Today is the kick-off of the vendor-fest that is HIMSS. Late last week on THCB, ONC director Karen De Salvo and Policy lead Jodi Daniel slammed the EMR vendors for putting up barriers to interoperability. Last year I had my own experience with that topic and I thought it would be timely to write it up. (I’ll also be in the Surescripts booth talking about it at 3.45 Monday)
I want to put this essay in the context of my day job as co-chairman of Health 2.0, where I look at and showcase new technologies in health. We have a three part definition for what we call Health 2.0. First, they must be adaptable technologies in health care, where one technology plugs into another easily using accessible APIs without a lot of rework and data moves between them. Second, we think a lot about the user experience, and over eight years we’ve been seeing tools with better and better user experiences–especially on the phone, iPad, and other screens. Finally, we think about using data to drive decisions and using data from all those devices to change and help us make decisions.
This is the Cal Pacific Medical Center up in San Francisco. The purple arrow on the left points to the door of the emergency entrance.
Cal Pacific is at the end of that big red arrow on the next photo. On that map there’s also a blue line which is my effort to add some social commentary. To the top left of that blue line in San Francisco is where the rich people live, and on the bottom right is where the poor people live. Cal Pacific is right in the middle of the rich side of town, and it’s where San Francisco’s yuppies go to have their babies.
Last year, on August 26, 2014 at about 1 am to be precise, I drove into this entrance rather fast. My wife was next to me and within an hour, we were upstairs and out came Aero. He’s named Aero because his big sister was reading a book about Frankie the Frog who wanted to fly and he was very aerodynamic. So when said, “What should we call your little brother?” She said, “I want to call him Aerodynamic.” We said, “OK, if he comes out fast we’ll call him the aerodynamic flying baby.” So he’s called Aero for short.
Thus began the Quest for Intra-Aero-Bili-ty –a title I hope will grow on you. The Bili part will become obvious in a paragraph or two.
Something had changed since we had been at Cal Pacific three years earlier for the birth of Coco, our first child.
If you look carefully at the top of Amanda’s head, there’s now a computer system. Like most big provider systems, Sutter–Cal Pacific’s parent company–has installed Epic and it’s in every room or on a COW (cart on wheels). Essentially we have spent the last few years putting EMRs in all hospitals. This is the result of the $24+ billion the US taxpayer (well, the Chinese taxpayer to be more accurate) has spent since the 2010 rollout of the HITECH act. Continue reading “In Search of Intra-Aero-Bili-ty”
Filed Under: Matthew Holt, THCB
Tagged: Data, EMR, Epic, Health 2.0, HITECH, intraoperability, Matthew Holt, NextGen, ONC
Apr 12, 2015
The use of the term ‘innovation’ is getting pretty worked up lately. In fact, almost every healthcare entity whether health plan, health system, IDN or even ‘mature ACO’ (morphed from an IPA or risk bearing PHO “chassis” or “carcass” as the case may be) seem to have anointed a ‘CIO’ as in ‘chief innovation officer’ to steward the critical transformation from volume-to-value during a yet to be determined period of conflicting if not schizophrenic incentives coupled with its legacy cultural inertia.
In fact some institutions via branded ‘Centers for Innovation or Transformation‘ have made substantial investments in people and infrastructure (“bricks, sticks and platforms”) as well as the promise of the essential ‘firewall inoculation’ and separation from the ‘mother-house’ to catalyze the required re-engineering during a likely period of cannibalization of traditional revenue streams.
So the ancient Chinese curse (paraphrased below) most likely applies here:
..we live in ‘interesting times’ with both ‘danger and opportunity’ before us.
For those tasked with this challenge and fortunate enough to participate in conferences (Health 2.0, Exponential Medicine, Health Datapalooza, TEDMED to name a few of the trophy organizers) at the disruptive and transformational tip of the spear, the nature of the challenge including opportunities to meet and leverage connections of like minded and focus colleagues is a distinct strategic advantage. Continue reading “Rooting and Leveraging the Innovation Economy”
Filed Under: Health 2.0, THCB
Tagged: chief innovation officer, Doug Gouldstein, Gregg Masters, Health 2.0, hospital
Mar 31, 2015
Matthew Holt, Co-Chairman of Health 2.0 recently interviewed David Chao, Director of Industry Solutions at Mulesoft. Mulesoft is a “connectivity company” with a vision to connect the world’s data, devices, and applications. During this interview, David shares the challenges within health care and gives an insight into how Mulesoft is re-framing health care delivery and ensuring health data moves freely between multiple systems as well as within organizations to be delivered at the point of care when and where it’s needed the most.
You can see David during the Care Delivery Innovation: Reinventing Access and Expectations session at HxRefactored on April 1-2 in Boston, MA.
