Susan Dawson, a training specialist from Genworth Financial gave a presentation that ran through the events each student had attended, goading them to spill what they had learned with tacky prizes of beer cozies and datebooks. She awarded points for connections made, cards received, coffee dates secured, and follow ups sent.
Before dinner, Macewan had called Q-Camp “life-changing.” When Dawson announced that Joe led all the top 120 business students at the university in points, Q-Camp really started to change his life. He had awoken, but was just beginning to emerge.
Dr. David Agus is a professor of medicine and engineering at the University of Southern California. A portion of his forthcoming book, The End of Illness,” was adapted for an article in the Wall Street Journal recently. It captures the absolute essence of how consumer oriented innovation will define how healthcare is delivered in the future.
The word empathy keeps coming to mind for me, as I consider these big, bold visions of the future – one which George Jetson would approve. They are empathetic towards what people actually want. Often, that’s now how businesses, like provider organizations, approach solving problems such as revenue or growth. We have to get better at thinking with empathy about designing how we deliver care. What do healthcare consumers want? That’s how new markets are created in other industries and, if Agus’s vision comes to fruition, it’s how we’ll all control our own health destiny in the future.
Also, note what Argus says about the role of the physician: “…doctors won’t just examine them once a year; they will continually monitor the next generation of patients, offering advice along the way.” Doesn’t that sound a lot like what empowered patients and the social media savvy ask for?
I see them being able to monitor and adjust their health in real time with the help of smartphones, wearable gadgets—perhaps like small, invisible stickers—to track the inner workings of their cells, and virtual replicas of their bodies that they will play much like videogames, allowing them to know exactly what they can do to optimize every aspect of their health. What happens when I take drug x at dosage y? How can I change the expression of my genes to stop cancer? Would eating more salmon and dark chocolate boost my metabolism and burn fat? Can red wine really lower my risk of heart attack?
From a drop of their blood, they will be able to upload information onto a personal biochip that can help to create an individualized plan of action, including both preventive measures and therapies for identified ailments or signs of “unhealthiness.” (Other body fluids—like tears and saliva—might be routinely tested, too.) They would be on the lookout for problems like imbalances in blood-sugar control, a risk factor for diabetes, and uncontrolled cell growth, which could signal cancer. Their doctors won’t just examine them once a year; they will continually monitor the next generation of patients, offering advice along the way.
“You can’t tell people you ran nine miles and expect to ever be treated normally again.” At least, according to Marc Parent writing his Newbie Chronicles article in the February 2012 issue of Runners World Magazine. “In the minds of most everyone…instantly you are done for, a gone. You are an “other,” a “them.” You’ll never be one of the old again again…”
I know what he means. Not just because I’ve taken up running – I’ll let you know when I hit nine miles – but it’s a universal truth isn’t it? When you cross over from casual to extreme in anything, you run the risk of becoming a “them.” Parent suggests, at least in running, there is a invisible line where people can imagine themselves running the same distance, say two or three miles. Beyond that line, you are into the extreme category.
That’s the thing about extremes, they are hard to relate to. Extremes are what attract us to action movies. The idea of someone stowing away to Hong King, kicking a door down, two guns blazing, jumping over fire and rescuing the damsel works because it’s a fantasy most of us won’t ever live. Extremes can have a way of alienating people. If we can’t imagine doing it, sometimes our reaction is to just shut down, or even to become defensive.
Innovations, particularly in conservative industries like healthcare, often trigger the latter reaction. What do you mean ‘open a low cost self pay 24/7 clinic in a drug store‘? That’s not how we do things! And yet, Minute Clinics are popping up everywhere. Anyone remember when the iPhone first came out? The naysayers took to the blogs like…will… internet naysays are wont to do. It will never work, it doesn’t even have 3g, they cried.
I’ve had a similar experience with my diet change. If you tell people you don’t eat meat, they generally react favorably. Hey, good for you, that sounds healthy….I’m trying to eat better too. They can imagine themselves having a salad instead of a burger. When you tell someone you are vegan, a perceived extreme, they tend to take a step back and look at you funny. Why the hell would you do something like that? What do you eat, beans and rice? See what I mean about extremes?
Innovation has the same challenges. If you propose something small, iterative, then people can generally wrap their minds around it. Let’s extend the hours of our clinic so people can come in after work. That’s understandable, we can imagine working an hour later, or flexing staff times. Suggest virtualizing primary care through a series of Skype visits and smart phone apps and you are going to the the nine mile vegan reaction. Why the hell would we do something like that?
I’m increasingly of the opinion a lot of disruptive changes are happening outside of the healthcare industry, in the consumer space. I had an experience recently where I was showing off some consumer oriented health and fitness related apps – blood pressure monitoring, weight management, pulse, and personal health record solutions. All of these are free sites or smartphone apps. The response from industry insiders is usually something like not everyone is as geeky as you are Nick. Maybe, but then why have some of the apps been downloaded millions of times?
It’s a catch 22 for healthcare. We are likely past the point of being able to make small tweaks to the model here and there. Regardless if the future holds ACOs, bundled payments, personal mandates or insurance exchanges, someone is going to be the iPhone of healthcare. Someone is going to do that thing the rest of us think is too extreme. They’ll run 9 miles, in Parent’s terms. The question becomes how we help get traditional provider organizations get onboard? Because, the bottom line is, as an industry, we need to get comfortable with rapid, extreme innovation. If we don’t someone else will. Someone else will create the app that diagnoses your patients and allows them to Skype a primary care physician in India. Someone else will sell your patients a health monitoring service. Someone else is going to make money on your re-admissions. Someone else is going to offer a no wait urgent care clinic.
