For those of us building the infrastructure required to power a consumer driven healthcare experience, it’s easy to get caught up in our own enthusiasm. But what about everyone else? How we talk about these patients or ‘consumers’ and their health will directly affect the future of this adoption, so it’s important to get a feel for how those conversations are already playing out.
Considering that notion, we thought we’d take to the media re: how Americans feel about technologies like telehealth, health IT innovations, and personal health records (PHRs) to name a few. The following outlines a snapshot of what we found.
On-Demand Healthcare: When Doctors Are Available Anywhere, Anytime
The Wall Street Journal’s Melinda Beck recently reported on a handful of telehealth and house call startups, like Pager (who we covered last year in our list of innovative healthcare startups), striving to become what WSJ calls an “Uber for healthcare.” It’s a compelling idea, and Beck wrote how these services have already found a core user base — and some healthcare professionals, who appreciate being able to connect one-on-one with patients. “I love my Pager shifts — it’s back to real medicine, just you and the patient,” one ER doc said.
Elsewhere in the healthcare universe, telehealth services are seeing pushback, New York Times’ reported Abby Goodnough noted: “Some doctors assert that hands-on exams are more effective and warn that the potential for misdiagnosis via video is great.” Medical boards in some states are taking this feedback to heart and a few are even trying to slow the rapid growth of virtual medicine. Many more however, are embracing the new, tech-centric world of virtual house calls by updating their laws, allowing doctor-patient relationships to be formed and medications to be prescribed via compliant video services.
Even the comments section of that story was full of both people who support the expansion of telehealth services, and other who were suspicious. “As an M.D., I can't comprehend doing a physical exam virtually,” one commenter wrote. “So much goes into seeing the patient walk, talk, speak, and noticing all the full-body nonverbals as well as doing the hands-on exam.”
Bill Bunting, Director of Healthcare Solutions at EMC and PokitFriend, acknowledged these criticisms in a post on the EMC blog and argued that fear mongers are holding back modern methods of healthcare delivery, including telemedicine.
“Vaccines, laparoscopic surgeries, joint replacements, not to mention heart transplants at one time seemed out of reach, reckless, uncertain, or doomed to fail—and yet they revolutionized medicine, they revolutionized our livelihood. Analysis on a scale never before possible today means we can tailor treatments to a patient’s own genetics, customize prevention for risk factors, and develop medications based on specific patient profiles. In essence, healthcare’s greatest challenge in the next century of patient care is getting out of its own way.”
Wearables: The Next Steps After Fitness Tracking
Millions of Americans are already in the habit of checking basic fitness data — steps walked, calories burned, hours slept — via consumer technology such as FitBits and Apple Watches. And that’s a great thing.
Healthcare’s next step, now, is to uncover deeper intelligence from all of those potential data points. The habits and the technology are already in place for people to constantly monitor various aspects of their health. In fact, Dr. Eric Schadt, Founding Director of the Icahn Institute for Genomics and Multiscale Biology at New York’s Mount Sinai Health System, told researchers at McKinsey & Company he thinks within a decade the best patient data will live not inside of the healthcare system, but in patients’ own devices, which, according to Dr. Schadt, “will force the engagement of that information by the medical community.”
Already, specific applications of wearable monitoring are appearing. Telegraph reporter Sophie Curtis highlighted a project at Northeastern University where researchers are developing a biometric wristband that can detect certain psychological signals in patients with severe autism. Such patients “are often unable to communicate through words or body language, are apt to dramatic behavioural changes that include self injury, aggression and running away,” Curtis said. Having an easy access to heart rate, surface skin temperature, perspiration, and limb movement data could signal important information to healthcare providers that would otherwise be difficult or impossible for the patient to communicate.
Similarly, the MIT Technology Review team recently ran a study to see whether smartphones can aid doctors in the early detection of bipolar disorder. “People with bipolar disorder often demonstrate well-known behavior patterns that are a signature of their condition...For example, the manic phase is often characterized by hyperactivity, which can be measured by an accelerometer and with a GPS device, by rapid speech, which can be monitored by speech analysis and by frequent conversations, which can be monitored through phone records.” Collecting that kind of data could help doctors diagnose and treat bipolar disorders more quickly.
As promising as this technology sounds, Aashima Gupta, VP of Digital Transformation for Apigee, a healthcare at API management company, points out in a TechCrunch article that the current group of consumers using fitness trackers are already fairly healthy people. This begs the question, are these technological advances helping the people who need it most? Tracking steps, while arguably a good thing, is very different than someone with chronic health issues monitoring his or her symptoms in real time. “In order to make meaningful intervention through mobile moments, we need to use the technology that is already at our fingertips to build a web of connections,” Gupta argued. “By analyzing the customer journey, we can link contextual and other pieces of disparate pieces of information that are all happening precisely in that moment and create a true health ‘graph,’” - which is precisely what our data science team is doing.
The tools are coming together to track these kinds of consumer, or patient, journeys. Fitness trackers are a great first step, and emerging applications will undoubtedly create new ways to contextualize a person’s health - and ultimately drive better outcomes.
Some Big-Picture Challenges With Patient Data
Patient data management is still a problem because of interoperability issues, indeed, but also because it is both valuable and in some cases easily accessible for the wrong people.
In a recent Bloomberg Businessweek piece, Monte Reel and Jordan Robertson wrote about how so many healthcare systems are easily accessible by hackers. They note a few stories of security companies and white-hat hackers who are shocked at how fragile the security is in many hospitals. One company, TrapX Security, tested across 60 hospitals re: their sensitivity to malware and phishing attacks. The test found that within six months, every one of those hospitals contained at least one infected device. As one security expert put it, hospitals seem to be “at least a decade behind the standard security curve.
You don’t have to look very hard to find people calling for massive changes to those insecure, non-interoperable systems. CVS Health Chief Digital Officer Brian Tilzer argues that the health industry needs to catch up to the world of consumer technology, and ClearCare CEO Geoffrey Nudd argues that “the opportunity is ripe” to revolutionize these rigid, complex systems.
Stay tuned for an upcoming post that discusses the security benefits of the API economy, specifically as it relates to healthcare and hospital systems.
The Ongoing Issue of Transparent Pricing
In order for consumer driven healthcare to become a universal reality, perhaps the most important area where transparency is needed lies something much simpler: pricing. NPR’s Elana Gordon told the story of one couple who opted into high-deductible insurance plans, which forced them to become smarter healthcare consumers — but not quite the way they expected.
This couple, among others, struggled to find reliable pricing data for any given procedure. And even when they found online calculators for ballpark figures, their healthcare providers often quotes a much higher price. “But the needle is starting to move,” Gordon wrote, pointing out how pressure is coming from both employers and state governments to make price information publicly available. PokitDok’s cash and insurance price APIs and of course our private label marketplace solution take a proactive step to address these steps toward price transparency.
In sum, that seems to capture the consensus across the board: consumer-side pressure is slowly but surely forcing healthcare to adapt to market demands, but the industry has a lot of legacy baggage to address. In all, the majority of people seem excited about the potential of healthcare innovation - and what impact if will drive on the future of healthcare.