A blog covering the health/care ecosystem and people.

I endured what very few people could (or would) do in the past ten days: I traveled to New Orleans to the annual conference of HIMSS, the Health Information Management Systems Society, which features hundreds of suppliers to the health care information technology industry. I returned home to kiss my family hello and goodbye, and a day later flew to Austin for the annual South-by-Southwest conference for music, movie and digital folks. The health track at SXSW has grown over the past five years, and provides a start contrast to “health care” as embodied at HIMSS, and “health” translated through

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

Patients are getting comfortable with remote health care – that is, receiving care from a health provider at a distance via, say, telehealth or via a Skype-type of set-up. Furthermore, 70% of people globally saying they would trust an automated device to provide a diagnosis that would help them determine whether or note they needed to see a doctor. Based on the findings from Cisco‘s survey summarized in the Cisco Connected Customer Experience Report – Healthcare, published March 4, 2013, just-in-time for the annual 2013 HIMSS conference, a majority patients the world over are embracing health care delivered via communications

Traditional venture capital in health care is so 2010: welcome to The Greenhouse Effect: How Accelerators Are Seeding Digital Health Innovation, explained in a new report from California HealthCare Foundation written by Aaron Apodaca. Aaron clearly explains the growing interest in and influence of health accelerators, which grew out of the first era of the Internet (read: dot-com bust v 1.0) and the founding of the Y Combinator, an internet incubator that made relatively small investments in exchange for equity positions in start-ups. Health accelerators emerged around 2011, first with Rock Health in San Francisco, which was quickly followed by

Most of us keep track of some aspect of our health. Half of all people who track do so “in their heads,” not on paper, Excel spreadsheet, or via digital platform. Furthermore, 36% update their health tracking data at least once a day; but 16% update at most twice a month, and 9% update less than once monthly. Tracking for Health from the Pew Internet & American Life Project paints a portrait of U.S. adults who, on one hand are quantifying themselves but largely aren’t taking advantage of automated and convenient ways of doing so. Overall, 69% of U.S. adults track

Reed Tuckson of UnitedHealthGroup was the first panelist to speak at the kickoff of the Digital Health Summit, the fastest-growing aspct of the 2013 Consumer Electronics Show (#2013CES). Tuckson implored the spillover audience to all, “self-deputize as national service agents in health,” recognizing that technology developers in the room at this show that’s focused on developers building Shiny New Digital Things have much to bring to health. As Andrew Thompson of Proteus Medical (the “invisible pill” company) said, “we can’t bend the health care cost curve; we have to break it.” This pioneering panel was all about offering new-new technologies

“The Internet will have a profound effect on the practice and business of medicine. Physicians, eager to provide high-quality care and forced by competition to offer online services, will introduce e-mail and patient-friendly Web sites to improve administrative services and manage common medical conditions. Patients will identify more helath information online and will take more responsibility for their care. The doctor/patient relationship will be altered. Some aspects of electronic communication will enhance the bond, and others will threaten it. Patients will have access to vast information sources of variable validity. Many physician organizations are preparing for the electronic transformation, but

While most players in health care see potential ROI through investing in health informatics, there’s a supply-side problem in the market in two ways: a labor shortage of health IT talent, and a dearth of clean and comprehensive data needed for specific objectives. Even with sufficient budgets, health care providers, plans, and pharma companies say, these two limiting factors prevent fully realizing the promise of health data. Deloitte and AMIA polled health providers, plans and life science companies on the state of informatics in health care, the results of which are summarized in The 2012 Deloitte-AMIA Health Informatics Industry Maturity Survey.