I’m not a huge fan of what I call blatant marketing. You know it when you see it, particularly with interactive campaigns online. You want me to do what? Like this page, give you my home address, and retweet your link for a chance to win an iPad? No thanks. I avoid frequent shopper cards at the grocery store for the same reason. When Vail Resorts launched Epic Mix last year, I was skeptical. Vail wants to track every move you make, literally, on their mountains.
Vail installed RF chip readers in every lift line and started putting RFID chips in their lift tickets. You go through a line, and they know it. They also know your age, gender, address, family members and travel dates. With the tracking and demographic data, they have a pretty good idea about your habits at their resorts. You can even tie your credit card to your ticket for on-mountain purchases. I imagine the database thinking something like this (you know, if databases could think):
The Jones family starts skiing at 10am most days. Not surprising since they are from the East coast and have the time change. The kids are both in ski school today … cha-ching! Oh look, mom and dad just stopped for lunch at the high end restaurant and the kids are eating pizza at the casual on-mountain restaurant. Mom skis black diamonds mostly and is logging 2x as much vertical as dad. They seem to come out every year around the same two weeks. Judging from their address, I bet they make about $110,000 a year and take two major vacations. We should email them a month before, I’ll make a note of it. I wonder if they’d want a time share….
Pretty spooky huh?
So what did Vail do to change the value proposition of their data capturing? They launched EpicMix, a customer facing portal into the data. You sign up and register the ID number from your lift ticket. From there, things get social very fast. There is a FourSquare like game component where you earn pins – just like the real pins you see on people’s hats or jackets – for accomplishments. Ski 26,400 feet and you get the 5 Miler pin. Head into the Northwoods area and you get the Gone Wild pin. The service also tracks your runs and vertical feet per day and season and lets you compete against friends and family. There’s even iPhone and Android apps to track your stats in real time. And, of course, it all connects to Facebook and Twitter.
This year, Vail gave professional third party photographers the boot. Now, Vail’s own photogs hang out near huge EpicMix Photo placards around the mountain. Ski up, and they scan the RFID tag on your ticket and snap a few pics. That evening, the pictures are uploaded to your EpicMix account and can be shared on Facebook or Twitter for free.
Vail took customer tracking and turned it into a value added service. It’s a draw, something Vail’s resorts have which other ski areas don’t have.
It will come as no surprise I see a healthcare analogue in all of this. Rather than capture data about customers and keep it to themselves, Vail turned it into a customer-facing service. Does your doctor treat your medical records the same way? Can you go online and look at them? Do you get rewarded, even virtually, for losing those 10 pounds or controlling your asthma? Can you chose to share parts of your record with family or friends? Can you chart your A1C scores over time?
Even with the rise of patient access into electronic medical records, we’ve still got a ways to go before we reach the same level of understanding about personal data. I continue to see consumer devices and services leading the trend, which tells me two things: 1) people do want to own, collect, monitor and selectively share aspects of their health and 2) the consumer oriented companies can do it for cheaper. The later is likely owed to less red tape, regulations, research, etc. To be fair, there are iPhone apps which will graph your weight. And there are iPhone apps which will track your skied vertical feet. But the value of that data changes when it’s shared with your provider (not that it has to originate with them, mind you).
Any thoughts? Are you aware of any provider organizations who are going beyond MyChart (an example of a patient EMR portal) and offering value added analysis and services on top of YOUR health data? What kinds of things would you want to see, beyond direct, unfettered access to the record?
By the way, according to my EpicMix dashboard, in the last 12 months, I’ve skied 121,453 vertical feet at Vail resorts… not too shabby for busted knees!
Since I’ve basically given Vail a free ad, I might as well embed their EpicMix video, it explains the service pretty well:
It’s not surprising, it happens to a lot of industries. Consumer devices and technology are making inroads where industry driven solutions are still struggling. People want access to health and fitness related data and so they are building their own solutions, outside of the provider-controlled walled garden. I suspect we’ll see a time when all of this merges together – consumer solutions, medical device makers, provider EMRs, etc. However, for now, it’s pretty clear that if you want to generate and control your own health related data, look towards the consumer space.
This announcement with Withings, maker of the popular Wi-Fi Body Scale (I love mine), highlights what is happening in the consumer world. Providers have been using sales sales with modem connected to your phone line to monitor weight gain in patients with congestive heart failure for years. They cost big bucks and the data goes into a seeming blackhole. The Withings scale is less than $150 and the data is available via API with existing interconnects to services like RunKeeper, FitBit, and now MedHelp (which is new to me).
We have recently discussed the Withings Health Cloud that allows users to import data from RunKeeper and Zeo into their Withings dashboard. The development of the Health Cloud however does not mean that we have given up our policy of making it possible for Withings users to export their data to other websites, quite the contrary. In the past weeks, we have added several new names to the list of our partners, both for the body scale and for the blood pressure monitor. Today, we’d like to shed some light on one of those partners: MedHelp.