The FDA Has Spoken, and It Will Regulate “Some” mHealth Apps
The FDA has spoken: there are 2 statutory definitions for a mobile health tool as a “medical device” that the Agency says it has regulatory oversight: To be used as an accessory to a regulated medical device, or To transform a mobile platform into a regulated medical device. On page 8 of the Guidance for Industry and Food and Drug Administration Staff, you can read the FDA’s expanded definition of a mobile health app as being: “…intended for use in performing a medical device function (i.e. for diagnosis of disease or other conditions, or the cure, mitigation, treatment, or prevention
Healing the Patient-Doctor Relationship with Health IT
A cadre of pioneering Americans has been meaningfully using personal health information technology (PHIT), largely outside of the U.S. health care system. These applications include self-tracking and wearable health technologies, mobile health apps, and digital medical tracking devices like glucometers that streamline tracking and recording blood glucose levels. In the meantime, only 21% of doctors surveyed by Accenture currently allow patients to have online access to their medical summary or patient chart – very basic components of the electronic health record. We know what’s primarily driving health providers’ adoption of health IT: namely, the HITECH Act’s provisions for incentives. But
Defining Mobile Health – the blur between health and health care
Mobilising Healthcare, a new report from Juniper Research, segments the mobile health sector into “healthcare” and “health & fitness” segments. The research summary notes that fitness is a relatively new market compared with health “care,” which has been around for eons. Fitness, the analysts say, “is exempt from government intervention.” Mobile healthcare (“mHealth”) applications explored include SMS health messaging, remote health provision such as cardiac monitoring, electronic health records and personal health records. In mFitness, Juniper looks into mobile tech for athletes and fitness conscious people, and activity tracking including heart function, distance, respiration, and perspiration, among other parameters. mHealth
Food and the household health budget: one pocket, shrinking access
Over 1 in 5 people in the U.S. have not had enough money to buy food for themselves or their families in the past year, according to the August 2013 Gallup Healthways Index. This is as many consumers as those who couldn’t afford food during the deepest months of the last recession. Lack of access to food is a challenge for a cadre of Americans who lack access to other basic needs such as shelter and health care. Gallup’s Basic Access Index looks at this market basket, and has found that Americans’ access to basic needs at 81.4 in August
Health information search online, an hour a week. Time with a doctor? An hour a year.
In game-scoring unit terms, 52 is the number of hours an average American spends seeking health information online each year. The 1 (hour) is roughly equivalent to the approximate total time a patient spends with a physician (an average of 3 visits, with an average time per vision of 20 minutes). Thus, 52:1. This means that the average U.S. health consumer spends much more time DIYing her health using digital information resources than speaking face-to-face with their physician in the doctor’s office. Still, the physician continues to be a go-to source for health information, according to Makovsky, a health communications
Chief Health Officers, Women, Are In Pain
Women are the Chief Health Officers of their families and in their communities. But stress is on the rise for women. Taking an inventory on several health risks for American women in 2013 paints a picture of pain: of overdosing, caregiver burnout, health disparities, financial stress, and over-drinking. Overdosing on opioids. Opioids are strong drugs prescribed for pain management such as hydrocodone, morphine, and oxycodone. The number of opioid prescriptions grew in the U.S. by over 300% between 1999 and 2010. Deaths from prescription painkiller overdoses among women have increased more than 400% since 1999, compared to 265% among men.
Needing a new kind of tracker to track #mhealth investments in 2013
The news this week that Fitbit attracted $42 million investment capital follows Withings’ announcement of $30 million (including Euro11 million from BPIFrance, the French national investment fund), Jawbone’s recent acquisition of Bodymedia for $100 million in April 2013, and MyFitnessPal raising $13 million earlier this month. The quick arithmetic for these four companies alone adds to roughly $200 mm in a few months going to these brands, which are feverishly competing for the heartbeats and footsteps of people who are keen to track their steps and stay healthy. Can you keep up? You need a new kind of activity tracker to track
Eat fruits and vegetables: it’s worth $11 trillion to you and the U.S. economy
More than 127,000 people die every year in America from cardiovascular disease, accruing $17 billion in medical spending. Heart disease is a “costly killer,” according to the Union of Concerned Scientists, who has calculated The $11 trillion reward: how simple dietary changes can save lives and money, and how we get there, published in August 2013. That $11 trillion opportunity is equal to the present value of lives saved. The solution to bolstering heart (and overall health) and saving money (medical spending and personal productivity) is in food. We’re not talking about genetically engineering anything special or out-of-the-ordinary. We are talking
Google, your new-tritionist
Your new-nutritionist is now Google, which launched a nutrition utility through Google Search. “From the basics of potatoes and carrots to more complex dishes like burritos and chow mein, you can simply ask, ‘How much protein is in a banana?’ or ‘How many calories are in an avocado?’ and get your answer right away,” the official Google Search blog explains. Over 1,000 items – fruits, vegetables, meats, dairy items, and prepared meals like Chinese and Mexican take out, as mentioned in Google’s quote above – are searchable via web and mobile, powered by Google’s Knowledge Graph. The Knowledge Graph is the
Cost prevents people from seeking preventive health care
3 in 4 Americans say that out-of-pocket costs are the main reason they decide whether or not to seek preventive care, in A Call for Change: How Adopting a Preventive Lifestyle Can Ensure a Healthy Future for More Americans from TeleVox, the communications company, published in June 2013. TeleVox surveyed over 1,015 U.S. adults 18 and over. That’s the snapshot on seeking care externally: but U.S. health consumers aren’t that self-motivated to undertake preventive self-care separate from the health system, either, based on TeleVox’s finding that 49% of people say they routinely exercise, and 52% say they’ve attempted to improve eating habits.
Money and health, migraines and sleep: how stress directly impacts health and wealth
There’s an issue that doctors and patients don’t discuss that’s among the most important contributors to ill health: it’s money, and it’s something Alexandra Drane calls an “Unmentionable.” Alex, Founder, Chief Visionary, and Board Chair at Eliza Corporation, coined Unmentionables as those aspects of daily living which everyone deals with, but few like to talk about: like sex (whether too much, too little), drugs (abusing), drinking (too much), toileting problems (such as incontinence or pooping problems), sleep trouble, and caring for others (not ourselves so much). These daily life challenges can negatively impact health, with financial stress being one of
As health cost increases moderate, consumers will pay more: will they seek less expensive care?