When the phrase “health care innovation” is considered, most people think about technologies like digital imaging, breakthroughs in cancer treatment, and robotic surgery. But before clinicians order or prescribe the use of any of those choices, there’s a cognitive process that gets them to that decision. It’s a cerebral mash-up of information, learned knowledge, and that special art of medicine embodied in the provider’s experience with patients, well-honed over time. How can innovation improve this process? “Healthcare innovation can be defined as the introduction of a new concept, idea, service, process, or product aimed at improving treatment, diagnosis, education, outreach, prevention and

A time-and-technology challenged FDA, proliferation of software-controlled medical devices in and outside of hospitals, and growth of hackers have resulted in medical technology that’s riddled with malware. Furthermore, lack of security built into the devices makes them ripe for hacking and malfeasance. Scenario: a famous figure (say, a politician with an implantable defibrillator or young rock star with an insulin pump) becomes targeted by a hacker, who industriously virtually works his way into the ICD’s software and delivers the man a shock so strong it’s akin to electrocution. Got the picture? Welcome to the dark side of health IT and

Wired magazine, longtime evangelist for all-things-tech, has played a growing role in serving up health-tech content over the past several years, especially through the work of Thomas Goetz. This month, Wired featured an informative section on living by numbers — the theme of a new Wired conference held 15-16 October 2012 in New York City. This feels like the week of digital health on the east coast of the U.S.: several major meetings have convened that highlight the role of technology — especially, the Internet, mobile platforms, and Big Data — on health. Among the meetings were the NYeC Digital Health conference, Digital

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

Target, the beloved retail channel for many design-minded value-conscious consumers, has opted in to mobile health through its purchase of SMARTCOACH mobile health coaching devices. SMARTCOACH is part of a growing category of wearable devices that monitor health behaviors like walking and calories consumed. What differentiates SMARTCOACH is the “coach” element, which provides real-time feedback throughout the day. Most other devices in the market simply track and record data. And it’s feedback loops that more experts say are key to sustaining health behavior change. Target will bring the device into stores for purchase in the fall. Like some other wearable

  On Tuesday, 9 July 2012, health industry stakeholders are convening in Philadelphia for the first CONVERGE conference, seeking to ignite conversation across siloed organizations to solve seemingly intractable problems in health care, together. Why “converge?” Because suppliers, providers, payers, health plans, and consumers have been fragmented for far too long based on arcane incentives that cause the U.S. health system to be stuck in a Rube Goldbergian knot of inefficiency, ineffectiveness and fragmentation of access….not to mention cost increases leading us to devote nearly one-fifth of national GDP on health care at a cost of nearly $3 trillion…and going up.

Half of patients globally expect that mobile health will improve health care. These health citizens expect that mobile health will help them manage their overall health, chronic conditions, how they manage their medications and measure and share their vital health information. Welcome to the new mobile health world, a picture captured in PwC’s report, Emerging mHealth: Paths for growth, published in June 2012 and written by the Economist Intelligence Unit. Patients’ views on mHealth are bullish, and while most doctors and payors share that vision, they also expect mHealth to come into focus more slowly, recognizing the institutional, cultural and

Once upon a time, patient satisfaction with visits to doctors’ offices used to be a function of bedside (exam room) manner, demeanor and responsiveness of the reception and insurance staff, and the age of magazines in the waiting room. Today, waiting time is a key factor, and social media is raising expectations around response time in health care. See the first chart, based on data from PwC’s survey, Social Media “Likes” Healthcare, published in late April 2012. The poll found that when U.S. adults use social media in healthcare, at least 4 in 10 people want complaints and information requests responded to

As I leave Asia, where I’ve been for the past two weeks, for the U.S. today, I am reading the daily newspaper, the Korea Joongang News. On today’s op-Ed age is The Fountain column titled, Embracing the do-it-yourself attitude. In it, Lee Na-ree writes, “Making something with your own hands is part of the American pioneer spirit.” He describes the Maker Faire events and the project of Caine’s Arcade, a game developed by a Los Angeles boy who used auto parts from his dad’s shop. Na-ree observes that Americans are ‘regretting’ mass consumption. Health Populi’s Hot Points: I happened upon

