The first day of the Health 2.0 Conference in San Francisco kicked off with a video illustrating the global reach of the Health 2.0 concept, from NY and Boston to Mumbai, Madrid, London, Tokyo and other points abroad. Technology is making the health world flatter and smarter…and sometimes, increasing problematic fragmentation, which is a theme that kept pinching me through the first day’s discussions and demonstrations.
Joe Flowers, health futurist, offered a cogent, crisp forecast in the morning, noting that health care is changing, undergoing fundamental economic changes that change everything about it. These are driving us to what may well be better and cheaper health care for everyone, eventually — but as Flowers showed a drawing that we are all on the top of a roller-coaster ride, about to head dramatically downward, Now is a moment of maximum instability where great change is possible. At this cusp, though, it feels very uncomfortable. Flowers anticipates that out of this chaos will emerge a vastly more complex ecology than we’re used to in health care. Care will be delivered more efficiently, more effectively, more upstream, closer to the customer, Flowers says: ” in her purse, in her iPhone, it has to be with you.” He expects, “we’ll see wild proliferation of places, ways, business models. business structures,” and all of this will be a tough fit for all involved in health care.
While health reform is a catalyst, it’s not the cause of this chaos and reconstruction. Demographics, an aging population, an aging workforce, economics, technology and data are all converging toward the new-new health care. “We have the data for the first time in the history of health care,” Flowers enthused. “We can see what is actually going on.” But know that this is a huge effort that Flowers believes is a Manhattan Project-sized program. This image made me think that the ARRA HITECH stimulus for EHR adoption would be only a drop in a much larger bucket required for building a health information infrastructure — which could not be accomplished by either the public or private sector alone.
He concluded on a positive note, saying, “Some of the beset hopes for the future are at Health 2.0 and what’s going on here.”
Flowers’ energy and thinking set the stage for the rest of the day, when over a hundred speakers spoke and demo’d tools and applications on the big stage and in breakout sessions covering the landscape of health ecosystem issues, from patient-provider communications and rating systems for doctor selection to innovative financing for start-ups and new approaches to motivating and sustaining peoples’ exercise and food choices.
Mark Bertolini, CEO and Chairman of Aetna, gave an inspiring talk about what the health plan is doing. I use the phrase “health plan” haltingly, because what we’re seeing with Aetna is a real-time morphing of a health plan into a new form of stakeholder in this ecosystem that Flowers painted. Bertolini’s talk was titled, “Bringing the health care system to consumers,” and Aetna’s assembling the building blocks — and integrating them — to do just that. So this goes well beyond health insurance. It’s a user-centered, engagingly designed health delivery vehicle or, better, an environment.
Bertolini confessed, he’s “looking to put health insurance out of business.”
Riffing on Flowers’ perspective, Bertolini talked about consumers “taking your health care system with you in your own pocket.” Thus, Aetna launched iNexx, a health App Store for physicians, last year. It is now used by 25,000 docs in 24 states, helping their practices become more efficient through workflow productivity tools, EMRs, clinical decision support, and Meaningful Use applications. Aetna is implementing this in ACO models across the country.
Thus Aetna continues to build a technology infrastructure/platform to improve health care for both consumers and providers, connecting assets like iNexx, Medicity, iTriage, and CarePass.
In a provocative statement that might have been missed by some (but not on me), Bertolini told the group that he was looking to build a clinical capacity exchange buying health services on the “spot market” (a la financial services) and will re-sell to consumers for their convenience. THINK: Ebay meets health care, Aetna-scale.
And so Flowers and Bertolini nicely set the table for the day’s demo’s and talks on platforms and “unplatforms” in health care, health apps, wireless networks,
Health Populi’s Hot Points: Many issues emerged through the day that are thorny and barrier-inducing: privacy and security; consumer and provider engagement (or lack thereof); government regulation as innovating/motivating or disincenting; the bigness and proliferation of Big Data and where it will ‘go,’ and how will it be analyzed and presented to the rigth people at the right time in the right (preferred useful) form.
Two Biggest Issues for me are:
1. Fragmentation: we already have the most arcane, labyrinthine, fragmented health system on the planet. Adding on more apps, tools and data without a thought to integration and artful design in use and data presentation will simply pile on.
2. The Unmentionables: Alexandra Drane, colleague and friend from Eliza Corporation, presented her annual viewon the parts of of life that benefit or exacerbate health problems including financial stress, life and work stress, lack of social networks (loneliness), and sex lives. If these magnify or soften chronic conditions, how do we incorporatethis understanding into how we deliver and pay for health care?
These two meta-topics aren’t un-mentionable: they should be top-of-mind as we all work toward re-imagining the New New Health Care.
And speaking of New-New, I’m looking forward to interviewing Mike Long, once CEO of Healtheon (now WebMD) on the big stage this morning! Mike had a featured role in Michael Lewis’s iconic book on Silicon Valley dot-com world, The New New Thing, which I’ll be quoting from in my intro to Mike today.