While there is big uncertainty about how health reform will roll out in 2014, and who will opt into the new (and improved?) system, health cost growth will slow to 6.5% signalling a trend of moderating medical costs in America. Even though more newly-insured people may seek care in 2014, the costs per “unit” (visit, pill, therapy encounter) should stay fairly level – at some of the lowest levels since the U.S. started to gauge national health spending in 1960. That’s due to “the imperative to do more with less has paved the way for a true transformation of the
The part-time medical home: retail health clinics
The number of retail health clinics will double between 2012 and 2015, according to a research brief from Accenture, Retail medical clinics: From Foe to Friend? published in June 2013. What are the driving market forces promoting the growth of retail clinics? Accenture points to a few key factors: Hospitals’ need to rationalize use of their emergency departments, which are often over-crowded and incorrectly utilized in cases of less-than-acute care. In addition, hospitals are now financially motivated under the Affordable Care Act (ACA, health reform) to reduce readmissions of patients into beds (particularly Medicare patients with acute myocardial infarction [heart attacks],
The emerging economy for consumer health and wellness
The notion of consumers’ greater skin in the game of U.S. health care — and the underlying theory of rational economic men and women that would drive people to greater self-care — permeated the agenda of the 2nd annual Consumer Health & Wellness Innovation Summit, chaired by Lisa Suennen of Psilos Ventures. Lisa kicked off the meeting providing a wellness market landscape, describing the opportunity that is the ‘real’ consumer-driven health care: people getting and staying well, and increasing participation in self-management of chronic conditions. The U.S. health system is transforming, she explained, with payors beginning to look like computer
The role of internet technologies in reducing health care costs: Meeker inspirations
Tablets, wearables, smartphones, video and QR codes: these are fast-growing platforms moving data around the global economy. They’re also fast=growing platforms for health care where we live, work, play and pray. Mary Meeker’s annual presentation on Internet Trends at the D11 Conference, is fresh off the virtual press in its shiny new 2013 version. Meeker has been with the investment firm Kleiner Perkins Caulfield Byers (KPCB) since 2011, and was with Morgan Stanley from 1991 to 2010. She’s a veteran who’s watched the Internet basically from The Beginning. Of the 117 slides in her informative, gargantuan deck (a Meeker hallmark every
The health and wellness gap between insured and uninsured people
If you have health insurance, chances are you take several actions to bolster your health such as take vitamins and supplements (which 2 in 3 American adults do), take medications as prescribed (done by 58% of insured people), and tried to improve your eating habits in the past two years (56%). Most people with insurance also say they exercise at least 3 times a week. Fewer people who are uninsured undertake these kinds of health behaviors: across-the-board, uninsured people tend toward healthy behaviors less than those with insurance. This is The Prevention Problem, gleaned from a survey conducted by TeleVox
Marketing Digital Health to Mom 2.0 on Mother’s Day 2013
Mainstream media, both print and online, peppered their 2013 Mother’s Day gift suggestions including pod coffeemakers, bangle bracelets, candy-colored accessories and digital health devices. Say, what? In Parade magazine, Mother’s Day 2013 gift ideas included the Fitbit “smart pedometer,” linked to a “buy” site at REI. You can’t get much more mainstream than Parade. In Entertainment Weekly, Bronwyn Barnes, style maven for the magazine, wrote a one-page “Get Ready for Mom 2.0” and her recommendations included the Pebble Smartwatch, the Jawbone Up wristband, and the HoodieBuddie with earbuds built into the drawstrings. Men’s Health told sons and husbands to check
Call it DTH, direct to home: Pfizer is shipping Viagra direct to consume
While the blockbuster erectile dysfunction (ED) drug has been shipped directly to consumer’s homes for years via pharmacy benefits management companies and specialty pharmacy retailers catering to the ED segment, Pfizer wants in on the transaction and has decided to get into the Direct-to-Consumer (DTC) distribution business for a prescription drug. Call this market development Direct-to-Home, or DTH. This is a kind of sentinel event signaling a pharmaceutical manufacturer cutting out the middle-man (read: retail pharmacy), and in this case getting up-close-and-personal with users of a drug that represents quality of life. Another motivation for Pfizer is trying to stem
A physical activity shortage: Let’s Move!
Only 1 in 5 Americans got the minimum recommended amount of physical activity in 2011, based on guidelines offered by the U.S. Centers for Disease Control. More men than women met the standard: 23.4% of men versus 17.9% of women. There are wide variations across the 50 states, as the map shows, with the healthiest folks exercise-wise living in the west, Alaska, upper midwest, and New England. The range runs from a 12.7% low in West Virginia and Tennessee to 27.3 at the high end in Colorado. That bar is set at 150 minutes a week (that’s 2.5 hours) of
Dietitians provide a health bridge between food and pharmacy
The registered dietitian is an in-demand labor resource for grocery stores around the U.S. Advertising Age covered the phenomenon of the growing clout of dietitians in food chains (April 14, 2013). Let’s dig further into this phenomenon through the Health Populi lens on healthcareDIY and peoples’ ability to bend their personal health care cost curves. Stores such as Giant Eagle, Hy-Vee, Safeway and Wegmans are morphing into wellness destinations, with pharmacies and natural food aisles taking up valuable square footage to meet consumers’ growing demands for healthy choices. Some stores are formalizing their approach to food = health by formulating a
Walgreens Steps with Balance program rewards both consumers and the store
Consumers who patronize Walgreens can get rewarded for tracking their physical activity For the Steps with Balance program kickoff, self-tracking consumers can earn 20 points for every mile walked or run and 20 points for tracking weight. Walgreens implemented the Walk with Walgreens program in 2012. The program won an Effie Award for an outstanding marketing program. With the success of Walk with Walgreens, the retail pharmacy company has expanded the program beyond simple steps to include weight tracking and health goals for earning loyalty points. The program enables a few of the most popular self-tracking devices to sync so
Arianna and Lupe and Deepak and Sanjay – will the cool factor drive mobile health adoption?
