A blog covering the health/care ecosystem and people.

By shifting primary care visits by 5 minutes, moving some administrative tasks and self-care duties to patients, the U.S. could conserve billions of dollars which could extend primary care to underserved people and regions, hire more PCPs, and drive quality and patient satisfaction. Accenture’s report, Virtual Health: The Untapped Opportunity to Get the Most out of Healthcare, highlights the $10 bn opportunity which translates into conserving thousands of primary care providers. PCPs are in short supply, so virtual care represents a way to conserve precious primary care resources and re-deploy them to their highest-and-best-use. The analysis looks at three scenarios

The fastest-growing category of products and services at Health 2.0 is consumer-facing digital health, and a panel of companies demonstrated various flavors of the New Retail Health. One of the most prominent companies featured in Health 2.0’s conferences from the inception has been MyFitnessPal (MFP), a long-time helpful tool I’ve used to manage my own health-life. Under Armour acquired MFP earlier this year, which I covered here in Health Populi. Under Armour’s original mission was to make all athletes better. With the company’s acquisition of MyFitnessPal, Under Armour continued its morphing from a textile and sports gear company to a

Direct-to-consumer retail health options are fast-growing in the U.S. health ecosystem. CVS Health brought three telemedicine vendors to its pharmacy brick-and-mortar stores. CVS also acquired Target’s pharmacies, expanding its retail health footprint. Rite Aid has added HealthSpot kiosks to its pharmacies, while Walgreens expanded its relationship with MDLive. And, Cox Cable acquired Trapollo to bring remote health monitoring into subscribers’ homes, along with the cable company’s venture with Cleveland Clinic, Vivre Health. Coupled with the growing supply side of telemedicine vendors, the latest National Business Group on Health survey found that most large employers plan to expand the telemedicine services they

CVS is expanding the beauty aisles in stores, along with adding fresh and refrigerated foods and healthy snacks to its offerings. This is part of the company’s re-positioning in its post-tobacco mission, having re-branded from CVS/pharmacy to CVS Health last year. (You can read more about this strategic transformation here in Health Populi and here in my Huffington Post column). When CVS made this announcement, a portfolio manager for Gabelli Funds noted that health and beauty products have very high profit margins. These margins will be useful as CVS replaces the tobacco sales lost last year when the company went tobacco-free.

From elite soccer and football fields to youth athletes in public school gyms, wearable technology has come to sports bringing two big benefits of gathering data at the point of exercise: to gauge performance and coach back to the athlete in real time, and to prevent injury. I discussed the advent of the Internet of Things in sports on the Scoop and Score podcast with Andrew Kahn, sports journalist and writer, and Stephen Kahn, sports enthusiast and business analyst. [In full disclosure these two Kahn’s are also my brilliant nephews.] We recorded the podcast on July 14, 2015, the day

In the growing shared economy, one centerpiece is people-powered health – co-creating, shared decision-making, and a greater appreciation for the impact of social on health. As we approach the mid-point of 2015, there are several signposts pointing to people-powered health/care. FasterCures launched the Science of Patient Input Project, with the objective of getting the patient’s voice into clinical discovery and decision-making. This video describes the intent of the program and its potential for people-powered health and user/patient-centered drug design, beyond the pure clinical efficacy of therapies. Another example of people-powered health comes from The Wall Street Journal dated 29 June 2015, which

When I clipped you to my underwear for the first time in 2011, I’d no idea that you were about to change my life, health and mindfulness. You were my first digital activity tracker and since then, I’ve purchased three versions of you…as well as others. Fitbit, you really did change my life and help me become more mindful of my activity, my calorie burn, ultimately supporting me in losing weight and keeping it off. Since its launch in 2009, the brand name “Fitbit” has become synonymous with digital activity tracking, the most popular digital pedometer on the market —

Headphones and smartphones are the top two electronics products U.S. consumers intend to purchase in 2015. But the emerging consumer electronics categories of wearable fitness trackers, smart watches, and smarthome devices (especially “smart” thermostats) are positioned to grow, too, in 2015, according to the 17th Annual CE Ownership and Market Potential Study from the Consumer Electronics Association (CEA). Wearable trackers have an installed base of about 17 million devices in the U.S., with 11% of U.S. households intending to purchase a tracker in 2015 — 6 percentage points up from 2014 (about a 50% increase over 2014). There are about 6 million smart

