A blog covering the health/care ecosystem and people.

Digital platforms and tools are fast-advancing in all industries, and especially in health and health care. But it’s people-first, and digital PLUS analog, based on Accenture’s latest forecast of five macro technology trends. The five forces are: Intelligent automation – 70% of health executives expect to invest more in artificial intelligence; Liquid workforce – 42% of health/care workers are expected to be contractors or free agents within organizations within 3 years’ Platform economy – 10x growth is expected in application programming interfaces (APIs) in the next five years, which will enable data to liquidly move across healthcare platforms Predictable disruption

Who better than a financial services institution based in Silicon Valley to assess the state of digital health? Few organizations are better situated, geographically and sector-wise, than SVB Analytics, a division of Silicon Valley Bank based in, yes, Silicon Valley (Santa Clara, to pinpoint). The group’s report, Digital Health: Opportunities for Advancing Healthcare, provides an up-to-date landscape on the convergence of healthcare and technology. SVB Analytics defines digital health as “solutions that use digital technology to improve patients’ health outcomes and/or reduce the cost of healthcare.” The report provides context for the digital health market in terms of health care costs,

Adoption of telehealth, remote health monitoring, patient engagement platforms, mobile and digital health applications, and the emergence of the Internet of Things in health care will all be bolstered in 2016 based on health care providers’ having to do more with less (money, labor, resources). The value-based healthcare world — the migration of payment “from volume to value” — requires greater investment in information and communications technology that moves care to lower-cost sites, with lower-priced labor (as appropriate), and shifting greater clinical self-care and financial skin-in-the-game to patients. My annual health IT forecast was published yesterday in iHealthBeat, 2016: Technology

U.S. spending on medicines will approach $590 billion in 2020, increasing 34% over 2015, IMS Institute for Healthcare Informatics projects in its forecast, Global Medicines Use in 2020. Growth in spending will be attributable to innovation (new products), price increases and some patent losses of exclusivity (e.g., branded drugs going generic). The U.S. will cover the bulk of drugs spending in 2020 at 41% of the world medicines market, shown in the first pie in the first chart. U.S. medicines spending dwarfs any other country or region in the world, including China which is expected to account for 11% of

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

In this week’s posts on Health Populi, we’re diving into three big reports focused on digital health and the Internet of Things (IoT) in healthcare: from the McKinsey Global Institute, Goldman Sachs, and Accenture. In this post, we dig into Goldman Sachs’ analysis, The Digital Revolution comes to US Healthcare, the investment firm’s fifth volume in their Internet of Things report series. Goldman Sachs’ definition of the Healthcare IoT is, “a device that is connected via the Internet and informs clinical decision making,” which bridges digital and physical worlds “to change physician and patient behavior.” The firm identifies three IoT

Startup Health, the health/care entrepreneur development company which has helped launch over 100 health/tech companies since “starting up” in 2011, announced a collaboration with Aurora Health Care today. This is one of the first ventures of its kind, linking up health/tech entrepreneurs with a health care provider organization as a living lab, or in the words of Unity Stoakes, Startup Health Co-Founder, a “collaboratory.” I spoke with Unity before the announcement went public, and learned that Startup Health sought a partner with shared values focused on getting innovations into patient care that could transform the healthcare delivery system. “Every single

In the past couple of weeks, a grocery store launched a telemedicine pilot, a pharmacy chain expanded telehealth to patients in 25 states, and several new virtual healthcare entrants received $millions in investments. On a parallel track, the AMA postponed dealing with medical ethics issues regarding telemedicine, the Texas Medical Association got stopped in its tracks in a case versus Teladoc, and the Centers for Medicare and Medicaid Services (CMS) issued a final rule for the Medicare Shared Savings Program that falls short of allowing Accountable Care Organizations (ACOs) to take full advantage of telehealth services. These events beg the

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

While there’s little evidence that the short-term impact of the Affordable Care Act has limited job growth or driven most employers to drop health insurance plans, the ACA has spawned a “cottage industry” of health companies since 2010, according to PwC. As the ACA turned five years of age, the PwC Health Research Institute led by Ceci Connolly identified at least 90 newcos addressing opportunities inspired by the ACA: Supporting telehealth platforms between patients and providers, such as Vivre Health Educating consumers, such as the transparency provider HealthSparq does Streamlining operations to enhance efficiency, the business of Cureate among others

They’re the team that built a brand with the phrase “Health 2.0” before the world barely recognized v 1.0 in healthcare. This week, those folks that brought you the Health 2.0 Conference unveiled the Market Intel database of over 3,000 companies, trying to make sense out of a very blurry and fast-morphing market landscape. I spoke with Matthew Holt and Kim Krueger of Health 2.0 earlier this week to discuss just what’s in this mine of information, and what they intend to do with it. In full disclosure, I have been a colleague and friend of Matthew Holt since his

