging, remote health provision such as cardiac monitoring, electronic health records and personal health records. In mFitness, Juniper looks into mobile tech for athletes and fitness conscious people, and activity tracking including heart function, distance, respiration, and perspiration, among other parameters. mHealth

In game-scoring unit terms, 52 is the number of hours an average American spends seeking health information online each year. The 1 (hour) is roughly equivalent to the approximate total time a patient spends with a physician (an average of 3 visits, with an average time per vision of 20 minutes). Thus, 52:1. This means that the average U.S. health consumer spends much more time DIYing her health using digital information resources than speaking face-to-face with their physician in the doctor’s office. Still, the physician continues to be a go-to source for health information, according to Makovsky, a health communications

The news this week that Fitbit attracted $42 million investment capital follows Withings’ announcement of $30 million (including Euro11 million from BPIFrance, the French national investment fund), Jawbone’s recent acquisition of Bodymedia for $100 million in April 2013, and MyFitnessPal raising $13 million earlier this month. The quick arithmetic for these four companies alone adds to roughly $200 mm in a few months going to these brands, which are feverishly competing for the heartbeats and footsteps of people who are keen to track their steps and stay healthy. Can you keep up? You need a new kind of activity tracker to track

Your new-nutritionist is now Google, which launched a nutrition utility through Google Search. “From the basics of potatoes and carrots to more complex dishes like burritos and chow mein, you can simply ask, ‘How much protein is in a banana?’ or ‘How many calories are in an avocado?’ and get your answer right away,” the official Google Search blog explains. Over 1,000 items – fruits, vegetables, meats, dairy items, and prepared meals like Chinese and Mexican take out, as mentioned in Google’s quote above – are searchable via web and mobile, powered by Google’s Knowledge Graph. The Knowledge Graph is the

There’s an issue that doctors and patients don’t discuss that’s among the most important contributors to ill health: it’s money, and it’s something Alexandra Drane calls an “Unmentionable.” Alex, Founder, Chief Visionary, and Board Chair at Eliza Corporation, coined Unmentionables as those aspects of daily living which everyone deals with, but few like to talk about: like sex (whether too much, too little), drugs (abusing), drinking (too much), toileting problems (such as incontinence or pooping problems), sleep trouble, and caring for others (not ourselves so much). These daily life challenges can negatively impact health, with financial stress being one of

The number of retail health clinics will double between 2012 and 2015, according to a research brief from Accenture, Retail medical clinics: From Foe to Friend? published in June 2013. What are the driving market forces promoting the growth of retail clinics? Accenture points to a few key factors: Hospitals’ need to rationalize use of their emergency departments, which are often over-crowded and incorrectly utilized in cases of less-than-acute care. In addition, hospitals are now financially motivated under the Affordable Care Act (ACA, health reform) to reduce readmissions of patients into beds (particularly Medicare patients with acute myocardial infarction [heart attacks],

Tablets, wearables, smartphones, video and QR codes: these are fast-growing platforms moving data around the global economy. They’re also fast=growing platforms for health care where we live, work, play and pray. Mary Meeker’s annual presentation on Internet Trends at the D11 Conference, is fresh off the virtual press in its shiny new 2013 version. Meeker has been with the investment firm Kleiner Perkins Caulfield Byers (KPCB) since 2011, and was with Morgan Stanley from 1991 to 2010. She’s a veteran who’s watched the Internet basically from The Beginning. Of the 117 slides in her informative, gargantuan deck (a Meeker hallmark every

Mainstream media, both print and online, peppered their 2013 Mother’s Day gift suggestions including pod coffeemakers, bangle bracelets, candy-colored accessories and digital health devices. Say, what? In Parade magazine, Mother’s Day 2013 gift ideas included the Fitbit “smart pedometer,” linked to a “buy” site at REI. You can’t get much more mainstream than Parade. In Entertainment Weekly, Bronwyn Barnes, style maven for the magazine, wrote a one-page “Get Ready for Mom 2.0” and her recommendations included the Pebble Smartwatch, the Jawbone Up wristband, and the HoodieBuddie with earbuds built into the drawstrings. Men’s Health told sons and husbands to check