It’s Mother’s Day 2015, so it’s time to praise moms and their role in making health: in their families, in their communities, and long-overlooked, for themselves. Mothers play a defining role in driving health in the world. Moms may be the most important social determinant of health. The National Partnership for Women & Families advocates for the role of women in building a healthy society, broadly defined. From the womb via the Childbirth Connection and Reproductive Health through economic security (such as fair wages and paid maternity leave) and women’s ability to access health information on behalf of their families and themselves,

Retail health v1.0 encompassed the pharmacy, then embraced urgent care and retail health clinics co-located in brick-and-mortar pharmacy chain stores. In v2.0, retail health encompasses all health/care, really, because people, patients and consumers are essentially self-insured up to the point when their health plan kicks in some cash. The high-deductible health plan era is ushering in the retail health era, broadly writ. Hospitals & Health Networks magazine (HHN) ran a story titled Think Like a Retailer to Engage Patients, covering founder of WEGO Health Jack Barrette‘s and my panel presentation at the 2015 HIMSS conference in Chicago last week. Writer

40% of U.S. consumers trust Big Retail to manage their health; 39% of U.S. consumers trust healthcare providers to manage their health. What’s wrong with this picture? The first chart shows the neck-and-neck tie in the horse race for consumer trust in personal health management. The Walmart primary care clinic vs. your doctor. The grocery pharmacy vis-a-vis the hospital or chain pharmacy. Costco compared to the chiropractor. Or Apple, Google, Microsoft, Samsung or UnderArmour, because “digitally-enabled companies” are virtually tied with health providers and large retailers as responsible health care managers. Welcome to The Birth of the Healthcare Consumer according

Health is the hot topic at SXSW. While edgy new movies and hot music are the foundational elements of the annual South-by-Southwest festival, health and health care are the fast-growing themes at the meet-up, where the new-new, month-old beautiful JW Marriott Hotel by the Convention Center hosted most of the digital health track sessions. Digital health today goes well beyond mobile apps and genomic futures. Philips was a major presence this year at SXSW with its vision, shared by me, THINK-Health, and the HeathcareDIY team, of connected health where we live, work, play, pray and learn. In the case of

As people take on self-service across all aspects of daily living, self-care in health is growing beyond the use of vitamins/minerals/supplements, over-the-counter meds, and trying out the blood-pressure cuff in the pharmacy waiting for a prescription to be filled. Today, health consumers the world over have begun to engage in self-care using digital technologies. And this isn’t just a phenomenon among people in the Millennial generation. Most seniors who regularly use technology (e.g., using computers and mobile phones) are also active in digitally tracking their weight, for example, learned in a survey by Accenture. Older people who use technology in daily

The 87th annual 2015 Oscars show (#Oscars15) feted more than the movie industry: the event celebrated health in both explicit and subtle ways. Julianne Moore took the golden statuette for Best Actress, playing the title role in Still Alice, the story a woman diagnosed with early-onset Alzheimer’s Disease. In accepting her award, Moore spoke of the need to recognize and “see” people with Alzheimer’s – so many people feel isolated and marginalized, Moore explained. Movies help us feel seen and not alone – and people with Alzheimer’s need to be seen so we can find a cure, she asserted. See Moore’s lovely

What does a bank have to do with health? Plenty, if you listen to 70% of consumers who say that financial health has a positive impact on physical health. TD Bank released the Fiscal Fitness survey this week, finding that consumers make a direct connection between fiscal and physical fitness. That’s what we here at THINK-Health refer to as financial wellness. TD learned that 80% of consumers made a health resolution in the New Year and 69% of people made a financial resolution 40% of people want to save more and spend less, and 42% want to get healthy and

2015 is already becoming a year where bedfellows of different stripes are joining together to build a health care ecosystem well beyond hospitals, doctors and health plans. Announcements launched last week at the 2015 Consumer Electronics Show in Las Vegas, and coming out this week at the J.P. Morgan Conference in San Francisco, the first two weeks of 2015 reveal that new entrants and legacy health stakeholders are crossing corporate and cultural chasms to (try and) solve challenges that prevent us from getting to that Holy Grail of The Triple Aim: improving health care outcomes, driving down per capita costs,