Digital health is attracting the likes of Bill Clinton, Lupe Fiasco, Deepak Chopra, Dr. Sanjay Gupta, Arianna Huffington, and numerous famous athletes who rep a growing array of activity trackers, wearable sensors, and mobile health apps. Will this diverse cadre of popular celebs drive consumer adoption of mobile health? Can a “cool factor” motivate people to try out mobile health tools that, over time, help people sustain healthy behaviors? Mobile and digital health is a fast-growing, good-news segment in the U.S. macroeconomy. The industry attracted more venture capital in 2012 than other health sectors, based on Rock Health’s analysis of the year-in-review. Digital health
Eric Topol creatively destroys medicine at #HIMSS13
Wearing his Walking Gallery jacket painted by (im)patient advocate, Regina Holliday, Dr. Eric Topol evangelized the benefits of digital medicine and consumer empowerment in health care, largely summarizing his epic (pun intended – wait for Hot Point, below) book, The Creative Destruction of Medicine. A founder of the West Wireless Health Institute (now known as West Health), Dr. Topol is a physician and researcher at Scripps and was recently named as editor at Medscape. A new piece of Topol Trivia for me is that GQ magazine called him a rock star of science. Dr. Topol is one of the more
Patients globally would embrace Jetsons-style health care…but will health providers?
Patients are getting comfortable with remote health care – that is, receiving care from a health provider at a distance via, say, telehealth or via a Skype-type of set-up. Furthermore, 70% of people globally saying they would trust an automated device to provide a diagnosis that would help them determine whether or note they needed to see a doctor. Based on the findings from Cisco‘s survey summarized in the Cisco Connected Customer Experience Report – Healthcare, published March 4, 2013, just-in-time for the annual 2013 HIMSS conference, a majority patients the world over are embracing health care delivered via communications
The future of sensors in health care – passive, designed, integrated
Here’s Ann R., who is a patient in the not-too-distance-future, when passive sensors will be embedded in her everyday life. The infographic illustrates a disruption in health care for people, where data are collected on us (with our permission) that can help us improve our own self-care, and help our clinicians know more about us outside of their offices, exam rooms and institutions. In Making Sense of Sensors: How New Technologies Can Change Patient Care, my paper for the California HealthCare Foundation, I set out to organize the many types of sensors proliferating the health care landscape, and identify key
Health is wealth and wealth, health
It’s America Saves Week (February 25-March 2, 2013). Do you know what your savings rate is? If you’re in the center of the American savings bell curve, you probably don’t have a savings plan with specific goals and don’t know your net worth. Two-thirds of U.S. adults say they have sufficient emergency savings for unexpected expenses like a visit to a doctor. However, only one-half of non-retired people believe they’re saving enough for a retirement where they’ll have a “desirable standard of living.” This six annual survey by the Consumer Federation of America, the American Savings Education Council, and the
Living paycheck to paycheck: what it means for health
While 50% of Americans feel they have a sound financial position, the other half is living paycheck to paycheck. 8% say they can’t even pay for essentials. The second annual Allstate “Life Tracks” Poll finds American adults split between have’s and have not’s, with even the “have’s” feeling less than financially literate. There is an equal split between people who feel they’re in an “excellent” or “good” financial position compared with those who feel they’re in financially “fair” or “poor” shape. Men feel more financially secure than women; 3 in 4 single parents feel less well-off compared to the average
Lower calories are good business
The restaurant chain business employs 10% of U.S. workers and accounts for $660 bn worth of the national economy. Where restaurant chains are growing fastest is in serving up lower-calorie meals, and it’s been a boon to the bottom-line. The case for lower calories leading to better business is made in Lower-Calorie Foods: It’s Just Good Business from the Hudson Institute‘s Obesity Solutions Initiative, published February 2013. In the report, researchers analyzed nitty-gritty restaurant chain data on servings and traffic from 2006-2011 to sort out whether sales of so-called lower-calorie menu items in 21 chains led to improved business. The chains
Dark chocolate as health food – a healthy salute to Valentine’s Day
On a recent Whole Living segment on Martha Stewart’s Sirius XM radio channel, I learned of the artisan chocolatier, Gnosis. The company, whose name is Greek for “knowledge,” grew out of the kitchen of a holistic health counselor, Vanessa Berg, who began to make nutritionally-infused sweets for her private clientele. Word-of-mouth made its way to a buyer from Whole Foods, who subsequently did a deal with Berg to sell Gnosis goods in some of the company’s stores in New Jersey and New York. Here’s a link to the radio interview. Chocolate is a health food for this company, and for
The more engaged a patient is, the lower their costs
There are many ways to measure and express “patient engagement.” One such metric is “patient activation,” innovated by Dr. Judith Hibbard, long affiliated with the University of Oregon. Dr. Hibbard has written extensively about the Patient Activation Measure, PAM, first described in 2004. She and a team of researchers have determined that the higher a patient’s PAM score, the lower their health costs. Hibbard et. al. published these findings in the February 2013 issue of Health Affairs, which is entirely devoted to patient engagement – a top topic in Health Populi. The team analyzed the medical records of 33,163 patients
The interoperability of consumer mHealth – reflecting on Jawbone + Massive Health + Visere
Consumers want multiple functions on single devices, smooth transitions from one screen to another, and value-laden experiences in the post-recession economy. I wrote about this phenomenon during the week of the 2013 Consumer Electronics Show, highlighting Accenture’s survey on consumer attitudes toward technology — the connected home as consumer medical home. In the fast-evolving mobile health (mHealth) era, the consumer-facing suppliers are fast-responding to these customer demands. This is fostering consumer-centered interoperability in mHealth. On the health care system and professional side of health IT, getting to interoperability remains elusive and slow-going, with a customer base (hospitals, physicians) that’s not
The flu shot economy
4 in 10 Americans got flu shots in this epidemic season, and most of these didn’t receive their immunization in their doctor’s office. The Flu Vaccination Survey from Ipsos Public Affairs, conducted in January 2013, paints a picture of U.S. health consumers who are project managing their personal approaches to preventing the flu in this historically hard-hitting flu season. The most expressed demand for flu shots has been among people 55 and over, one-half of whom have received vaccinations, with the lowest use been in the 25-35 year age group. Geographically, the most covered health citizens live in New England