The ability to get the data is the #1 obstacle that will slow the adoption of data analytics in health care, according to IBM’s report, The value of analytics in healthcare: from insights to outcomes. Healthcare “high performers,” as IBM calls them, use data analytics for guiding future strategy, product research and development, and sales and marketing functions. 90% of healthcare CIOs told IBM that developing “insight and intelligence” were key focuses of their organizations over the next 3 to 5 years. Underneath this macro objective are 3 business goals that data analytics addresses in healthcare: to improve clinical effectiveness

IBM is celebrating the first birthday of Watson this week. I had the opportunity to brainstorm some of the short- and long-term meanings of Watson in health care this week at HIMSS 2012 in Las Vegas. When most people think of Watson, an image of the Jeopardy! game featuring the technology versus the legendary player Ken Jennings comes to mind. However, Watson has the potential to play a transformational role in health care, globally – for population health, and for the patient N=1. Watson is a supercomputer’s supercomputer: underneath the formidable hood are dozens of programs that enable Watson to

As we approach 2012, we health prognosticators like to forecast what we’ll likely see in 2012. One of the for-certain trends will be the uptake of telehealth programs, which will be publicly, privately, and jointly-funded. The business case is clear for telehealth, both in the U.S. and globally. Jon Linkous, CEO of the American Telemedicine Association, told the mHealth Summit last week that, the “shift in the way healthcare is paid will put providers in driver’s seat when it comes to choosing the best way  to deliver healthcare and whether or not to use telemedicine.” The forces are converging for telehealth

There is broad consensus among doctors, patients and health administrators that the current U.S. health system is broken and unsustainable; preventive services is under-utilized and -valued, quality is highly variable from region to region and patient to patient, and costs continue to spiral upward without demonstrating value. While these 3 segments – physicians, people-patient-consumers, and hospital execs, agree on this topline assessment, what they see about the future of health delivery in America varies, according to a new survey from the new Optum Institute for Sustainable Health, Sustainable health communities: A manifesto for improvement. This is the kick-off of the Optum Institute, a member of the

3 in 4 of the Fortune 50 companies are part of the U.S. health economy in some way. Only 1 in 3 of these is in traditional health industries like pharmaceutical and life science companies, insurance, and businesses in the Old School Health Care value chain. 2 in 3 of the Fortune 50 companies involved in health are in new-new segments. In their report, The New Gold Rush, PricewaterhouseCoopers (PwC) identifies four roles for “prospectors” in the new health economy which will represent 20% of the GDP by 2019: Fixers Connectors Retailers, and Implementers. These are the disruptive roles that will

With health reform uncertainties, growing health regulations, and ever-increasing costs, employers who sponsor health plans for their workforce will continue to cover active employees. That is, at least until 2017, according to the crystal ball used by Mercer, explained in the Health & Benefits Perspective called Emerging challenges…and opportunities…in the new health care world, published in May 2011. Note that it’s “active” employees who Mercer expects will retain access to health benefits. For retirees, however, it’s another story. They need to be ready to take on more responsibility, financially and perhaps going-to-market to select coverage, while employers may continue some level

“Value” in prescription drugs is first and foremost about outcomes, in the eyes of physicians and biopharma. For managed care, “value” is first about safety, then patient outcomes. However, although one-third of patients managing a chronic condition cannot define “value” in health care, 9 in 10 say that prescription drugs are “valuable” to their health and wellbeing. In fact, 80% say that the money they spend on prescription medications is “worth it.” Yet patients feel largely out of the prescription drug development process. These findings come from Quintiles research report, The 2011 New Health Report, subtitled: exploring perceptions of value and collaborative relationships among

Randomized controlled trials (RCTs) have been the rational cornerstone of medical decision making for decades. RCTs demonstrate a drug or therapeutic course’s efficacy – that is, the extent to which a specific intervention, procedure, or regimen produces a beneficial result under ideal conditions. Of course, how a particular therapy works in an individual is highly personalized based not only on a body’s biochemistry, but personal preferences, perceptions, and personality. That’s why Dr. Andrew Weil and his colleagues, Dr. Scott Shannon and Dr. Bonnie Kaplan, say that medical decision making should take into account the patient perspective. In Medical Decision Making in