Men are from Mars and Women, Venus, when it comes to managing health and using digital tools and apps, based on a poll conducted by A&D Medical, who will be one of several hundred healthcare companies exhibiting at the 2015 Consumer Electronics Show this week in Las Vegas. Digital health, connected homes and cars, and the Internet of Things (IoT) will prominently feature at the 2015 Consumer Electronics Show in Las Vegas this week. I’ll be attending this mega-conference, meeting up with digital health companies and platform providers that will enable the Internet of Healthy “Me” — consumers’ ability to self-track,

“Disruption” is a well-used word these days in business and, in the past few years, in the health care business. That’s because there’s a general consensus that the U.S. health care system is broken. “System” is a word that I shouldn’t use as my friend J.D. Kleinke smartly argued that it’s that lack of system-ness that makes using the phrase “health care system” an Oxymoron. The fragmented health care environment creates innumerable pain points when accessing, receiving, and paying for services. And it’s women who feel so much of that pain. In that context, I’m gratified and humbled to be one

Consumers’ growing health care cost burden is competing with other household spending: basic costs for Americans are eroding what’s left of the traditionally-defined Middle Class. At the front end of health costs is the health insurance premium, the largest single line item for a family. It looks like a big number because it is: Milliman gauged the cost for an employer to cover a family of four in a PPO in the U.S. at around $23K, with the employee bearing an increasing percent of the premium, copays, coinsurance, and a larger deductible this year than last, on average. There are

There’s an emerging health-committed consumer, one of over 70% of people who believe they’re less healthy than the generations who came before them. 9 in 10 consumers overall believe that what you eat impacts how you feel. Those who are health-committed spend 70% of their grocery budgets on healthy products, read food labels, spend more and shop more frequently than low health-committed consumers, according to Healthy, Wealthy, & Wise, a survey report from Dunnhumby. The number of health-committed consumers globally grew by 38% since 2009. Most consumers look first to themselves to drive health, then to doctors, and third to food companies

The health care industry is undergoing a retail transformation, according to Retail Reigns in Health Care: The rise of consumer power and its organization & workforce implications from Deloitte. Deloitte’s report published in October 2014 focuses on the health insurance business, which is newly-dealing with uninsured people largely unfamiliar with how to evaluate health plan options. This by any definition requires new muscles for both buyers and sellers on a health insurance exchange: new product access + uninformed consumer = retail challenge. Deloitte notes another supply and demand challenge, and that’s with the health insurance company workforce: while 93% of health

Of all the functions a smartwatch could play, it’s activity tracking that’s top of most consumers’ minds. GfK conducted a survey in August 2014 among 5,000 smartphone-owning consumers in five countries — China, Germany, South Korea, the UK, and the U.S. The market research firm found that 29% of people see “activity tracking” the most important function. Phone calls ranked second with 13% of consumers, telling time 11%, and 10% voted for basic apps and navigation system. 7% of consumers noted the smartwatch would be desirable for basic web search. In this survey, activity tracking included the broad definition covering

There’s a health information disconnect among U.S. adults: most people believe online access to their personal health information is important, but three-quarters of people who were offered access to their health data and didn’t do so didn’t perceive the need to. The first two graphs illustrate each of these points. When people do access their online health records, they use their information for a variety of reasons, including monitoring their health (73%), sharing their information with family or care providers (44%), or downloading the data to a mobile device or computer (39%). In this context, note that 1 in 3

Remote health monitoring is in the Trough of Disillusionment. Wearables are at the Peak of Inflated Expectations, with Big Data leapfrogging wearables from the 2013 forecast — both descending toward the Disillusionment Trough. Mobile (remote) health monitoring, however, has fallen into that Trough of Disillusionment as RHM has been undergoing reality checks in the health care system especially for monitoring and patient self-management of heart disease (most notably heart failure) and diabetes. Welcome to the 2014 edition of the Gartner Hype Cycle, one of my most-trusted data sources for doing health industry forecasts in my advisory work. Compared with last year’s