65 million people know that food journaling works for losing weight, that it’s engaging to do on a well-designed app, and that health is social. MyFitnessPal (MFP) has the distinction of being a top health app used longer by more people and more effectively than probably any other mobile health tool. Under Armour, the athletic goods company, now has MFP under its corporate umbrella, along with Endomondo, another very popular motivating mobile health tool. You may know Under Armour as a company that manufactures and markets functional workout gear. But this deal is so not about the wearable. It’s about

Three laws that shape the digital world have kicked into high gear, changing our lives in ways we cannot yet imagine. Those three forces are Metcalfe’s Law (in brief, the increasing value of networks), Moore’s Law (that processing power doubles every 18 months, or even faster), and the Law of Accelerating Returns (the fast pace of technological change). The guy who told me about that at the 2015 Consumer Electronics Show (#CES2015) was Shelly Palmer, something of a Renaissance Man in the evolving digital world, advising communications companies, composing music, patenting TV technology, investing in ventures, hosting shows on digital living,

Are you Feelin’ Groovy about wearables? Well slow down, you move too fast… …at least, according to Accenture’s latest survey into consumers’ perspectives on new technologies, published this week in conjunction with the 2015 Consumer Electronics Show in Las Vegas, the largest annual convention in the U.S. featuring technology for people. At #CES2015, we’re seeing a rich trove of blinged-out, multi-sensor, shiny new wearable things at the 2015 Consumer Electronics Show. Swarovski crystals are paired with Misfit Wearables, called the Swarovski Shine, shown here as a shiny new thing, indeed. Withings launched its Activite fitness tracking watch in new colors.

Doctors and hospitals live and work in a parallel universe than the consumers, patients and caregivers they serve, a prominent Chief Medical Information Officer told me last week. In one world, clinicians and health care providers continue to implement the electronic health records systems they’ve adopted over the past several years, respond to financial incentives for Meaningful Use, and re-engineering workflows to manage the business of healthcare under constrained reimbursement (read: lower payments from payors). In the other world, illustrated here by the graphic artist Sean Kane for the American Academy of Family Practice, people — patients, healthy consumers, newly insured folks,

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

Dr. Joseph Kvedar has led the Center for Connected Health for as long as I’ve used the word “telehealth” in my work – over 20 years. After two decades, the Center and other pioneers in connected health have evidence proving the benefits, ROI (“hard” in terms of dollars, and “soft” in terms of patient and physician satisfaction), and technology efficacy for connecting health. The 11th Annual Connected Health Symposium is taking place as I write this post at the Seaport Hotel in Boston, bringing health providers, payers, plans and researchers together to share best practices, learnings and evidence supporting the

Wearables met health and medicine at the 8th annual Health 2.0 Conference in Santa Clara, CA, last week. I had the real pleasure of shepherding a wearables panel of five innovators during the conference, in a well-attended session followed by an energetic Q&A. The organizations who demonstrated their tools and brainstormed the wearables market included, in alphabetical order, Atlas Wearables, Heartmath, MySugr, SunSprite and Withings. I hasten to add that among the five presenters, two were women: that 2 in 5 = 40% gender representation is, happily to my way of thinking about women’s roles in health-making, a very good

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

The supply side of telehealth has been readying itself for nearly a decade. The demand side appears to be aligning in 2014 for adoption to grow and sustain (some) solid business models. On the demand side, Towers Watson’s 2014 survey of large employers forecasts growth among companies that will offer telemedicine in 2015. Towers found that 37% of employers planned to offer telemedicine to workers as a lower-cost site of care; 34% more employers were considering telemedicine in 2016 or 2017.  The health benefits adviser calculates that employers could save over $6 billion if industry replaces virtual health consultations with

Smarter homes can conserve energy, do dirty jobs, and remind you to take your medicine. In doing all these things, smart homes can also collect data about what you do inside every single room of that home. The fast convergence of Wi-Fi and sensors are laying the foundation for the Internet of Things, where objects embedded with sensors do things they’re specially designed to do, and collect information while doing them. This begs the questions: what do you want to know about yourself and your family? How much do you want to know? And, with whom do you want to

Three of the world’s biggest technology companies – Apple, Google and Samsung — have made big announcements in the world of connected health in the past few weeks. A fourth is positioned to enter the fray. These major announcements illustrate the convergence of consumer technology, health, and wearables, with the potential for Big Data and population health impacts. Among the three tech giants, Samsung announced its consumer health/tech story first, on May 28, 2014, at its Digital Health Initiative meeting. Samsung unveiled the Samsung Architecture Multimodal Interactions platform, SAMI, along with the Simband prototype wristband that would enable users to