The announcement that Verizon, the telecommunications giant, will partner with Healthsense, a home health monitoring company, indicates that the adoption of telehealth services beyond project pilots and government-funds required to bolster the market is real. Verizon is upgrading the FiOS network, which it will extend to senior housing and assisted living communities that would use Healthsense’s suite of remote health monitoring, personal emergency response systems, wireless nurse call, and wellness monitoring products. The broadband FiOS network is upgradeable to 100 megabits per second, which would enable the bandwidth required by home health technologies that require high performance and reliable network connectivity. These

Today’s kickoff of the National eHealth Collaborative‘s Consumer Consortium on eHealth convened the most diverse workgroup of over 70 stakeholders with various lenses on consumers and health, rarely seen at similar meetings, as Lygeia Ricciardi (@lygeia) of the Office of the National Coordiantor for Health IT (ONC) in the Department of Health and Human Services, observed. However, although representing every conceivable segment of health consumer stakeholders, from seniors (AARP)  and physicians (MGMA) to people with disabilities (AAPD), women (National Partnership for Women and Families) and people who fall through the health safety net (the National Health IT Collaborative for the Underserved), there was concurrence

Doctors practicing in the U.S. are becoming increasingly conscious of the increasing costs of health care. Most consider themselves cost-conscious, and are considering the impact of their practice patterns — in terms of prescribing medicines, tests, and procedures — on the nation’s health bill. In fact, most physicians feel they have a responsibility to bring down health costs. This perspective on physicians comes from the survey report, The new cost-conscious doctor: Changing America’s healthcare landscape, from Bain & Company, published in March 2011. Bain spoke with over 300 U.S. physicians to assess their perspectives on managing costs, drug and device usage, and

In the “House & Home” section of last weekend’s Financial Times, an article titled ‘Domestic Science’ talked about internet-operated vacuum cleaners that feed pets, refrigerators that track emptying cartons of milk, and the $10 Savant TruControl iPad app that helps control home systems’ remotely (tied to a $6,000 home-based system). The article also touched on the Withings WiFi body scale. The Withings scale communicates wirelessly to a computer or mobile phone, transferring and automatically recording the user’s weight, BMI, body fat percentage and other parameters to a secure, password-protected online system. The user can choose to tweet their weight via Twitter if they choose

In December 2010, an article describing a telehealth remote monitoring program for heart failure patients concluded that telemonitoring did not improve patient outcomes. The paper, Telemonitoring in Patients with Heart Failure, written by Sarwat I. Chaudhry, M.D, and nine other authors, analyzed 1,653 CHF patients, 826 of whom participated in a remote health intervention: a telephone-based interactive voice-response system that patients dialed into on a daily basis to report symptoms and weight; this was designed to occur every day over six months.  These data were then reviewed by patients’ clinicians who could contact patients when data pointed to the clinical need to adjust patients’ medications and other parameters.

“Employers and health insurers, through benefit design and medical management, are now playing a larger role in curbing use of healthcare services….spurring a more permanent cultural shift in consumer behavior,” Moody’s writes in a special comment dated February 16, 2011. “This will continue to constrain healthcare demand even as the economy recovers.” The chart illustrates one of the main reasons for the so-called “constrained healthcare demand:” increasing costs on health consumers. Look at the slope of the line on average out-of-pocket maximum costs for an employee receiving health insurance at work: the raw number grew from $2,742 in 2008 to

The U.S. has few bright spots when accounting for global trade: we import much more than we export. Entertainment is America’s #1 export. After that, medical innovation shines. But the window on that lead is closing. 92% of Americans believe it’s important for the U.S. to be the global leader in medical innovation and research. And, most Americans believe the U.S. has been in a strong position in medical innovation, research and development, and technical innovation, especially for new cures and treatments for patients, and medical innovations that create jobs and drive economic growth; but a weakening position in science,