In the past few weeks, several events bolster the reality that health and health care are in Blurred Lines mode. Not Robin Thicke Blurred Lines, mind you, but the Venn Diagram overlapping kind. Walmart launched real primary care clinics in South Carolina and Texas. These will provide services beyond urgent care, charging $4 a visit for company employees and $40 a visit for other people The U.S. Department of Agriculture issued a report promoting “nudges” to grocery shoppers enrolled in the Supplemental Nutrition Access Program (SNAP) to buy healthy foods Apple is talking with Cleveland Clinic, Johnson Hopkins, and Mount Sinai Medical

In the post-Recession American economy, people shop for value in all things. And that includes health care services like MRIs — when patients are informed of pricing differences among imaging facilities and given free rein to pick-and-choose among them. In addition to lowering imaging costs in a community, price transparency also generated competition between providers. Health Affairs published this research detailed in Price Transparency for MRIs Increased Use of Less Costly Providers And Triggered Provider Competition in August 2014. An Economics 101 course teaches us that a well-oiled (perfect) market depends on lots of sellers of a product and lots of

This is the summer of big spending leaps for groceries, gas and health care. Here’s hoping that food, energy and visits to doctors make us happy, because we won’t be getting much joy from travel, dining out, leisure activities, or consumer electronics purchases, all of which are declining in terms of consumer spending. The Gallup survey published July 12, 2014, finds that 59% of people are spending more on groceries, 58% on gas/fuel, and 42% on health care. Net spending on each of those spending categories increased 49%, 46%, and 34% respectively this week compared with one year ago. Personal

Consumers around the world are feeling more knowledgeable, self-confident and realistic, enabled by mobile platforms, the democratic power of social “choruses,” and a more sharing economy featuring collaborative consumption. As peoples’ phones get smarter and smarter, they carry more powerful multichannel information devices in their hands which empower Homo Informaticus – the new global digital consumer, described in EY’s report, How to copilot the multichannel journal. EY polled 29,943 consumers in the Consumers on Board survey living in 34 countries: across the Americas, Asia-Pacific, the Middle East, India and Africa. Homo informaticus is the rational consumer smartly using technology to filter information.

There’s a growing number of wearable digital health devices on the market, and more will appear at the 2015 Consumer Electronics Show in Las Vegas. Four new such products competed live today at CE Week’s Battle of the Bands, an event launched by Living in Digital Times. The competitors included GoQii, Healbe, Skulpt, and Wellograph, Wellograph calls itself “the world’s first wellness watch.” Made of sapphire crystal, the watch has a sleek design, targeting a working professional audience who wants a view on health throughout the day. The watch has an Integrated heart rate sensor, taking readings from the wrist for pulse,

What do you get when you pair Meredith Wilson, the writer-composer of The Music Man, with Robert Preston (who acted the starring role of Harold Hill, the traveling music-band instrument salesman) with a President committed to reversing the “softness” he saw in American health citizens? You get “Go, You Chicken Fat, Go,” a rousing band-and-choir backed anthem to promote people to engage in more exercise and shed their “chicken fat.” President Kennedy was the public health Prez who, in 1960, asked Meredith Wilson to pen a national anthem to motivate Americans who he considered were growing “soft.” Back in the

As Big Payors continue to shift more costs onto health consumers in the U.S., the importance of and need for transparency grows. 39% of large employers offered consumer-directed health plans (CDHPs) in 2013, and by 2016, 64% of large employers plan to offer CDHPs.  These plans require members to pay first-dollar, out-of-pocket, to reach the agreed deductible, and at the same time manage a health savings account (HSA). In the past several weeks, many reports have published on the subject and several tools to promote consumer engagement in health finance have made announcements. This week of posts provides an update on

The Consumer Electronics Association (CEA) has formed a new Health and Fitness Technology Division, signalling the growing-up and mainstreaming of digital health in everyday life. The CEA represents companies that design, manufacture and market goods for people who pay for stuff that plugs into electric sockets and operate on batteries — like TVs, phones, music playing and listening, kitchen appliances, electronic games, and quite prominent at the 2014 Consumer Electronics Show, e-cigarettes (rebranding “safe smoking” as “vaping” technology). In its press release announcing this news, CEA President and CEO Gary Shapiro says, “Technology innovations now offer unprecedented opportunities for consumers to

