Connected health isn’t about the devices – it must align people and providers


Under a normal statistical curve, between the chronically ill and the “motivated healthy,” is the largest segment of health citizens who are seeking missing information and solutions that could help them lead healthier lives. IBM has called out this information seeking segment, asserting that these people represent a huge unserved cohort of health care consumers.

In The future of connected health devices: liberating the information seeker,  the IBM Institute for Value makes the case for stakeholders in the health ecosystem to come together to provide solutions for this population. IBM says there are four critical success factors for meeting their needs: make it easy, design the solution with the end result in mind, pick a position and partner well, and help set the rules.

In addition to these, health consumers are looking for simplicity in device usability while maintaining privacy and security.

IBM points out that both the motivated healthy and the chronically monitored health segments are already using health devices for tracking and managing health (note: this is not a universal fact for all patients in 2011). The motivated healthy people tend to like gadgets and invest time to learn how to use and optimize them. On the other end of this continuum are the chronically monitored, who are in poor health and often caregiver-dependent. These people use devices that are largely prescribed by their physicians and paid-for by health plans.

The largest cohort’s in the middle: IBM calls them ‘information seekers.’ They’re “willing but currently underserved,” IBM writes. They’re also diverse, often addicted to bad health behaviors like smoking and sedentariness, and have a hard time keeping to prescribed therapeutic regimens for chronic conditions like high blood pressure and diabetes (e.g., filling and sticking with prescribed medications and glucose testing).

Fostering the demand that IBM foresees are underlying market drivers: most people have access to the internet, most carry mobile phones, most have broadband access. Furthermore, social networking in health is reaching a tipping point: fully one-third of U.S. adults uses a social network for health in some way, which Manhattan Research discovered in Cybercitizen Health version 9.0, as shown in the chart.

However, there are limiting factors to growing the information seeker market which counterbalance these drivers: most notably, IBM’s finding that 8 in 10 health consumers aren’t open to paying more than $100 for a health device today. Only 1 in 10 people are paying out-of-pocket for their health devices.  Within two years most people expect to be paying “something” out of pocket for these devices, perhaps via a monthly charge.

Health Populi’s Hot Points:  Those who regularly read this blog as well as my published reports sponsored by the California HealthCare Foundation and others know I’m a proponent of The Connected Patient, Connected Health, and what the West Wireless Health Institute calls “infrastructure independent health care.” However, this isn’t really about information seeking as IBM has framed the opportunity.

The many health apps developers with whom I work, which range from large Fortune 100 companies to boot-strapped start-ups, are learning that if it was just health information-seeking that would change health behavior, we would have reached the Holy Grail of Health by now. Information-seeking isn’t quite the right motivation here. The Pew Internet & American Life survey data on consumers’ use of the internet for seeking health information demonstrates that most people already seek health information. That’s necessary, but not sufficient, for health behavior change.

What’s key to health engagement are two factors that IBM points out are important to consumers: that people are looking for real-time feedback and connectivity, and that consumers trust their health providers’ advice. To consumers, sharing their data with health professionals is nearly as high a priority as keeping personal health data private and secure.

The reasons that people don’t engage in health are many and varied, and personal to the individual. But the fact that most consumers don’t see their role as health device-payer will be a major limiting factor in adoption among mainstream information seekers. There’s a reason that the chronically monitored and motivated healthy are connected: the former are generally covered by a health plan, and the latter are motivated to pay out-of-pocket.

What changes the payment equation will be the growing out-of-pocket costs for their health care that consumers will bear, a trend that began over the past several years and will escalate in the 2012 health plan year as employers plan to levy greater costs – in the form of increased premium sharing, higher co-pays and coinsurance percentages. Consumers will need to do a risk-benefit calculation to analyze  their personal health risk – say, for heart disease – arrayed against the up-front cost  for a health device to track and monitor blood pressure.

But that’s only one-half of the picture: consumers want to share that kind of information with providers. So the other side of the payment equation is provider reimbursement. New models of accountable care and medical homes could provide the impetus for doctors to join with patients in 360-degrees of participatory health care. Today’s health payment mechanisms won’t foster that adoption. But alignment of consumers and providers with the goal of Connected Health can move this market beyond the kinds of innovative partnerships that IBM is suggested can. Providing cool, usable technology is the supply side of the economics of health monitoring. The demand side must also be ready for prime time.


About Jane Sarasohn-Kahn

Jane Sarasohn-Kahn is a health economist, advisor and trend-weaver to organizations at the intersection of health, technology and people. Jane founded THINK-Health after spending a decade as a health care consultant in firms in the U.S. and Europe. Jane’s clients are all stakeholders in health, including technology, bio/life sciences, providers, plans, financial services, consumer products, public sector and not-for-profit organizations. Jane founded the Health Populi blog in 2007, covering health policy, technology, and consumers.
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