Now that Google has put its ill-fated Google Health project to rest, we are wondering who will make the next big attempt to establish a personal health record (PHR) platform for healthy people. Many have tried and many have failed, and there is still no popular platform for gathering, analyzing and sharing health data.
Adam Bosworth founded Google Health in 2006 to provide an online place for consumers to store their own health data. Bosworth left shortly thereafter and went on to found Keas, a SF-based web startup which takes a more social approach to tracking one’s health via a competitive point system. In a recent interview on TechCrunch, Bosworth spoke about why he thought Google Health had failed, “It’s not social,” and “Google didn’t push to see what they could do that people would want.”
Google Health failed in part because the user interface did not motivate most users to upload their health data. By contrast, one of the fastest-growing health sites on the internet, PatientsLikeMe.com, has built its online health community to an impressive 105,000 subscribers, focused first on patients suffering from chronic diseases like ALS (Lou Gehrig’s disease). The implied reward for this was high given the unmet health need, so it was an easy choice for patients to take the time to enter their valuable data. Healthy people have no such incentive for using PatientsLikeMe, but many seem to want to get in on the action. Armed with smartphones and social network memberships, a new health-savvy generation is looking to catalyze the growth of a new movement.
For every startup entering this field, the million dollar question is “just how easy can we make it for people to enter data and track their health?” It practically has to be automated in order to go viral, a prerequisite for aggregating the “big data” that could lead to marketable conclusions. There is a new line of VC-backed startups tackling this daunting task.
Withings, based in France, has produced a Body Mass Index (BMI) weight scale which tracks BMI via iPhone or computer and even sends automatic tweets. Americans can get in-shape, and French people can laugh at the tweets of overweight Americans. With all parties happy, why haven’t we seen more development in this area of diagnostic innovation for healthy people? For one, there’s a large VC question around whether or not these startups can make a large ROI with their one-trick ponies. Won’t they be killed off by apps or hardware add-ons created for next-generation smart phones?
Consider Fitbit, a small, lightweight device that functions as a pedometer that tracks sleep and burnt calories throughout the day. One could argue that a small body clip is much more comfortable to wear than an iPhone 4, but Fitbit is primarily a consumer software play. Its hardware is no more than a tricked-out accelerometer, not unlike the ones found inside Nintendo Wii controllers. Recalling Flip Video, I can’t help but think the VCs at Softtech and True Ventures are losing some precious Fitbit-measured “actual sleep time” over certain prickly questions. Will next-gen smart phones eventually eat up FitBit’s market? Will Fitbit be lucky enough to get an exit before time runs out?
Withings, despite being partnered with the late Google Health, seems to have a flop-proof strategy of targeting diagnostic applications that are unlikely to be eaten up by new-fangled mobile devices. They recently released an FDA-approved blood pressure monitor that connects directly to the iPhone, and more impressively, already have two products on the market – with a baby monitor expected to hit the market later this year. While they may not be making big returns just yet, they might be able to become a leader in this space by putting up a solid enough barrier to entry.
What would need to happen for these companies to really take off? It’s probably going to involve a concerted effort from players in social networking to form better integrated health networks – a place for the data to live. Even though Google Health flopped, Adam Bosworth seems pretty confident about his new gig, but Keas is not exactly going viral just yet. So who’s left to take charge of the movement?
PatientsLikeMe is currently limited to the chronically ill, and Facebook doesn’t seem to be making strides in this direction anytime soon. One of the most promising new platforms is Google+, termed “the Facebook killer.” If successful, Google has a golden opportunity to use Google+’s platform to provide a framework for people to manage personal healthcare data. For example, Circles allows users to select specific people and groups for sharing personal data of all varieties, including health data. Importantly, the platform can aggregate anonymized data across a very large user base. Will Google+ eventually become the personal health data platform? I would love to see this happen, but so far there is no hint that anyone at Google is working on healthcare apps for Google+. We can’t wait to see some startups tackle this. It’s only a matter of time.
Rich Whalley (rwhalley@cbtadvisors.com) is an associate at CBT Advisors, a boutique consulting firm in Cambridge, MA. Rich graduated from MIT in 2010 with a Bachelor of Science in Chemistry.
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The greater issue is cross-platform, cross-company, cross-insurance, cross-healthcare system interoperability (and automation, taking the required man-hours out of the equation). Disparate systems inevitably do not “talk” well. There are many benefits to a PHR that talks to an EHR…that also talks to the insurance company. But if there are any un-user-friendly aspects to the equation, it won’t be used. As Americans, we love choices and invariably everyone will have their preference. A standard data dictionary has to be developed if any of these solutions are to stand a chance in making a real impact on the problem. The benefits of such a pipe dream are immeasurable: for the patient, the provider, the health of the population, and the economy. The closest solution I’ve encountered is the VA’s “VISTA”, not without its own drawbacks. Additionally, open source solutions are currently available but have a long way to go. This open source platform allows for anyone to contribute… if they have a good idea to improve it. It would be difficult to argue that free ($) and open sharing of information wouldn’t benefit the advancement of the PHR/EHR dilemma.
I also love to see what happens with Google+ in the few months or let say a year later.
Thanks for this article. While responding to it and to Dr. Mike’s comment, I realized that my comment had become an article itself, which you can read on my blog.
To summarize, I believe the needed tools are just about here: a sensor for 24/7 personal health data gathering and sending to your electronic PHR, and from there to your EHR at the medical practice.
Needed: program to record out-of-range results and alert docs/nurses, maybe weekly, so they can proactively discuss concerns with their patients. Both working together, using new tools, a new paradigm for health care can result. The responsibility is shared, and needs to be shared.
The point isn’t what’s in it for google and pharma, the point is what is in it for patients? Patients will never take the effort to maintain an accurate PHR simply to be a part of discovering trends or providing feedback to pharma. Are you really interested in “gathering, analyzing, and sharing” your own personal health data? No, I didn’t think so. And neither is anybody else. In order for the suits to have something to analyze you have to give the patients a reason to enter the data in the first place, and that reason does not yet exist, at least not sufficiently to attract the numbers of patients needed to make a successful PHR.
The idea is that Google can take advantage of big data, just like patientslikeme.com has done for chronic disease patients. People will be interested to see what trends emerge from health data collected from a large user base. Pharma, in particular, is looking for “phase IV” feedback on their therapies. It’s not necessarily supposed to integrate EHR and feed back to the physician. That’s not where the main value lies at this time for Google, or for patients.
I agree.
These are mostly toys and may succeed to the extend that Angry Birds is successful. May even develop a new breed of worried well to jack up health care expenditures even more.
The problem is that if you go to all these (and more) gizmos websites, including one for iPhone EKG, they all offer to send all your thousands of self indulging measurements to your physician. And what exactly is the physician supposed to do with this flood of data?
(more here: http://bit.ly/jnBA8y )
There was a post from a VC on this blog a while ago. I can’t find it now, but that his argument was that there is no point investing in these things until we find a way for doctors to do something useful (and reimbursable) with this data.
Good idea! Great article.
How can any PHR succeed if it does not involve the patient’s physician? Would not a PHR that at least included a subset of my EHR (patient portal) be of far greater value to my patients?