Today on Health in 2 Point 00, Jess and I are in New Orleans at the ATA Annual Conference. In this episode, Jess asks me about my takeaways from the conference, Cityblock’s $65 million raise, and Microsoft HealthVault shutting down. In terms of virtual care, it seems that there’s been low adoption of telehealth visits—but things are on the cusp, with lots of companies doing interesting things and with CMS expanding Medicare Advantage coverage of telehealth services. —Matthew Holt
Whether we admit it or not, most of us are afraid of growing old. There is a sense of loss, of youth and vigor, coupled with the burden of managing your health in relative isolation. Although as a country we would like to think that we are each responsible for our own care, most of us as individuals would prefer for someone to be there, helping us through our time of need. Years ago when I was advising one of the Presidential hopefuls regarding a healthcare platform, I suggested that the campaign should be propose that individual was responsible for their own health, but as a country we would partner to provide the tools for the individual to succeed. Now, almost a decade later, we are not much closer to this goal.
Personal Health Records (PHR) were thought to be the answer. These records differ from more traditional EMR in that they are owned by the patient and aggregate information from multiple sources to give a complete picture of the patient. For example, they might include clinic visits from multiple providers, hospitalizations and updates on an exercise program. Literally billions were spent on PHRs by the likes of Microsoft (HealthVault) and Google. Both efforts were failures with thousands (in the single digits) rather than the expected millions of enrollees. As noted by David Shaywitz, healthcare is a negative good, something viewed more with resentment than in anyway positive. And that extends to things that keep us healthy. To interact with your health means you are imperfect, you are mortality.
What user personas do healthcare technology designers and entrepreneurs have in mind as they create their products? And how often is it the family caregiver of an elderly person?
This is the question I found myself mulling over as I wandered around the Health Refactored conference recently, surrounded by developers, designers, and entrepreneurs.
The issue particularly popped into my head when I decided to try Microsoft Healthvault after listening to Microsoft’s Sean Nolan give a very good keynote on the perils of pilots and the praises of platforms (such as HealthVault).
As some know, I’ve been in search of apps and services that can help older adults and their families keep track of lengthy and frequently-changing medication lists. For years now I’ve been urging family caregivers to maintain some kind of online list of medications, but so far I haven’t found a specific app or service to recommend.
Why? Because they all require way too much effort to enter long medication lists. Which means they are hardly usable for my patients’ families.
Could HealthVault do better? Having heard generally promising things about the service these past several months, I signed up and decided to pretend I was the daughter of one of my elderly patients, who had finally decided to take Dr. Kernisan’s advice and find some online way to keep track of Mom’s 15 medications.
Sigh. It’s nice and easy to sign up for HealthVault. However, it’s not so easy to add 15 medications into the system. When I click the “+” sign next to current medications, I am offered a pop-up box with several fields to complete.
In a piece just posted at TheAtlantic.com, I discuss what I see as the next great quest in applied science: the assembly of a unified health database, a “big data” project that would collect in one searchable repository all the parameters that measure or could conceivably reflect human well-being.
I don’t expect the insights gained from these data will obsolete physicians, but rather empower them (as well as patients and other stakeholders) and make them better, informing their clinical judgment without supplanting their empathy.
I also discuss how many companies and academic researchers are focusing their efforts on defined subsets of the information challenge, generally at the intersection of data domains. I observe that one notable exception seems to be big pharma, as many large drug companies seem to have decided that hefty big data analytics is a service to be outsourced, rather than a core competency to be built. I then ask whether this is savvy judgment or a profound miscalculation, and suggest that if you were going to create the health solutions provider of the future, arguably your first move would be to recruit a cutting-edge analytics team.
The question of core competencies is more than just semantics – it is perhaps the most important strategic question facing biopharma companies as they peer into a frightening and uncertain future.
Seems like everybody on the web (or at least in our little Healthcare corner of it) has an opinion on the news that Google Health is shutting down. Just in case you’re thinking about sending me the link — yes, I’ve heard. 🙂
First off — sincere thanks to Aaron, Adam, Missy, Paul, Marc, Crutcher, Alan, Eric, Alfred, and all the others over at Google who built a great service and fought hard for the idea that the only way to really fix healthcare is to consumerize it. There will continue to be plenty of short-term debates about privacy, data ownership, standards, etc., but ultimately it’s inevitable — we’ll get there, and Google Health moved the ball forward.
Second — what does this mean for HealthVault? The “buzz” online ranges wildly, but the real and simple answer is: nothing. As I said a few months ago, HealthVault is a key piece of our overall approach:
HealthVault is a critical component in our broader project strategy — which is to (1) connect care across the ecosystem, from the home to the clinic to the hospital to the research lab, and (2) do so in a way that includes and encourages innovation from as many different organizations as possible.
Solving only the consumer side isn’t enough — that’s why we have Microsoft Amalga on the enterprise side. Our two platforms combine to enable the transformative all-up story: enabling clinical integrations like mynyp.org and MedPlus, home monitoring programs with Kaiser, CCF and UMass, and so on.Continue reading…