Most women want to be healthy, buy healthy
Health and wellness motivations among women cross all generations, driving them to purchase products that bolster health as they define it…not how media and stereotyping advertising have typically portrayed it, according to a survey report from Anthem Worldwide, What Women Really Want From Health and Wellness. Over all generations, 3 in 4 women say they make choices to benefit their health and wellness. Anthem asked women about the “external voices” of health/wellness messaging versus their “internal voice.” The external represent societal expectations: over 80% of women expect to take responsibility for their family’s health, and about 70% of women say the
Formally tracking health data changes health behavior and drives social health
Most of us keep track of some aspect of our health. Half of all people who track do so “in their heads,” not on paper, Excel spreadsheet, or via digital platform. Furthermore, 36% update their health tracking data at least once a day; but 16% update at most twice a month, and 9% update less than once monthly. Tracking for Health from the Pew Internet & American Life Project paints a portrait of U.S. adults who, on one hand are quantifying themselves but largely aren’t taking advantage of automated and convenient ways of doing so. Overall, 69% of U.S. adults track
More consumers want to make health care decisions
U.S. consumers’ desire to take an active role in their health decisions is growing, according to the Altarum Institute Survey of Consumer Health Care Opinions. 61% of people want to make health decisions either on their own (26%) or with input from their doctor (38%). The proportion of people wanting to be “completely in charge of my decisions” rose 4 percentage points in one year, from 2011. This statistic skews younger, with 33% of people 25-34 and 31% of those 35-44 wanting to be “completely in charge.” Only 17% of those 55-64 felt like being totally in charge of their
The connected home as consumer medical home
Consumers are looking for electronic devices that do many things, don’t care much about what platforms they use, like the convenience that cloud computing enables, and are bringing their own devices to the workplace for productivity, conference calls, and communication. Accenture has studied the wired consumer and developed this infographic, which illustrates these four key findings. Accenture says it’s “an open playing field” when it comes to consumer technology: there are many suppliers who can develop products and sell into this market, where consumers seem pretty agnostic relative to operating systems and even brands — as long as the devices
Battle of the (wrist)Bands at the Digital Health Summit, 2013 CES
One of the fastest-growing segments at the 2013 Consumer Electronics Show in Las Vegas this week is digital health. And within that segment, there’s a battle brewing for what technology companies seem to think is the most valuable part of real estate on the human body: the wrist. I counted at least fifty products as I cruised aisles 26000-27000 in the South Hall at the Las Vegas Convention Center that had wristbands, usually black, plastic or rubbery, and often able to click in and out of the band for use in-hand, in pocket, or in a few cases, on a
We are all health deputies in the #digitalhealth era: live from the 2013 Consumer Electronic Show
Reed Tuckson of UnitedHealthGroup was the first panelist to speak at the kickoff of the Digital Health Summit, the fastest-growing aspct of the 2013 Consumer Electronics Show (#2013CES). Tuckson implored the spillover audience to all, “self-deputize as national service agents in health,” recognizing that technology developers in the room at this show that’s focused on developers building Shiny New Digital Things have much to bring to health. As Andrew Thompson of Proteus Medical (the “invisible pill” company) said, “we can’t bend the health care cost curve; we have to break it.” This pioneering panel was all about offering new-new technologies
One-third of U.S. consumers plan to buy a new fitness tech in 2013, but most buyers are already healthy
Over one-third of U.S. consumers plan to buy a new fitness technology in the next year, especially women. They’ll buy these at mass merchants (females in particular, shopping at Target and Walmart), sporting goods retailers (more male buyers here), online and at electronics stores like Best Buy. These potential buyers consider themselves in good or excellent physical health. They’ll see the latest applications on retail store shelves in pedometers, calorie trackers, fitness video games, digital weight scales, and heart rate monitors that will be launched this week at the 2013 Consumer Electronics Show in Las Vegas. In advance of the
New Year’s Resolutions for health, and the 2013 Consumer Electronics Show
When it comes to taking on personal responsibility, the #1 New Year’s Resolution is to engage in fitness and exercise, cited by 43% of U.S. adults, followed by healthy eating, noted by 37% of people. Other resolutions involving personal responsibility are Family (26%) Spirituality and faith (22%) Managing personal finances (22%. This survey was undertaken as part of Liberty Mutual’s The Responsibility Project (RP), which is taglined: “Explore what it means to do the right thing.” Launched in 2008, Liberty Mutual’s RP has been diving into the many aspects of daily living for which we, each of us, could take responsibility…including
Call them hidden, direct or discretionary, health care costs are a growing burden on U.S. consumers
Estimates on health spending in the U.S. are under-valued, according to The hidden costs of U.S. health care: Consumer discretionary health care spending, an analysis by Deloitte’s Center for Health Solutions. Health spending in the U.S. is aggregated in the National Health Expenditure Accounts (NHEA), assembled by the Department of Health and Human Services (DHHS) Centers for Medicare and Medicaid Services (CMS). In 2010, the NHEA calculated that $2.6 trillion were spent on health care based on the categories they “count” for health spending. These line items include: Hospital care Professional services (doctors, ambulatory care, lab services) Dental services Residential
Nurses, pharmacists and doctors rank top in honesty, says Gallup poll
Nurses, pharmacists and doctors rank tops with Americans when it comes to honesty and ethics. Most people also rate engineers, dentists, police officers, clergy and college teachers as high on honesty metrics. Lawmakers (THINK: Congress) and car salesman fall to the bottom of the honesty-and-trust roster, who only 1 in 10 Americans believe act with honesty and integrity. Other low-ranking professions on this list are HMO managers, stockbrokers, and folks in the advertising business. Welcome to this year’s Gallup Poll on consumers’ perceptions of honesty and ethics in 22 professions in the U.S. Gallup measures six health care professions
Consumers seek emotional connections with health care
