Who Has Health Data to Leverage?

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Samsung, Apple, and most recently Google recently announced that they are creating platforms to aggregate digital health and wellness data. Samsung and Apple are working with big healthcare brands like UCSF and Epic, respectively.

The story goes that the consumerization of healthcare; the proliferation of tracking devices, sensors, and apps; and the changing landscape of payment reform and accountable (lowercase) care are going to disrupt healthcare, opening up opportunities for new entrants, tools, and services powered by technology. Microsoft, to its credit or potentially poor judgment, has stood strong on the consumer side of healthcare with HealthVault for a long time.

The consumer health giants are moving into healthcare through data aggregation. They are leveraging their widespread consumer adoption, mostly on the mobile side, as a platform for pulling together new sources of health and wellness data (nutrition, sleep, activity, weight, glucose tracking). Apple and Samsung are looking to combine those new sources of data with existing sources of clinical data, such as systems like Epic, to help inform consumer and clinician decision making.

While Samsung and Apple are wading into healthcare, Google seems content to be the bridge from health app to health app, with less of a focus on traditional healthcare software and vendors. In fact, just last month the Google co-founder Sergey Brin said:

Generally, health is just so heavily regulated. It’s just a painful business to be in. It’s just not necessarily how I want to spend my time. Even though we do have some health projects, and we’ll be doing that to a certain extent. But I think the regulatory burden in the U.S. is so high that think it would dissuade a lot of entrepreneurs.

This makes perfect sense for Google, which at its core is about organizing and making sense of lots of different sources of information. By intentionally avoiding traditional health data (ePHI) that might expose it to regulation, Google sidesteps specific requirements and risks. And since Google Fit is just one of several "health projects" from Google, it may not work and it may be shelved like other Google projects — Google Health being the most relevant example. Or it may be a roaring success amongst the health motivated or quantified self crowd.

However, I question – especially when considering the disruptive nature of these consumer health giants — whether the major problems in healthcare of cost, quality, experience, and fraud are really big data problems. Is analyzing data from apps and devices disruptive? The problems in healthcare are much more complicated. They are only partially data problems.

Aggregating wellness and clinical data is not an end in and of itself. There’s potential in consumer-collected data aggregation — both at the individual as well as population level — but the problems in healthcare aren’t caused by a lack of data aggregation and analytics. Whether these ventures are disruptive or ill-fated is not the topic of this post, but I welcome opinions on that in the comments.

What’s interesting about the different approaches to big data is that the non-healthcare regulated approach — the approach Google seems to be following — is already widely used and successful. The California Healthcare Foundation released a report this month about personal information being used in healthcare for tracking and analytics. The report digs into all of the different personal information that can be used in healthcare: purchasing history (fast food, cigarettes), Internet browsing, (visiting sites about erectile dysfunction), free email services (Gmail), and of course activity tracking (the focus of the recent announcements by Google, Apple, and Samsung).

Activity data is the obvious data set, but passively tracked data is more interesting to me. I imagine Google already has more information about the health of people than Epic, despite Epic having records on a 50-60 percent of the US. Chronic disease patients and patients with specific, acute conditions have exhaustive clinical records, but I’d bet Google has more information on most of the US, and that information isn’t governed by healthcare-specific regulations.

That means Google and its partners — as well as other third parties that buy and aggregate data – already have a rich set of data that insurance companies and hospitals should be using. If you read the above report and this recent article on UPMC, you’ll see example of how the data is already being leveraged for marketing. Why not use it to improve care and reduce costs?

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Travis Good, MD/MBA, is co-founder of Catalyze. More about me.

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