Filed Under: Health 2.0, THCB
Tagged: David Chao, Health 2.0, HxRefactored, Mulesoft
Mar 30, 2015
We hear a lot about how US medicine is broken, from how much we spend annually ($4 trillion) for unimpressive outcomes, to the growing epidemic of obesity and diabetes, to problematic financial models, to the growing malaise amongst doctors.
Across US health care, a lot of smart people are crafting solutions to these problems, but in my view the reality is that many of them are generating efficiencies on top of a broken product.
The real problem is that conventional primary care as it’s practiced today no longer serves the needs of most people, be they wealthy or under-served, be they patient or provider.
I am starting Parsley Health, a new kind of medical practice that directly addresses these problems, first by providing something called Functional Medicine rather than traditional primary care, and second by providing functional medicine in a tech driven, modern and affordable way.
What is Functional Medicine?
I became a functional medicine doctor because early on I recognized two major limitations of the conventional medicine.
Continue reading “Why I’m Starting a Radically Different Kind of Medical Practice”
Filed Under: THCB, The Business of Health Care
Tagged: Concierge medicine, functional medicine, Health 2.0, New York City, Parsley Health, Physicians, Robin Berzin
Dec 29, 2014
You may have seen some news regarding a study MyFitnessPal recently did with UCLA.
I wanted to take a minute to address this study, since we participated in it directly. We are excited that we got to work with some very smart people to answer a question we also wanted to know the answer to. We jumped at the opportunity to find out—is having your physician introduce you to the app and help you sign up enough to kickstart a health journey?
What we learned is that just introducing people to MyFitnessPal wasn’t enough. People have to be ready and willing to do the hard work.
The app itself does work—if you use it. Our own data and the data from the study show that the more you log on, the more you use the app, the more success you will see. Users that logged in the most lost the most weight. In fact, we already know that 88% of users who log for 7 days lose weight.
We make tools designed to make it as clear and simple as possible for you to see the path to achieving your fitness goals. We are not, however, making a magic bullet—because there is no magic bullet. Ultimately, you’re the one who has to do the work.
Continue reading “MyFitnessPal Works If You Use It”
Filed Under: Tech, THCB
Tagged: Apps, fitness, Health 2.0, Mike Lee, MyFitnessPal, Quantified Self, Tracking
Nov 24, 2014
Investments in digital health have never been higher, with reports indicating that $5 Billion has been invested in health tech startups in 2014. Encouraged by the increasingly favorable changes being made to health policy in the U.S., many entrepreneurs have answered the call to action to solve problems related to health care delivery and access, disease management, and cost reduction. Venture capitalists recognize the value of innovation in health care through technology yet few of these tools have gained widespread adoption. Health care organizations and providers are wary of implementing new technologies that haven’t been tested for fear of disrupting their workflows and causing more problems than before.
Market R&D Pilot Challenge Website
Recognizing these high barriers to entry for digital health startups the Office of the National Coordinator for Health Information Technology (ONC) is hosting the Market R&D Pilot Challenge to bridge the gap between health care providers and innovators. This competition, which is administered by Health 2.0, may award pilot proposals in four different domains: clinical environments (e.g., hospitals, ambulatory care, surgical centers), public health and community environments (e.g., public health departments, community health workers, mobile medical trucks, and school-based clinics), consumer health (e.g., self-insured employers, pharmacies, laboratories) and research and data (e.g, novel ways of collecting data from patients). Continue reading “ONC launches Pilot Program to Catalyze Health IT Innovation”
Filed Under: THCB
Tagged: community health, consumer health, Health 2.0, Innovation, Pilots
Nov 10, 2014
Health 2.0 announces the inaugural event, WinterTech: The New Consumer Health Landscape on January 15th, 2015 during JP Morgan Week in San Francisco, CA. Industry leaders Walmart, Samsung, Target, Qualcomm Life, MyFitnessPal and many others will discuss major digital health themes in the marketplace such as: investing in consumer health, the new role of retail environments in health care, new platforms and interfaces for personal health, the informed health care consumer, and how consumer data is contributing to new clinical insights.
Participating organizations and speakers at WinterTech include:
Ben Wanamaker (Walmart)
Bakul Patel (United States Food and Drug Administration)
Rick Valencia (Qualcomm Life)
Tara Montgomery (Consumer Reports)
Karan Singh (Ginger.io)
Agenda highlights include: Continue reading “Health 2.0 Announces Agenda Highlights for WinterTech”
Filed Under: THCB
Tagged: consumer health, Health 2.0, WinterTech
Oct 29, 2014
Making Sense of Blue Button, Meaningful Use, and What’s Going on in Washington …
At the recent Health 2.0 Conference in Santa Clara, co-chair Matt Holt expressed frustration about the difficulty of getting copies of his young daughter’s medical records. His experience catalyzed a heated discussion about individuals’ electronic access to their own health information. Many people are confused about or unaware of their legal rights, the policies that support those rights, and the potential implications of digital access to health data by individuals. The Health 2.0 conference crowd included 2000 entrepreneurs, consumer technology companies, patient advocates, and other potentially “disruptive” forces in healthcare, in addition to more traditional health system players.