83% of consumers would pay more for a product or service from a company they feel puts them first, finds rbb Public Relations in their 2012 Nationwide Breakout Brand Survey. Emotional connections matter most in health care, say 76% of U.S. consumers, followed by banks (63%), professional services (62% – think: accountant, financial planner, estate lawyer), travel (56%), insurance (55%) and autos (52%). Interestingly, apparel and beauty rank the lowest in the poll – with only 18% and 19% of consumers looking for emotional connections from those industries. The top 10 breakout brands on the emotional front are Apple Amazon
Most smartphone owners seek health information online via mobile
The ubiquity of mobile phones, increasingly smart ones (one-half of all mobile phones in the U.S. ), means people are walking around, working, playing and driving with self-tracking devices and ultra-mini computers in their pockets and totebags. 52% of smartphone owners seek health information on their phones, and overall 1 in 3 people seek health information on all mobile phones — nearly doubling the percent of those seeking health info via mobile in 2010 (17%). People who are sicker, caregivers, and those who have had a big change in health are also more prone to using phones for health, as
Wired health: living by numbers – a review of the event
Wired magazine, longtime evangelist for all-things-tech, has played a growing role in serving up health-tech content over the past several years, especially through the work of Thomas Goetz. This month, Wired featured an informative section on living by numbers — the theme of a new Wired conference held 15-16 October 2012 in New York City. This feels like the week of digital health on the east coast of the U.S.: several major meetings have convened that highlight the role of technology — especially, the Internet, mobile platforms, and Big Data — on health. Among the meetings were the NYeC Digital Health conference, Digital
In sickness and in health: consumers expect doctors to be wellness coaches, too
4 in 5 health consumers expect doctors not only to treat them when they’re sick, but to keep them healthy. “In sickness and in health” now morphs over to the doctor-patient relationship, beyond the marriage vow. Better Health through Better Patient Communications, a survey from Varolii, finds that people are looking for health, beyond health care, from their physicians. Varolii is a customer interaction company that claims to have interacted with 1 in 3 Americans through some sort of company communication: they work with major Fortune 1000 companies, including banks, airlines, retail, and, yes, health care. They recently attracted a
From fragmentation and sensors to health care in your pocket – Health 2.0, Day 1
The first day of the Health 2.0 Conference in San Francisco kicked off with a video illustrating the global reach of the Health 2.0 concept, from NY and Boston to Mumbai, Madrid, London, Tokyo and other points abroad. Technology is making the health world flatter and smarter…and sometimes, increasing problematic fragmentation, which is a theme that kept pinching me through the first day’s discussions and demonstrations. Joe Flowers, health futurist, offered a cogent, crisp forecast in the morning, noting that health care is changing, undergoing fundamental economic changes that change everything about it. These are driving us to what may
What Jerry the Bear means for Health 2.0
A teddy bear in the arms of a child with diabetes can change health care. At least, Jerry the Bear can. Yesterday kicked off the sixth autumn mega-version of the Health 2.0 Conference in San Francisco. Co-founded by Matthew Holt and Indu Subaiya, a long-time health analyst and physician, respectively, this meeting features new-new tools, apps and devices aimed at improving individual and population health, as well as health processes and workflows for physicians, hospitals, pharma, and other stakeholders in the health care ecosystem – even health lawyers, who met on October 7 to discuss up-to-the-minute e-health law issues. Yesterday was
Primary care is the new black: Walmart and Humana team up for health
Good food is a key component of health. So when Humana partners with Walmart to discount good-for-you foods, it’s a sign in the market that two of America’s most visible health brands are looking to motivate people to eat healthier — and, to be sure, drive sales in the growing health marketplace. This unique partnership brings together one of the nation’s largest health insurance companies with the world’s largest retailer. The venture joins HumanaVitality, a rewards program providing incentives for members (currently, about one million) to make sound health decisions, and Walmart, who will offer 5% savings on products that
Aging in the US – seniors are health-confident, less financially so
Most seniors look forward to aging in place, and are confident in their ability to do so. Such is the top-line feel-good finding from the National Council on Aging‘s (NCOA) survey, The United States of Aging, sponsored by USA Today and United Healthcare. A majority of seniors have a sense of purpose and plans for their future. Three-fourths of older Americans say staying physically fit through exercise and proactively managing their health is important. However, only 36% of seniors say they exercise or engage in physical activity every day. 11% never do. The most common chronic conditions noted by seniors
Lab tests and knowing our numbers can inspire patient engagement
One-half of the members of Kaiser Permanente use the plans’ personal health record system, MyHealthManager. The most-used function of MyHealthManager is accessing lab results, according to KP. Now that Quest, the lab and health information company, has launched the mobile phone app, Gazelle, more health citizens will have access to lab test results. This could be a health-activating opportunity inspiring patient engagement. While Gazelle is a fully functional personal health record (PHR), it’s the connection to lab test results that’s the lightbulb moment. PHRs have been available to health consumers for over a decade. There are millions of users of
Good Housekeeping features Facebook for health: health social networks go mainstream
Using social networks for health is no longer a pioneering, first-wave adoption activity: Facebook has gone mainstream in health. What’s the indicator that says we’ve hit the tipping point in consumers going Health 2,0, beyond Paging Doctor Google? A story in the July 2012 issue of Good Housekeeping magazine titled, Miracle on Facebook. What’s powerful about this is that articles on health social networks have been largely focused in health IT trade publications, business magazines like Forbes (focusing on sustainbale business modeels) and technology channels such as Fast Company and Wired. Looking at Good Housekeeping’s ad pages, its readership is mostly
Converging for health care: how collaborating is breaking down silos to achieve the Triple Aim
On Tuesday, 9 July 2012, health industry stakeholders are convening in Philadelphia for the first CONVERGE conference, seeking to ignite conversation across siloed organizations to solve seemingly intractable problems in health care, together. Why “converge?” Because suppliers, providers, payers, health plans, and consumers have been fragmented for far too long based on arcane incentives that cause the U.S. health system to be stuck in a Rube Goldbergian knot of inefficiency, ineffectiveness and fragmentation of access….not to mention cost increases leading us to devote nearly one-fifth of national GDP on health care at a cost of nearly $3 trillion…and going up.