Employer wellness programs are growing in the U.S., bundled with consumer-directed plans and health savings accounts. A wellness company’s work with employee groups is demonstrating that workers who adopt mobile health technologies — especially “wearables” coupled with smartphone apps — helps change behavior and drive health outcomes. Results of one such program are summarized in Wearables at Work, a technical brief from Vitality, a joint venture of Humana and Discovery Ltd., published April 23, 2014. Vitality has been working in workplace wellness since 2005, first using pedometers to track workers’ workouts. In 2008, Vitality adopted the Polar heart rate monitor for

In the not-too-distant future, will our health care be universally available to all, standardized with limited choices? Or, will we be in self-care mode, able to “buy up” if we can afford it like luxury goods? Will health care delivery be totally tech- and information-driven? Or, will care be driven by insurers’ health plans with artful designs that (almost) predetermine our choices? Welcome to four futures of health care, brought to us by PA Consulting whose report, How Can We Stop Healthcare From Bankrupting Our Children? speaks to scenarios based on 2 uncertainties, whether: Health care will be a personal

Today kicked off the 2014 South-by-Southwest Festival (#SXSW) in Austin, TX, running until March 16 and featuring dozens of sessions, concerts, video, and fireside chats in music, film and interactive segments. I’ll be involved in an interactive session on Tuesday called “The Digital Health Bubble – Is It About to Burst?” This panel includes Marc Monseau (@MDMonseau) who is a pioneer in health and social media (building J&J’s early leadership in social health online); Marco Smit (@MrHealth20) who leads Health 2.0 Advisors and is a veteran strategist in several health/tech companies; and, Robert Stern, Founder/CEO of @PointofCare, a health IT platform that

This is my second post for the #HIMSS14 Blog Carnival, written to coincide with the annual 2014 HIMSS Conference convening health IT leaders in Orlando, FL, 23-28 February 2014. I am gratified to be one of a dozen+ Social Media Ambassadors to the Conference. The first post, on why health IT ‘should’ matter to consumers, can be found here.  Investments in the digital health space reached nearly $2 billion in 2013, based on Rock Health’s look back at venture funding in the market. These financings covered $245 mm that went toward electronic health records and clinical workflow; $161 toward analytics

While the prescription drug bill makes up about 10% of U.S. national health spending, the fastest-growing component of pharmacy spending is specialty medications. These are categorized as “specialty” drugs because they rarely have generic equivalents, and treat serious or life-threatening diseases (such as cancer, MS, and rheumatoid arthritis). They are also “special” because specialty pharmaceuticals average $3,000 per patient per month and can surpass $100,000 a year for certain products. As a result, the top two goals for managing specialty medications among employers are #1, to reduce inappropriate utilization, and #2, to reduce drug acquisition costs, based on a survey

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

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

At the Venture+ Forum at the 2013 Mobile Health Summit yesterday, Lisa Suennen, Managing Director of Psilos Ventures was asked what she and her venture capital fund look for in choosing new investments for their health care portfolio. She succinctly said, “technologies that lower costs.” With nearly $1 in $5 of the U.S. economy attributable to health spending, Lisa’s got a point. Technology in U.S. health care has been mostly additive and expense-inducing, not reducing: fax machines and printers, for example, continue to proliferate in health care settings as part of “networking,” and once you add a new clinical technology

Games are part of peoples’ lives in the 20-teens. Gamification has been used in military and business training and now is a growing method to help change peoples’ behavior across a variety of issues — health, among them. But it’s not all “fun and games” when it comes to succeeding in applying gaming methods in health, according to Gaming to Engage the Healthcare Consumer, a report from ICF International. ICF’s roots are in the defense industry, and the team that wrote this paper together have decades of experience in military applications. These learnings can be quite useful when translated into the

In the aftermath of the snafu that was/is the failed launch of the Affordable Care Act’s Health Insurance Exchange comes, today via Reuters, an article called Obama’s tech expert becomes target over healthcare website woes. The piece, by Roberta Rampton and Sarah McBride, states that Todd Park, Chief Technology Officer at The White House, “now finds himself among a handful of officials with targets on their backs as Republicans try to root out who is responsible for this month’s glitch-ridden rollout of Healthcare.gov,” going on to say that “The White House trotted him out in July to talk up the new version”

Can we age more slowly? And if so, what impact would senescence — delaying aging — have on health care costs on the U.S. economy? In addition to reclaiming $7.1 trillion over 50 years, we’d add an additional 2.2 years to life expectancy (with good quality of life). This is the calculation derived in Substantial Health And Economic Returns From Delayed Aging May Warrant A New Focus For Medical Research, published in the October 2013 issue of Health Affairs. The chart graphs changes in Medicare and Medicaid spending in 3 scenarios modeled in the study: when aging is delayed, more people qualify