Only 1 in 5 Americans got the minimum recommended amount of physical activity in 2011, based on guidelines offered by the U.S. Centers for Disease Control. More men than women met the standard: 23.4% of men versus 17.9% of women. There are wide variations across the 50 states, as the map shows, with the healthiest folks exercise-wise living in the west, Alaska, upper midwest, and New England. The range runs from a 12.7% low in West Virginia and Tennessee to 27.3 at the high end in Colorado. That bar is set at 150 minutes a week (that’s 2.5 hours) of

Consumers who patronize Walgreens can get rewarded for tracking their physical activity   For the Steps with Balance program kickoff, self-tracking consumers can earn 20 points for every mile walked or run and 20 points for tracking weight. Walgreens implemented the Walk with Walgreens program in 2012. The program won an Effie Award for an outstanding marketing program. With the success of Walk with Walgreens, the retail pharmacy company has expanded the program beyond simple steps to include weight tracking and health goals for earning loyalty points. The program enables a few of the most popular self-tracking devices to sync so

Wearing his Walking Gallery jacket painted by (im)patient advocate, Regina Holliday, Dr. Eric Topol evangelized the benefits of digital medicine and consumer empowerment in health care, largely summarizing his epic (pun intended – wait for Hot Point, below) book, The Creative Destruction of Medicine. A founder of the West Wireless Health Institute (now known as West Health), Dr. Topol is a physician and researcher at Scripps and was recently named as editor at Medscape. A new piece of Topol Trivia for me is that GQ magazine called him a rock star of science. Dr. Topol is one of the more

Here’s Ann R., who is a patient in the not-too-distance-future, when passive sensors will be embedded in her everyday life. The infographic illustrates a disruption in health care for people, where data are collected on us (with our permission) that can help us improve our own self-care, and help our clinicians know more about us outside of their offices, exam rooms and institutions. In Making Sense of Sensors: How New Technologies Can Change Patient Care, my paper for the California HealthCare Foundation, I set out to organize the many types of sensors proliferating the health care landscape, and identify key

While 50% of Americans feel they have a sound financial position, the other half is living paycheck to paycheck. 8% say they can’t even pay for essentials. The second annual Allstate “Life Tracks” Poll finds American adults split between have’s and have not’s, with even the “have’s” feeling less than financially literate. There is an equal split between people who feel they’re in an “excellent” or “good” financial position compared with those who feel they’re in financially “fair” or “poor” shape. Men feel more financially secure than women; 3 in 4 single parents feel less well-off compared to the average

On a recent Whole Living segment on Martha Stewart’s Sirius XM radio channel, I learned of the artisan chocolatier, Gnosis. The company, whose name is Greek for “knowledge,” grew out of the kitchen of a holistic health counselor, Vanessa Berg, who began to make nutritionally-infused sweets for her private clientele. Word-of-mouth made its way to a buyer from Whole Foods, who subsequently did a deal with Berg to sell Gnosis goods in some of the company’s stores in New Jersey and New York. Here’s a link to the radio interview. Chocolate is a health food for this company, and for

Consumers want multiple functions on single devices, smooth transitions from one screen to another, and value-laden experiences in the post-recession economy. I wrote about this phenomenon during the week of the 2013 Consumer Electronics Show, highlighting Accenture’s survey on consumer attitudes toward technology — the connected home as consumer medical home. In the fast-evolving mobile health (mHealth) era, the consumer-facing suppliers are fast-responding to these customer demands. This is fostering consumer-centered interoperability in mHealth. On the health care system and professional side of health IT, getting to interoperability remains elusive and slow-going, with a customer base (hospitals, physicians) that’s not

Health and wellness motivations among women cross all generations, driving them to purchase products that bolster health as they define it…not how media and stereotyping advertising have typically portrayed it, according to a survey report from Anthem Worldwide, What Women Really Want From Health and Wellness. Over all generations, 3 in 4 women say they make choices to benefit their health and wellness. Anthem asked women about the “external voices” of health/wellness messaging versus their “internal voice.” The external represent societal expectations: over 80% of women expect to take responsibility for their family’s health, and about 70% of women say the

U.S. consumers’ desire to take an active role in their health decisions is growing, according to the Altarum Institute Survey of Consumer Health Care Opinions. 61% of people want to make health decisions either on their own (26%) or with input from their doctor (38%). The proportion of people wanting to be “completely in charge of my decisions” rose 4 percentage points in one year, from 2011. This statistic skews younger, with 33% of people 25-34 and 31% of those 35-44 wanting to be “completely in charge.” Only 17% of those 55-64 felt like being totally in charge of their