Self-service healthcare: patients like online and mobile access, but still want F2F time
The supply-side of healthcare DIY is growing, with the advancement of Castlight Health through its $100mm VC influx and Cakehealth’s new version for managing health spending online. Consumer demand is growing, too, for these services. But don’t get over-hyped by the healthcare, everywhere, scenario. Health citizens also demand face-to-face time with their physicians and clinicians, evidenced by a survey from Accenture titled, Is healthcare self-service online enough to satisfy patients? The answer is a clear, “no.” 90% of U.S. adults like the idea of digital health self-service, 83% want online access to personal health information, 72% want to book appointments
Thinking about Dad as Digital “Mom”
What is a Mom, and especially, who is a “Digital Mom?” I’ve been asked to consider this question in a webinar today hosted by Enspektos, who published the report Digging Beneath the Surface: Understanding the Digital Health Mom in May 2012. I wrote my review of that study in Health Populi here on May 15. In today’s webinar, my remarks are couched as “Caveats About the Digital Mom: a multiple persona.” Look at the graphic. On the left, the first persona is a mother with children under 18. Most “mom segmentations” in market research focus on this segment. But what
Patients in emerging countries value mHealth, but sustaining mHealth behaviors is tough
Half of patients globally expect that mobile health will improve health care. These health citizens expect that mobile health will help them manage their overall health, chronic conditions, how they manage their medications and measure and share their vital health information. Welcome to the new mobile health world, a picture captured in PwC’s report, Emerging mHealth: Paths for growth, published in June 2012 and written by the Economist Intelligence Unit. Patients’ views on mHealth are bullish, and while most doctors and payors share that vision, they also expect mHealth to come into focus more slowly, recognizing the institutional, cultural and
What we can learn from centenarians about health
To get to be 100 years or older requires exercise, social connectedness, and good sleep, according to a majority of centennarians polled in UnitedHealthcare’s 100@100 Survey, 2012 Report of Findings. The key findings of this fascinating survey are that: Centenarians have better eating and sleeping habits than Boomers. One-half of centenarians regularly exercise. The most common forms of exercise are walking or hiking, muscle strengthening, gardening, indoor cardio exercise, exercise classes, and yoga/Tai Chi or other mind/body/spirit forms. Social networks bolster health, with most old-old people communicating with family or friends nearly every day And, laughter is a vitamin, with most
Fruits, financial incentives and remote coaching: evidence for behavior change
Increasing intake of fruits and vegetables, coupled with remote health coaching and financial incentives, together help people adopt and maintain healthy behavior changes. This is the conclusion of a randomized controlled trial using mobile technology, published in the May 28, 2012, issue of Archives of Internal Medicine. Dr. Bonnie Spring of Northwestern University’s Department of Preventive Medicine led the study. The researchers developed the trial, called Make Better Choices, to sort out which behavior changes would enable people to reduce major risk factors for cardiovascular disease, cancer and diabetes. Four combinations were assessed in the intervention among 204 people: Increasing fruit
Statins, food and a mobile app: Pfizer and Eating Well partner up as generic Lipitor hits the market
On May 23, 2012, Pfizer announced its teaming with EatingWell magazine to launch a mobile app for patients on Lipitor. Eight days later, on May 31, 2012, generic versions of Lipitor will hit the market. Lipitor is the best-selling drug in pharmaceutical history, to-date. Sales of the product top $125 billion. While generic atorvastatin has been available in the U.S. since November 2011 from two manufacturers, low prices for the generic will drop to $10 or less for a month’s supply at the end of May. This is Pfizer’s first foray into a prescription drug-affiliated app. The free mHealth app,
Consumer trust in health care: online information trumps health plans
Trust is a precursor to health engagement. Trust impacts health outcomes such as a patient’s willingness to follow a doctor’s or health plan’s instructions. Two new studies point out that U.S. consumers don’t trust every touchpoint in the health system. Online medical information has become a trusted channel. Health plans? Not so much. Wolters Kluwer’s Health Q1 Poll on Self-Diagnosis found that consumers trust online health information to inform themselves — even for self-diagnosis. 57% of U.S. adults turn to the Internet to find answers to medical information; 25% “never” do, and 18% rarely do. Two-thirds of people say they trust
Improving health care through Big Data: a meeting of the minds at SAS
Some 500 data analytics gurus representing the health care ecosystem including hospitals, physician practices, life science companies, academia and consulting came together on the lush campus of SAS in Cary, North Carolina, this week to discuss how Big Data could solve health care’s Triple Aim, as coined by keynote speaker Dr. Donald Berwick: improve the care experience, improve health outcomes, and reduce costs. Before Dr. Berwick, appointed as President Obama’s first head of the Centers for Medicare & Medicaid Services, Clayton Christensen of the Harvard Business School, godfather of the theory of disruptive innovation in business, spokee about his journey
For consumers, time is money and life when it comes to health care
Once upon a time, patient satisfaction with visits to doctors’ offices used to be a function of bedside (exam room) manner, demeanor and responsiveness of the reception and insurance staff, and the age of magazines in the waiting room. Today, waiting time is a key factor, and social media is raising expectations around response time in health care. See the first chart, based on data from PwC’s survey, Social Media “Likes” Healthcare, published in late April 2012. The poll found that when U.S. adults use social media in healthcare, at least 4 in 10 people want complaints and information requests responded to
Your doctor’s appointment on your phone: out of beta and into your pocket
You can now carry a doctor with you in your pocket. Two top telehealth companies that support online physician-patient visits have gone mobile. This upgrade was announced this week at the 2012 American Telemedicine Association conference, being held in San Jose, CA. In enabling mobile physician visits, American Well and Consult A Doctor join Myca, which has offered mobile phone-based visits for clients for at least two years to employer clinic customers. In April 2010, my report, How Smartphones Are Changing Healthcare for Consumers and Providers, talked about Myca’s work with Qualcomm: the telecomms company armed traveling employees with mobile phones that could connect
Health consumers’ digital adoption gets more social, approaching nearly half of U.S. consumers
Nearly 1 in 2 U.S. adults now uses social media in health, according to Manhattan Research’s latest look into Cybercitizens, fielded in Q311. That 45% of U.S. health consumers use social media in health is a significantly higher percentage than recent studies fielded by PwC and Deloitte, which have found about 1 in 3 consumers using social media for health. Manhattan Research defines social media use in health as having created or consumed health-related user-generated content on blogs, social networks, health ratings websites, online health communities and message boards, or patient testimonials. Key findings are that, 14% of health-social media folks are
What the FDA needs to know about Rx health consumers: most Americans see value in pharma-sponsored health social networks
In PwC‘s landmark report, Social Media “Likes” Healthcare, there’s a data point obscured by lots of great information generated by the firm’s survey of 1,060 U.S. adults: that over one-half of people value patient support groups and social networks with other patients that are offered by drug companies. Not surprisingly, U.S. consumers. who are taking on increasing financial responsibility to pay for health care products and services, also highly value discounts and coupons, and access to information that helps them find the “cheapest” medications — both favored by two-thirds of people. The report found, overall, that over one-third of U.S. adults
Leverage the American DIY attitude for health
As I leave Asia, where I’ve been for the past two weeks, for the U.S. today, I am reading the daily newspaper, the Korea Joongang News. On today’s op-Ed age is The Fountain column titled, Embracing the do-it-yourself attitude. In it, Lee Na-ree writes, “Making something with your own hands is part of the American pioneer spirit.” He describes the Maker Faire events and the project of Caine’s Arcade, a game developed by a Los Angeles boy who used auto parts from his dad’s shop. Na-ree observes that Americans are ‘regretting’ mass consumption. Health Populi’s Hot Points: I happened upon
Right-sizing food and healthcare
In our fast-texting, quick-thinking, Blink-ing society, Jason Riis talks about slowing down our relationship with food. At the Edelman Wellness Ignited meet-up on March 26, 2012, Jason riffed on food intervention and economics for healthy eating. Jason is a professor at Harvard Business School and among his many research interests is how to change culture to morph away from obesity and Type 2 diabetes toward health. The U.S. is a shopping nation: retail is destination, fun, entertaining, life, for millions of Americans. Jason’s asking what retailers can do about fast and food. This isn’t only about ‘fast food,’ which, of course,
Wellness Ignited! Edelman panel talks about how to build a health culture in the U.S.
