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Help us, IBM-Dell-Apple. You’re our only hope.

By healthcare industry, media commentary, politics, technology

I’ve been on the road a lot over the last six months, getting the chance to interact with (and, I hope, influence), audiences in health tech and health policy. There’s so much desire for change, search for innovation, and just straight up “desperately seeking [something]” out there, it’s almost hilarious that no real change/shift/what-have-you has yet occurred in the giant $3-trillion/year-and-rising sucking sound that is the American healthcare system.

Which is why I concluded, long ago, that the system would not be re-invented from within, particularly when it comes to the tech side of the party. Since the medical-industrial complex is keeping the fax machine manufacturers of the universe in business, it’s hard not to snort with laughter at tech “innovations” that emerge from inside the complex’s ivory towers.

Tech innovation – on both the consumer and the system side – will come from companies with a proven history of delighting ground-level customers. The ones I like to call “people.” Here’s a Casey-ism that will be appearing in a new report on tech in healthcare from The Beryl Institute:

“My sense about technology, and whether it’s engagement or system improvement or anything in this zone, I think that the change is going to come from outside the healthcare industry. The solutions are going to be delivered by companies or entities that have a history of putting technology in the hands of consumers (people) and having those consumers (people) say ‘awesome!’ and just start using it.”

I don’t think anyone – consumer or clinician – has touched anything related to Electronic Health Records (EHR) tech and said anything resembling “awesome” about the experience.

ehr-no-one-ever

We, as a nation, have thrown $30+ billion at getting our healthcare delivery system into the 21st century, but have so far only seen it get to the point where it’s partying like it’s 1995 (Windows 95 – it’s AWESOME! Not.). Data exchange, a/k/a “interop,” is still a distant dream, which is why I have a QR code tattooed on my sternum as a political statement. “I am my own HIE,” essentially.

What we need here is a “1984” moment in healthcare. Not the George Orwell book, but the Mac computer ad that ran on Jan. 22, 1984 during the third quarter of the Super Bowl.

Epic Systems won’t deliver it. As much as Jonathan Bush would like athenahealth to deliver it … nope. Our “Obi Wan only hope” is going to have to come from a company that’s got a track record – distant or current – of delivering into the hands of consumers easy-to-use tech that has them saying “awesome!” and then … just using it.

ibm-dell-apple-3-way
“Help us, IBM-Dell-Apple. You’re our only hope.”

Which is why I’m saying “help us, IBM-Dell-Apple, you’re our only hope.” I’m not including Google, because they’ve already tried/failed, with GoogleHealth, and then (IMO, stupidly) abandoned the healthcare vertical after one play.

IBM might seem like an odd player to include here, but I know what they’re up to at the Serious Games lab at UNC under gamer-grrl extraordinaire Phaedra Boinodoris. (The Medical Minecraft project is of particular note there.)

Dell is in the personalized-medicine space, particularly in pediatric cancer, where they’ve built the Neuroblastoma and Medulloblastoma Translational Research Consortium (NMTRC) as a tumor board tool across 25 universities and children’s hospitals looking to build some real precision medicine/faster cures to fight children’s brain cancer.

Apple is the only player to serve up an actual consumer device with health apps – the iWatch and the ResearchKit, which turns an iPhone into a research contribution engine for a variety of projects looking at conditions from autism to breast cancer to Parkinson’s disease.

People, consumers, are ready (desperate?) to engage with the healthcare system using the same digital tools they use daily to manage everything from soccer practice to shopping lists to banking: their smartphones. The challenge to the healthcare system is to make tools to make that possible … which they have utterly failed to do, to date.

It’s time to hand the problem to proven consumer-delighters.

“Help us, IBM-Dell-Apple. You’re our only hope.”

Internet of Things (IoT) + healthcare = what, exactly?

By healthcare industry, technology

You can’t turn around these days without running into a headline about the Internet of Things (IoT). It seems as if everything from your car to your cardiac pacemaker is talking to everything else on the internet, and we’re all about to

If you’re confused about the whole IoT thing, and what it means to healthcare, you’re not alone.

As buzzphrases go, “Internet of Things” is having its Andy Warhol 15 minutes of fame on an auto-replay loop right now … but what will the actual interconnectedness of the technology we use in our daily lives deliver to us in the way of helping us live better/healthier lives? Will we find ourselves living out a cautionary “I, Robot” sci-fi tale as we become slaves to our IoT robot masters?

The answer is … (wait for it) … “it depends.” And what it depends on is how we humans build and interact with our robot mast … um, the Internet of Things.

The biggest challenge is that healthcare, as an industry, sees the people it serves – we’ll call those people “patients” – as the product, not the customer. Which, I think, goes a long way to explaining why this most human of all industry sectors – the one we seek help from when we get sick – has so resolutely resisted becoming digitally accessible/approachable to its customer base.

If you need a ride, Uber. If you want to shop, Amazon. If you want dinner, Yelp or BlueApron. If you need a doctor’s appointment … well, you can call the office to make an appointment. Or use the portal (if there is one). Or hit up the local urgent care. But there will be plenty of waiting, and it’s unlikely to be a tech-assisted process in any meaningful way.

How could the IoT help you in this situation? Well, if you have an iWatch, or an Android smartwatch (yes, there are such things), you could share your health-related data with your doctor (if s/he has an electronic medical records system that allows for that – pro tip: there ain’t many of those). There are a few consumer-accessible IoT devices that can communicate with clinical teams, like the AliveCor mobile ECG.

The IoT revolution, which allows your refrigerator to alert you if you’re low on milk and your car to text you to remind you it’s time for an oil change, hasn’t really arrived in healthcare. Sure, your iWatch and your Fitbit can send and receive health-related data via the web to you, and to anyone you’ve shared it with, but that “anyone” is unlikely to be your doctor unless s/he is a *very* early-adopter, tech-wise.

For those of us who are early-adopters on the consumer side of tech, this presents an opportunity to be leaders in the healthcare arena by testing and assessing IoT quantified-self and self-tracking tools. When we find something that works well for us – in losing weight, in managing a chronic condition – we can then encourage our healthcare partners (our doctors and nurses) to join in our tech-enabled self-care.

What about the hackers who are lying in wait for all that user-generated data on the Internet of Things? The folks at Arxan sent me the infographic below, which is a great starting place to assess the security of any IoT app or device you’re assessing.

Meanwhile, gotta dash. My Fitbit is reminding me it’s time for a walk.