In our increasingly-DIY society, most consumers expect high levels of access and customer service from the organizations with whom we engage. With more consumers reaching into their pockets to pay for health services and products, the health industry is increasingly a retail-facing environment. So expect quality service levels from their healthcare touch points. The pharmaceutical and prescription drug touch point is not exempt from this expectation, as learned by an Accenture survey analyzed in Great Expectations: Why Pharma Companies Can’t Ignore Patient Services. As the first picture shows, 70% of patients think pharma companies are responsible for bundling information and services

The CEO of a family-owned grocery store chain wrote a letter to New York State lawmakers to support $65 million worth of spending on a computer system for health information in the state. That grocer is Danny Wegman, and that project is the Statewide Health Information Network, aka SHIN-NY. In his letter beginning, “Dear New York Legislator,” Wegman identifies several benefits he expects would flow out of the health IT project: 1. Improve health care for all New Yorkers 2. Lower health care costs, through reducing hospital readmission rates and reducing duplicate testing. 3. Lead to health data “liquidity” (my

Thinking about personal health information technology – the wearable devices, remote health monitors, digital weight scales, and Bluetooth-enabled medical equipment scaled for the home – there are two glasses. One is half-full and the other, half-empty. The half-full glass is the proliferation of consumer-facing devices like Fitbit, Jawbone and Nike, which comprise the lion’s market share in the health wearables segment; the mass adoption of mobile phones and tablets; consumers’ multi-screen media behavior (as tracked by Nielsen); and consumers’ growing share of medical spending, now about 40% of annual spending (or something north of $8,000 for a family of four

IBM’s data analytics engine Watson, having cut its teeth on complex health care conditions like cancer, is now entering an even more challenging space: wellness. Why is wellness more challenging? Because understanding a person’s wellness goes beyond mining data from health care claims silos in hospitals, pharmacies, and physicians’ electronic health records. Wellness happens where we live, work, play and pray. Wellness is nurtured through choices made every day at home, in the workplace, and at moments-of-truth in the grocery store and restaurant where slick marketing messages planted in our subconscious compete with our more rational minds that tell us to

Bravo! to CVS/pharmacy who today announced it would pull tobacco products from store shelves by October 2014. “The sale of tobacco products is inconsistent with our purpose,” the company’s press release asserts. The move will cost CVS $1.5 billion in revenue annually, as the company seeks to consolidate its position as a health company. CVS/pharmacy is part of CVS Caremark, which includes the retail pharmacy chain (the second-largest in the U.S.), a pharmacy benefit management company (Caremark), and retail health clinics (Minute Clinics). CVS Caremark also participates in a healthy communities program issuing grants for projects that focus on health

If your wallets are lighter at the end of the month, you’re likely to have less access to quality food, and more likely to be admitted to the hospital if you have diabetes. The hypothesis that people with low incomes whose household budgets are spent before the end of the month have greater health inequities was tested in the article, Exhaustion of Food Budgets At Month’s End And Hospital Admissions For Hypoglycemia, published in the January 2014 issue of Health Affairs. Researchers from the University of California – San Francisco found that, indeed, the health in households with low-income suffer from

This post appeared in my Huffington Post column on January 16, 2013. In the afterglow of the 2014 Consumer Electronics Show (CES), away from the neon lights of Las Vegas, 4D curved TV screens, and uber-hip Google Glass wearers, a big question remains: Do we, the people, really want to tech our way to self-health? The number of digital health companies exhibiting at CES grew by 40 percent, exceeding 300 based on the count of the International Consumer Electronics Association, sponsor of the event. The hockey-stick growth of “wearable technology” seen at the 2014 Consumer Electronics Show begs the question: Are there

Madame Onassis got nothing on you, Rod Stewart complimented in his hit You Wear It Well in 1972. Now we can all wear it well, based on the fashion-meets-health-mashups at the 2014 Consumer Electronics Show. Several events underline this observation at the CES this year: – Fitbit has signed up Tory Burch to put her mark accessorizing the company’s activity trackers – The CSR Bluetooth smart pendant was designed with the chic jeweler Cellini; the device can receive alerts from an iPhone (think: medication adherence, or a message from mom in Florida). This is featured in the first photo. –