Dr. Andrew Weil, the iconic guru of all-things-health, was joined by a panel of health stakeholders at this morning’s Edelman salon discussing Wellness Ignited – Now and Next. Representatives from the American Heart Association, Columbia University, Walgreens, Google, Harvard Business School, and urban media mavens Quincy Jones III and Shawn Ullman, who lead Feel Rich, a health media organization, were joined by Nancy Turett, Edelman’s Chief Strategist of Health & Society, in the mix. Each participant offered a statement about what they do related to health and wellness, encapsulating a trend identified by Jennifer Pfahler, EVP of Edelman. Trend 1: Integrative
Employers shopping for value in health – Towers Watson/NBGH 2012 survey results
Employers expect total health costs to reach $11,664 per active employee this year, over $700 more than in 2011. Employees’ share of that will be nearly $3,000, the highest contribution by workers in history. In 2012, workers are contributing 34% more to health costs than they did 5 years ago. The metric is that for every $1,000 employers will spend on health care in 2012, workers will pay $344 for premium and out-of-pocket costs. Still, health care cost increases are expected to level off to about 6% in 2012, that’s still twice as great as general consumer price inflation. with
The economics of mHealth – incentives align more easily outside of U.S., but times (and incentives) are a’changing
A global analysis of mobile health (mHealth) by the Boston Consulting Group (BCG) for Telenor, the telecomms company, illustrates many forms of return-on-investment using mobile platforms in health: Improved quality of life for individuals and families A more educated society Lower absenteeism for employers, and Greater incomes for people. Together, these micro-benefits yield macro societal benefits such as freeing up (acute) health systems due to a lower burden of chronic care; positive impacts on people, labor participation, and productivity; and, long-term economic growth. BCG believes that, “the smartphone is the most popular technology among doctors since the stethoscope.” That phone can
Wellness and the global health citizen – carrying our own doctors, inside
Every patient carries her or his doctor inside, said the great Renaissance man, Albert Schweitzer. Based on Euro RSCG Worldwide’s Prosumer Report – My Body, Myself, Our Problem: Health and Wellness in Modern Times, health citizens globally have begun to take on Dr. Schweitzer’s vision. Clement Boisseau of Euro RSCG points out that people, globally, are fairly schizophrenic when it comes to thinking about empowerment over illness: check out the chart for perceptions by condition and disease state. Boisseau says that people perceive health today both in modern terms (such as feeling empowered to control some conditions), and archaic or “magically
Under 10% of people manage health via mobile: a reality check on remote health monitoring from HIMSS
With mobile health consumer market projections for ranging from $7 billion to $43 billion, according to PricewaterhouseCoopers, a casual reader might think that a plethora of health citizens are tracking their health, weight, food intake, exercise, and other observations of daily living by smartphones and tablets. But as the chart shows, health self-trackers number around 1 in 20 U.S. adults, according to a survey conducted for HIMSS Analytics and sponsored by Qualcomm Life. HIMSS Analytics’ report, A New Prescription for Chronic Disease: remote monitoring devices, was published in conjunction with the annual HIMSS conference which highlights the latest health information technology
The digital future in focus, according to comScore: health grew fastest in 2011
comScore has issued its annual report on the state of the American digital consumer in U.S. Digital Future in Focus 2012 and the topline is that mobile and Facebook are redefining communication in both the digital and physical worlds. This disruptive phenomenon has transformational implications for health and health care. comScore’s macro observations are that: – Social networking, and especially Facebook, is capturing a growing proportion of online users’ time, thus redefining how brands and organizations must interact with customers offline and on-. – Google remains the search leader but Bing has grown, surpassing Yahoo! as #2 in 2011. –
Moving from operational efficiency to personalized healthcare value – IBM on redefining success in healthcare
A health system that’s built to last: this is the latest sound-bite echoing through health policy circles. The theme of sustainability is permeating all matters of policy, from education and business to health care. Enter IBM, with a rigorous approach to Redefining Value and Success in Healthcare: Charting the path to the future, from the group’s Healthcare and Life Sciences thinkers. What’s inspiring about this report is the team’s integrative thinking, bridging the relationship between operational effectiveness built on a robust information infrastructure that enables team-based care (the “collaboration” aspect in the middle of the pyramid), which then drive personalized healthcare
The Connected Consumer – she loves her iPad, and she’ll be able to Connect for Health
She’s likely to be female, Facebooking, smartphoning, and digitally shopping. She’s the Connected Consumer, and she’s a lot older than you might expect: on average, 40 years of age, and with a mean household income of $63,000. And Connected she is: in addition to having a PC or laptop computer, 43% have a smartphone, and 16%, a tablet. Meet the Connected Consumer is a report from Zmags, a digital design company. Zmags surveyed 1,500 U.S. adults in November 2012 who owned a tablet, a smartphone and/or a computer, asking people their views on shopping, apps and the digital lifestyle. Connected
On the road to retail health: healthcareDIY and primary care, everywhere
At the ConvUrgent Care Symposium in Orlando, attendees from the worlds of clinics, ambulatory care, hospital beds, pharmacies, medical devices, life sciences, health information, health IT, health plans, academic medical centers and professional medical societies came together to share and learn about the morphing landscape of retail health. The topline message: primary care is everywhere, and based on the response to my keynote talk this morning, every stakeholder segment gets it. My mantra, courtesy of the U.S. Surgeon General Regina Benjamin: don’t look at health in isolation, that is, where the doctor and hospital are. Health happens wherever the person
Stop SOPA
Health Populi’s Hot Points: Please stop censorship in the United States of America. Click on this hyperlink to easily contact your Congressional representatives and express your opinion on SOPA and PIPA – two laws that would limit basic freedom in the marketplace of ideas and commerce.