Why is this topic so important? Until now, most people haven’t accessed their own health records, whether electronically or in paper, and I believe that making it easier to do so will help tip the scales toward more meaningful consumer/patient engagement in healthcare and in health. Access by individuals and their families to their own health records can empower them to coordinate care among multiple healthcare providers, find and address dangerous factual errors, and take advantage of a growing ecosystem of apps and tools for improving health-related behaviors, saving money on health services, and getting more convenient, personalized care.
A shorthand phrase for this kind of personal empowerment through access to digital health data is “Blue Button,” which is also the name of a public-private initiative in which hundreds of leading healthcare organizations across the US participate. The Blue Button Initiative is bolstered by the electronic access to health information requirements for patients in the “Meaningful Use” EHR Incentive Program, which is administered by CMS (the Centers for Medicare & Medicaid Services) with companion standards and certification requirements set by ONC (the Office of the National Coordinator for Health Information Technology). Continue reading “Getting Your Own Health Records Online: The Good and the Not So Good”
Filed Under: Patients, Tech, THCB
Tagged: ACA, Blue Button, Deb Peel, Health 2.0, Health Data, Matthew Holt, Meaningful Use, ONC, Wellness
Oct 14, 2014
I hate to give away all the punch lines from my California Healthcare Foundation report on healthcare accelerators, so you will just have to read it for yourself. However, a few extra tidbits that didn’t make it in are here below (as you can imagine, I can’t be quite as Lisa-ish in a commissioned report as in my blog). Among my many discussions with a myriad of willing report interviewees (thanks to all of you!), I started collecting some funny stories that I have begun to refer to as Tales from the Accelerator Crypt. A few of them are here below for your amusement.
- From an East Coast Economic Development-Focused Accelerator: By far the worst idea pitched to us was from a company that proposed to prevent falls among the elderly with a vest containing an airbag whose deployment is triggered by EEG signals coming from a wearable computer brain interface. It’s probably obvious why this is so insane. Getting beyond who might actually wear such a thing around their home or to bed, can you imagine the number of erroneous deployments from the notoriously unpredictable, noisy EEG signal? If only they had made a video. That same week in the same city, I was amazed to be introduced to a rival company also developing a wearable airbag for accidental falls, but at least this one was triggered by an accelerometer. File under “You know wearables have jumped the shark when…”
- From a University Program in CA: The most awful pitch we had was from a clinician-entrepreneur whose answer to every probing question on commercial viability was “This is going to save countless lives.” It was his answer to every question, clinical to operational to financial. The most entertaining stage moment, however, was when a CEO of a company developing a ‘next generation’ needle-free injector did a live demonstration of his product by injecting himself with saline while up on stage doing his pitch. He unbuttoned his shirt, gave himself the shot and buttoned up again, claiming how painless it was. As he continued to speak, blood pooled and spread from the injection site, down his arm and across his entire white shirt. It was a slow motion disaster. He didn’t recover very well. Needless to say they didn’t win the demo day competition.
Continue reading “Tales From the Accelerator”
Filed Under: Health 2.0
Tagged: Accelerator, Accelerator Checklists, Health 2.0, Investing, Lisa Suennen, Pitch, Startups, venture capital
Oct 10, 2014
Such a good question from my friend David Shaywitz, MD, PhD, (and co-author with me of the book Tech Tonics). David has spoken and written about this this theme frequently, and most recently at the Health 2.0 conference held last week in Santa Clara, CA. He and I and 2000 of our closest friends were there to talk healthcare technology. Isn’t it ironic that it takes that level of human interaction to talk about the ways healthcare can disintermediate humans from healthcare?
What struck me so loudly at the conference was how easy it is for us all to forget how human the healthcare experience really is. I moderated and attended numerous sessions at the conference, each a twist on the theme of how technology can make healthcare delivery more accurate, more efficient, more effective than anything we have going today.
David participated in a session withMatthew Holt, Vinod Khosla and Dr. Jordan Shlain, who could not be farther part from each other on the topic of doctor vs. machine (David played the role of moderate guy in the middle), Mr. Khosla backed away or at least clarified his earlier statements about how 80% of doctors will be unnecessary in the coming new age of healthcare technology. His revision was that 80% of alldiagnosis will, in the future, be done by computers, not doctors, because computers are far better at seeing a holistic view of a patient and taking in all of the relevant data. He talked about how certain digital technologies can know everything about you, including when you are sleeping and when you are awake. It made me think that Santa Claus must be worried about being replaced by an app.
Continue reading “Wait, Maybe Technology Won’t Replace Doctors After All!”
Filed Under: Tech, THCB
Tagged: Diagnosis, Health 2.0, Jordan Shlain, Matthew Holt, Vinod Khosla
Oct 2, 2014