Status and Pace of Technology 7/25/12

I’m going to be in Boston today for the mHealth Innovation Exchange Conference. My first flight was cancelled and my rebooked travel was significantly delayed, but I think I’m going to make it, though I won’t get much sleep. I was impressed but not surprised that Kayak sent me a flight cancellation e-mail about 10 minutes before United.

The conferences tomorrow should make for an interesting day with a good group of speakers and 10 startups pitching, all focused on mobile health. The goal of the conference is to link new startups with potential pilot customers, which means health systems and payers, mostly. I’m on a panel, and one of the possible topics of discussion is the pace of technology innovation and investment in mobile health.

I’ve been thinking a lot about the pace of technology in and out of healthcare, which has gotten me thinking about health and wellness and technology and scale and obstacles and a bunch of other interrelated topics. Everybody, me included, loves to write and read about all the fancy new sensors, gadgets, and apps out, frequently describing them as disruptive for our industry. "Disruptive" is another word that is starting to experience overuse abuse, and has accordingly lost some significance.

Anyway, I think we can all agree that the pace of technology is astounding. The thing is, there is more than enough technology currently available to have a huge impact in health and wellness. In my own personal experience, there are two examples that come to mind that fit into use cases that we talk about for future state telehealth and patient engagement.

For telehealth, I recently sliced off the top of my thumb cutting carrots. It was a deep cut, leaving a small, thick flap of skin loosely attached. After about 90 minutes of being unable to stop the bleeding, I finally got my wife to look at the wound (she’s squeamish when it comes to injuries on family and friends) and take a picture with her iPhone. She sent the picture to a doctor friend who came over and injected it with lidocaine and epinephrine, which fortunately provided a nice relief from the pain, but also stopped the bleeding. It was a really fun educational experience for our kids, too. We bandaged it up with good pressure to hold the flap. I sent another picture in the morning and it was recommended to Super Glue around the edges and re-bandage. We kept taking pictures daily and getting wound care advice and it’s healing very nicely. In a world without HIPAA concerns and payment reform, remote consultations are considerably easier. Technology is not the barrier.

In terms of patient engagement, I log my runs using the Nike+. When I start running, friends get a notification on their phones and can send me "cheers". As cheesy as it is, I really like hearing the cheers while I run. I also feel accountable when I take days off. I have friends that check in at the gym and get responses from friends. We take pictures of meals and send recipes we find. My wife shares her NikeFuel status with friends. We do it privately, but all of this can be done with larger, more open networks like Twitter and Facebook. My friends and I have access to the technology, but this is becoming less of a barrier in the general population with the growth of smartphones. We are also all motivated and I think that is the key difference. We’re using existing technology and social connections to help our collective group live healthier. Again, technology is not the issue.

Another technology example, though this one isn’t personal. I remember reporting on a company called GreenGoose that launched at a pitch event last year. The company was going to attach low-cost sensors to things and turn real-life activities into a game. At the time, and this was very early for GreenGoose, the speculation was around using the technology to help promote healthy activity like exercise. Maybe GreenGoose will get there, but currently the three products it has are 1) a tooth-brushing app for kids that helps assure they brush for a full minute (my kids already have toothbrushes that light up for a minute, no sensor needed); 2) an app to make sure you don’t forget to walk or feed your dog; and 3) an app to remind men to put the toilet seat down. The technology is very cool, but the application seems slightly less grand than it once did.

I’m not anti-innovation and I don’t think we should stop developing new technologies. I just think we currently have technology that can create meaningful change in health and wellness. If you look at it in terms of cause and effect, the problem is that we’re not unhealthy (collectively speaking) because of lack of tech. We don’t have a diabetes and obesity epidemic because people don’t have access to their medical records. I understand that access to data is a first, necessary step but it’s not the answer.

When it comes to patient engagement, we need to find a way to motivate people to use the technology that currently exists to make healthy decisions a part of their daily lives. I think this will only happen when we see these technologies as extenders of our healthcare system and of our providers; this is the same with telelealth. I do not believe that consumers and patients are going to drive this themselves. For these technologies to be extenders of established care, we need providers to 1) know they exist, 2) have evidence that they work, 3) have assurances in terms of liability, and 4) have an incentive to use them. Unfortunately, the pace of these necessary changes is a tad slower than new technology development.

Travis Good is an MD/MBA involved with health IT startups. More about me.

  • Marcia

    Once again, great insight, Travis. Kudos! And stay away from carrots, or eat them whole!

  • David

    Travis, this is an excellent discussion on the advances in technologies. Your last section on adherence/compliance issues is the key no doubt. I believe that unfortunately the changes in relation to this critical component can’t come from healthcare as in healthcare the consumer, i.e. patient is not a critical client of the patient cycle. However, in the health and wellness space, so many of the stakeholders are gone and it is the consumer, healthy individual, who is in control. I feel that the consumer still tends to lump health and wellness with healthcare so the expectations are similar to healthcare, i.e. someone else will take care of it. There needs to be a seed change in terms of the technology developers. You refer to GreenGoose as an example. Health management needs to become fun!

  • Christopher Wasden

    my wife and I use Fitbit and it does create great motivation and transparency of our ability and commitment to realize our health goals. A recent study indicated that people who use pedometers have twice the level of activity versus those who don’t.

    In addition, you should look up the new PwC index on mobile technology innovation to indicate the pace and magnitude of change taking place.

    One final point on “disruptive innovation.” I too find it entirely over used. So I have created my own definition of this. I used to run a medical technology incubator and everyone trying to get me to take on their technology called theirs disruptive. They all couldn’t be disruptive. So I created the Explosive C4 of Disruptive Innovation. To be disruptive you had to show exponential changes in Cost, Convenience, Confidence and Compensation from your innovation. If not exponential, then it is merely incremental and therefore not disruptive. I often use graphs of mobile telephony and genomics to make my case.

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