Hey, Big Spender: 1% of US health citizens consume 20% of costs
Cue up the song “Hey Big Spender” from the Broadway hit, Sweet Charity, when you read the January 2012 AHRQ report with the long-winded title, The Concentration and Persistence in the Level of Health Expenditures over Time: Estimates for the U.S. Population, 2008-2009.” The report’s headline is that 1% of the U.S. population consumed 20% of all health costs spent in the U.S. in 2008 and 2009, illustrated by the chart. These Big Health Spenders tend to be in poor or fair health, older, female, non-Hispanic whites and people with only publicly-provided health insurance. Their mean expenditure was $90,061. The top 10%
Connected Health and obesity – will mObesity be able to mitigate the epidemic?
It’s January and the #1 most popular post-New Year’s resolution is to lose weight, get fit, and live well. The signs of this are manifested in ads featuring Janet Jackson promoting Nutrisystem, Jennifer Hudson dueting with her then-and-now selves pitching Weight Watchers, as well as the new Weight Watchers for Men promotion starring Charles Barkley. But there are new signs that losing weight and getting fit are going beyond “diets” and food plans: research shows that moving around and getting exercise can help people sustain hard-earned weight loss more than just changing food intake and “dieting.” So the Apple store
Make 2012 the year of living health-fully
When I would meet up with clients and friends during the latter half of 2011, people whom I hadn’t seen for months would do a double-take when they saw me. “What have you done?” they have asked. In this first post of 2012, I will share with Health Populi readers my story of 2011 — a year of living health-fully for me. One of the blessings of my work-life is that I have access to some of the great minds in health and health care. But not until I began to personally harness their wisdom, intentionally incorporating what they’ve learned into my own life-flow and
Consumers are at the center of the business of health and wellness
The market for health and wellness has traditionally included over-the-counter medicines, gym memberships, and vitamins/minerals/supplements. In 2012, the boundaries of health/wellness are blurring beyond these line items toward preventive medical services and consumer electronics. This morphing market is discussed by Cambridge Consultants in their report on the disruptions driving The Business of Health & Wellness: Engaging consumers and making money. Cambridge correctly introduces this analysis by saying that economics, the growing prevalence of chronic diseases, an aging population, and demand consumers are shaping health/wellness, “recharacterizing” the market as one driven by “life events.” Cambridge sees that health consumers are changing their spending
Value and values will drive the adoption of mobile health
This week’s mHealth Summit in Washington, DC, features scores of presentations, posters, and corporate announcements demonstrating the typical chaos of emerging technology markets: the Big Question at this stage on S-curves for new tech is always, “what’s the timing of the pace of change,” or for you mathematically-inclined readers, “what’s the slope of the mHealth adoption curve?” Before we address that question, let’s be transparent about the fact that there are several definitions of just what ‘mHealth’ is: purists may conceive it as covering only those health tools and applications that ‘go’ mobile–that is, that are deployed via mobile phones and
Why a Foundation and the Federal Reserve are working together to improve health in the U.S.
Health philanthropies are about more than making grants. The Robert Wood Johnson Association, among the largest health philanthropic organizations in the world, is partnering with the Federal Reserve Bank (the Fed) on how community development impacts health — and vice versa. You cannot have a healthy community without focusing on housing, schools, and other neighborhood stakeholders, Dr. Risa Lavizzo-Mourey told the conference on Healthy Communities: Building Systems to Integrate Community Development and Health. In this context, Dr. Lavizzo-Mourey quoted Robert Kennedy who said, “The gross national product does not allow for the health of our children, the quality of their education, or
Consumer electronics comes to health care — but don’t overestimate consumer demand just yet
More people with higher levels of concern about their health feel they are in good health, see their doctors regularly for check-ups, take prescription meds “exactly” as instructed, feel they eat right, and prefer lifestyle changes over using medicines. And 40% of these highly-health-concerned people have also used a health technology in the past year. At the other end of the spectrum are people with low levels of health concern: few see the doctor regularly for check-ups, less than one-half take their meds as prescribed by their doctors, only 31% feel they eat right, and only 36% feel they’re in
Tech fast forward families are ripe for health care self-care
Kids lead their parents in the adoption of digital technologies; that’s why the youngers are called Digital Natives. An intriguing survey of adults’ use of technologies finds that those who do so like “childlike play,” and at the same time, for kids, make them feel more grown up. The trend, Ogilvy says, is blurring generational lines: market to adults as kids, and kids as adults. This convergence is leading families to become more “units” — parents and kids increasingly on the same page in purchase decisions. In Tech Fast Forward: Plug in to see the brighter side of life, from
The tough nut of health behavior change: it’s about today, not next week
While women may equally ‘value’ healthy aging in the long-run, it’s their daily quality of life that may motivate them to stick with exercise routines. Simply put, immediate payoffs are more motivating to sustaining behavior change than the long-term promise of “health.” In Rebranding exercise: closing the gap between values and behavior, Michelle Segar and colleagues from the University of Michigan (disclosure: my beloved alma mater) describe the state of women and chronic illness, and the difficulty in sustaining physical activity especially in middle age. “While a number of interventions can help individuals successfully initiate an exercise program, most interventions have failed
Caregiving in the USA – the burden intensifies, and technology’s promise
29% of people in the U.S. have served as unpaid family caregivers in the past year. That’s 66 million people, mostly female (66%), middle age (on average 48 years old), usually taking care of a relative (86%).These sobering stats come out of Caregiving in the U.S. 2009, a study from the National Alliance for Caregiving in collaboration with AARP. The research, funded by the MetLife Foundation, follows up a similar study in 2004 and shows the proportion of Americans caregiving has substantially changed over the past five years.But both caregivers of adults and those for whom they provide care are
The Future of Retail – Implications for Health
I’ve been looking at health care through a retail lens for some time. Perhaps it’s that I’m a rag trader’s daughter, or that I’ve been known to like shopping, that I have clients in consumer goods, or that I understand how tiered drug pricing impacts the consumption of medicines (answer: it’s all of the above). I’ve just reviewed the latest trend report from PricewaterhouseCoopers and TNS Retail Forward on the future of retailing. My mind is connecting the dots between the future of retail and the American health care consumer. Four future retail trends are already embedding in health care
My Magazine, My Health Portal
U.S. News and World Report is well-known for its Top 100 “best” lists assessing hospitals, doctors, and health plans. Watch for it to further build its position as consumer health information provider for Americans by expanding into a comprehensive health portal online. U.S. News published this cover in November 2004. So the magazine is no newcomer to this role. However, the publication and its editors (and savvy financial management) recognize the opportunity to exploit their brand position in the consumer health information space. This isn’t just about arming Americans with health information to be ‘smart.’ This is a smart move