Where can you shop the health and beauty aisles, pick up some groceries and a prescription, get a flu vaccine, and weigh in on Obamacare and what digital health tools you like? Why, at one of several thousand retail stores where you can find a SoloHealth kiosk. As of yesterday afternoon, over 32 million encounters were recorded on SoloHealth kiosks, based on an app I saw on the company CEO Bart Foster’s smartphone. Kiosks are locatted around the United States in retailers including Walmart and Sam’s Clubs, along with major grocery chains like Schnuck’s and Publix, and the CVS pharmacy

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

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

The Food & Drug Administration (FDA) launched its new website for and about patients, the Patient Network, with the tagline, “Bringing your voice to drug and device approval and safety.” With this move, the FDA moves toward social health, someplace where at least one-third of U.S. consumers already opine, shop, share personal info, crowdsource cures, and support each other on all-matters-health-and-illness. The objective of the Patient Network is, “to help FDA help patients have a bigger voice.” Dr. Margaret Hamburg, the Commissioner of the FDA, talks about the concept here. The rationale? “When patients better understand the intricacies of how

Comparing health care prices in the U.S. with those in other developed countries is an exercise in sticker shock. The cost of a hospital day in the U.S. was, on average, $4,287 in 2012. It was $853 in France, a nation often lauded for its excellent health system and patient outcomes but with a health system that’s financially strapped. A routine office visit to a doctor cost an average of $95 in the U.S. in 2012. The same visit was priced at $30 in Canada and $30 in France, as well. A hip replacement cost $40,364 on average in the

I endured what very few people could (or would) do in the past ten days: I traveled to New Orleans to the annual conference of HIMSS, the Health Information Management Systems Society, which features hundreds of suppliers to the health care information technology industry. I returned home to kiss my family hello and goodbye, and a day later flew to Austin for the annual South-by-Southwest conference for music, movie and digital folks. The health track at SXSW has grown over the past five years, and provides a start contrast to “health care” as embodied at HIMSS, and “health” translated through

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 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

Traditional venture capital in health care is so 2010: welcome to The Greenhouse Effect: How Accelerators Are Seeding Digital Health Innovation, explained in a new report from California HealthCare Foundation written by Aaron Apodaca. Aaron clearly explains the growing interest in and influence of health accelerators, which grew out of the first era of the Internet (read: dot-com bust v 1.0) and the founding of the Y Combinator, an internet incubator that made relatively small investments in exchange for equity positions in start-ups. Health accelerators emerged around 2011, first with Rock Health in San Francisco, which was quickly followed by

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

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

“The Internet will have a profound effect on the practice and business of medicine. Physicians, eager to provide high-quality care and forced by competition to offer online services, will introduce e-mail and patient-friendly Web sites to improve administrative services and manage common medical conditions. Patients will identify more helath information online and will take more responsibility for their care. The doctor/patient relationship will be altered. Some aspects of electronic communication will enhance the bond, and others will threaten it. Patients will have access to vast information sources of variable validity. Many physician organizations are preparing for the electronic transformation, but

While most players in health care see potential ROI through investing in health informatics, there’s a supply-side problem in the market in two ways: a labor shortage of health IT talent, and a dearth of clean and comprehensive data needed for specific objectives. Even with sufficient budgets, health care providers, plans, and pharma companies say, these two limiting factors prevent fully realizing the promise of health data. Deloitte and AMIA polled health providers, plans and life science companies on the state of informatics in health care, the results of which are summarized in The 2012 Deloitte-AMIA Health Informatics Industry Maturity Survey.

When the phrase “health care innovation” is considered, most people think about technologies like digital imaging, breakthroughs in cancer treatment, and robotic surgery. But before clinicians order or prescribe the use of any of those choices, there’s a cognitive process that gets them to that decision. It’s a cerebral mash-up of information, learned knowledge, and that special art of medicine embodied in the provider’s experience with patients, well-honed over time. How can innovation improve this process? “Healthcare innovation can be defined as the introduction of a new concept, idea, service, process, or product aimed at improving treatment, diagnosis, education, outreach, prevention and

A time-and-technology challenged FDA, proliferation of software-controlled medical devices in and outside of hospitals, and growth of hackers have resulted in medical technology that’s riddled with malware. Furthermore, lack of security built into the devices makes them ripe for hacking and malfeasance. Scenario: a famous figure (say, a politician with an implantable defibrillator or young rock star with an insulin pump) becomes targeted by a hacker, who industriously virtually works his way into the ICD’s software and delivers the man a shock so strong it’s akin to electrocution. Got the picture? Welcome to the dark side of health IT and

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