The rise of digital health at the 2014 Consumer Electronics Show signals the hockey-stick growth of consumer-facing health devices for fitness and, increasingly, more medical applications in the hands of people, patients, and caregivers. This year at #CES2014, while the 40% growth of the CES digital health footprint will get the headlines, the underlying story will go beyond wristbands and step-tracking generating data from an N of 1 to tools that generate data to bolster shared-decision making between people and the health system, and eventually support population health. For example: – Aetna is partnering with J&J to deploy their Care4Today

While about 53% of people globally are willing to share various types of personal data overall, the kind of data willing-to-be-shared varies by type of information — and what country we’re from. When asked how likely they would be to anonymously share information if it could lead to improvements or innovations in that technology, Americans are less likely to be willing to share any type of personal data — except for gender. When it comes to sharing several specific types of health information, fewer Americans are likely to want to share it as Intel found in their survey published in the company’s Healthcare

This Thanksgiving, we’re once again participating in the annual Engage With Grace blog rally, encouraging those who haven’t considered their end-of-life preferences to start thinking about them, and asking those who have done it to consider how their decisions may have changed over time. It’s good food for thought. Wishing you all a happy, healthy holiday season.  Most of us find ourselves pretty fascinating… flipping through photos and slowing down for the ones where we’re included, tweeting our favorite tidbits of information, Facebook-ing progress on this or that… We find other people captivating as well.  In fact, there’s a meme going around

23andme received word from the Food & Drug Administration (FDA) on November 22, 2013, that they must cease and desist selling the company’s Saliva Collection Kit and Personal Genome Service (PGS). FDA explained in their Warning Letter, “Most of the intended uses for PGS listed on your website, a list that has grown over time, are medical device uses under section 201(h) of the FD&C Act. Most of these uses have not been classified and thus require premarket approval or de novo classification, as FDA has explained to you on numerous occasions. “Some of the uses for which PGS is intended are

Self-service – people DIYing health care — can help solve the primary care shortage in America, based on the findings of 23 studies published this week. If health information technologies (health IT) were “fully implemented” in 30% of doctors’ offices, demand for physicians would fall by 4 to 9%, according to The Impact of Health Information Technology and e-Health On the Future Demand for Physician Services, published in the November 2013 issue of Health Affairs. Weiner, Yeh and Blumenthal did a meta-analysis of the literature on health IT and its potential to improve productivity and extend physician services and found

When it comes to retail shopping, most people spend most of their time shopping in brick-and-mortar stores – not online. 92% of spending happens in stores. 3 in 10 people spend most their shopping time online. Brick-and-mortar is far from dead, concludes the report Recasting the Retail Store in Today’s Omnichannel World from AT Kearney. This study looked into the shopping behaviors for consumers in the US and the UK in February 2013. What is true is that the growth of online retail has taught consumers how to shop on the basis of more transparent pricing and supply. This then drives

Women and binge drinking…job and financial stress…sleeplessness…caregiving challenges…sex…these were the topics covered in Health 2.0 Conference’s session aptly called “The Unmentionables.” The panel on October 1, 2013, was a rich, sobering and authentic conversation among 7 women and 1 man who kept it very real on the main stage of this mega-meeting that convenes health technology developers, marketers, health providers, insurers, investors, patient advocates, and public sector representatives (who, sadly, had to depart for Washington, DC, much earlier than intended due to the government shutdown). The Unmentionables is the brainchild of Alexandra Drane and her brilliant team at the Eliza

This is a personal post about a very personal idea: medical rights and freedom of choice. When it has to do with your child, especially when she is a minor, then it’s ever-the-more personal. I have permission to use my daughter’s name, Anna, for this post. Anna’s public high school hosted a flu vaccine clinic this week. As I believe and live the mantra that health is where we live, work, play and pray — that health is not locked up isolated in a doctor’s office or hospital bed — I embrace the role that schools can play to bolster

U.S. health consumers faced greater out-of-pocket health care costs in 2012, especially for outpatient services (think: doctors’ visits) and generic drugs, as presented in The 2012 Health Care Cost and Utilization Report  from the Health Care Cost Institute (HCCI) published in September 2013. At the same time between 2011 and 2012, wages grew about 3%, remaining fairly flat over the past decade as health care costs continued to grow much faster. HCCI found that per capita (per person) out-of-pocket growth for outpatient visits amounted to an average of $118 between 2011 and 2012. But the biggest share of out-of-pocket costs for