By Carolyn Wang
It is cold in Austin. Not the negative ten with wind chill in NY, but also not the highly touted “warm and sunny” clime I promised myself (where did I hear that?). Luckily, it was dry yesterday – making it quite a bit lovelier than the days prior. (For those planning to attend #SXSW in future years, bring a raincoat.) Yesterday’s line-up represented the most concentrated digital health content – with panels and fireside chats focused on wearables for health (#SHAQualcomm), the cross over between health and tech venture investment, and a highly anticipated keynote from 23andMe* founder, Anne Wojcicki.
I’ve been fortunate to collaborate with Fred Trotter, hactivist, healthcare data journalist and author, on a panel discussing the digital tools and services that are gaining traction or still to come that could bring to life the vision of the actively engaged health consumer, “Hacking Your Life for Better Health.” Other panelists included Dr. Charles (Chuck) Saunders, CEO of Healthagen, Michele Polz, AVP of patient insights & analytics at Sanofi US Diabetes, and Dr. James (Jim) Mault, VP and CMO of Qualcomm Life.
During a VC and accelerator panel focused on digital health in the morning, Ted Maidenberg and Malay Gandhi discussed concrete evidence of how technology is positively impacting care. Propeller Health has seen a significant reduction in incidence of rescue inhaler use in its population of asthmatics using its Bluetooth-enabled inhaler sensor and paired mobile app to manage their disease. Mango Health, a mobile app that applies gaming to medication adherence, has demonstrated 90% adherence in patients and is now able to charge $3 per patient. It became clear fairly quickly in our panel later that day that SXSW participants believe change in healthcare is happening too slowly, despite these early results, and there were a lot of questions as to why developers and tech professional haven’t been able to hack their way through it as they have in other industries. What follows below are short snippets (some paraphrased) of the conversation. Check out #hacklife for more.
Fred Trotter: We see a lot of geeks designing for geeks – wonderful ideas that may have no impact on patient health. How do you get past the early adopter, freaks and geeks stage?
Michele Polz: The question is how do you stop designing for the healthy population, and look at how to solve for people that need it? [Sanofi’s] fourth generation of the Diabetes Design Challenge is leveraging open data and Sanofi does not own the IP. We need to solve for the lives living with diabetes by collaborating with service innovators. And we’ve found that their ability to connect with the end user (patients) enables true rapid prototyping.
Chuck Saunders: The patient universe is heterogenous, and it’s a complex problem. I think about consumer engagement as a different animal than patient engagement. Patients are generally more intimate with the health care system, and it’s a transactional relationship; in that context there are a number of jobs that need to be done by the patients like decision support, navigation of options, liquidity of confidential information for access, and transacting clinical business with the provider. We must solve for complexity while delivering value in the mind of patient. Products must be compelling and engaging, meaning beautiful, easy, fun – and importantly, highly available – they must have access to a broad distribution.
Audience question: How can design be informed by real people who live in the “mass middle” – those who are not sick and also not geeks?
Chuck Saunders: When you aggregate data it has value. What makes it difficult are determining the actions taken based on that information. The real work is to integrate data and make inferences from it. Clinical data is dirty. [Healthagen does] Care Considerations where you interpret massive information with algorithms to determine what people need to do to decrease risks. It must be in a language they understand – at a grade level they understand – and provided to their caregivers. It is much harder to design the action than the algorithm.
Audience question: Why has healthtech been allowed to get away with clunky US/UI for so long?
Jim Mault: There hasn’t been a multi-million dollar market for this, but now providers will be at the mercy of whether they can get patients to engage or even use their blood pressure meter, for example.
Chuck Saunders: It also has to do with the design paradigm in healthcare. A lot of tools have been designed as forms and documentation or workflow systems for capturing a lot of data. The emphasis was on systems integration and data capture. Also there was not a lot of competition. Now the world has changed and consumers are a part of that – we’re pulling in artists and designers from Silicon Valley and they are coming up with designs that are beautiful and agile.
Audience question: Even if we have the trinity of data (genomics, biology & behavior), can we use it effectively when companies don’t want to share?
Jim Mault: The stars are finally aligning and we’re seeing democratization of health information and the necessity of data liquidity. The sheer nature of payment systems moving to risk-based payment models means you’re now forcing healthcare systems to behave as a care team for an entire population of patients. It means we must share data, and it’s a problem if EMRs can’t talk to one another, for example. The market is driving to better systems that interoperate, and the ONC and FTC have been doing great things. Individuals should have the right to own all data about them from any database. That’s best for our health economy. We will see stronger positions that the patients have the right to their data in electronic form, and should be able to access and share that information with a push of a button – to the benefit of our patients, providers and the healthcare economy.
Chuck Saunders: Providers are motivated by sharing responsibility and having information transparency so they can make rational decisions. You can’t have a proprietary interest in the solution, it must be neutral.
Audience question: There is data available now that these tools support behavior change. How can we leap forward here with what we already have?
Jim Mault: We still lack the longer terms results and outcomes and those will be a long time coming. It is difficult to do prospective trials that prove the cost/benefit for these technologies. But there’s a lot of positive early data, and its driving excitement for early trends in wearables, for example.
Michele Polz: We are starting to see patterns of behavior changes. For example, my Fitbit plus the new platform has me running more and wanting to track my weight more. It’s creating a pattern and behavior change, and we can already see how many “[teachable] moments” it may take for a woman to continue on a program versus a man.
*23andMe and QualcommLife are clients of WCG.