November 21, 2014

Population Health - It's About the Conversation First



 We are all aware how the geometry of healthcare is changing from a linear office-based communication schema to a platform-based model that does a better job of pulling together the producers and consumers of care. Mobile applications, remote monitoring and wearable devices are part of this transition and have captured much of the attention in the literature and shown beneficial outcomes in many early pilots.  It is the temptation of this new technology that shadows the greatest value being delivered across a platform - the conversations with the patient that increase their engagement in managing their health. 

Taking a step back to map out how to leverage yesterday’s “phone/pager tag” linearity into a platform that compresses and streamlines interactions is the beginning of creating the essential and most effective first-step interaction needed for wellness – a conversation. By including the patient in the conversation through remote technology, their isolation, safety and engagement is improved while showing this to be the most cost-efficient delivery of wellness.  The next step is to delineate the best use of video, voice and data in meeting the “triple aim” of simultaneously improving population health, improving the patient experience of care, and reducing per capita cost.

Will remote sensing monitors stay plugged in and useful unless they are a feature of a larger wellness and social offering…doubtful in most cases?  Moving forward, the sensible solutions will be as much, if not more, about social interaction and clinical conversations as it may be about sensing technology.   

September 26, 2014

Population Health - Wearable Healthcare Consolidating



Apple’s HealthBook and iWatch, and Samsung’s “Simi” and Simband” are great starts at aggregating  data from proprietary and 3rd party devices and apps into an easier to absorb presentation layer.  This is the first step in the natural evolution from single utility monitoring apps that haven’t really fared well in the market to bio-health service ecosystems that aggregate utility and offers greater value to the health-engaged consumer and more so the participatory patient.By presenting personal health data like diet, activity and weight with clinical measurements like blood pressure, oxygen saturation and other physiologic measures on dashboards, we will get a more compelling picture of our health which may lead to a greater personal engagement in optimizing it. 

This is just the beginning, when we combine this with the “lab on a chip” technology that proteomics is starting to promise  and the cloud we will have an ecosystem that will allow us to detect sooner the sentinel signs of bad health and avoid cataclysmic health events like heart attacks and cancer.

In a rudimentary form, we may see the ultimate goal - a fully integrated health ecosystem - where noninvasive monitoring, automated-charting and presentation dashboards will be seen on our wrists long before we see it in the hospital or doctor’s office. 

This bottom up approach from the empowered patient  may change the “siloed”  workflow in clinical healthcare and advance the “triple aim” of  improving the experience of care, improving the health of populations, and reducing per capita costs.

April 24, 2014

Jon Schumacher interviews Jim Bloedau: Work Force Multipliers - The Key Thing To Keep In Mind

Jon Schumacher, is a practicing physical therapist and has started a new pod cast over at New Wave Healthcare.  He interviewed me this week and I have to enthusiastically say, he does a great job and is a delight to work with.  Although he's just getting started, his interview skills are quite mature.  Support Jon if you can, and vendors or any thought leaders don't hesitate to see how you can help him.  I expect great things from you, Jon.  Go get 'em!  

To sum up what I had to say.... Keep in mind that whatever you are developing for healthcare, the proven rules around "work force multipliers" that improve proitability has been and will always be a primary consideration in healthcare.  No matter how slick and zippy your system, app or device is, if you don't have a full story around this point - you are pushing the wrong rock up the hill.


February 12, 2014

Hans Rosling - A Great Presentation on Population Health

Hans Rosling is a Swedish global health educator.  This is a dynamic presentation that looks how health and wealth have evolved together.


December 28, 2013

Healthcare Technology Transformation Over Disruption In the ACO PCMH Models by Jim Bloedau


With 47 million new users to be added, the US health system just had a big new bureaucracy placed on top of it and that costs money.  A couple of things are clear:
  • Above all else, cost pressures will rule – the amount of money available for healthcare will be spread much thinner.
  • For those people who will experience higher co-pays under the ACA than what they are used to, this will make the patient think twice about whether a certain procedure is really needed.
With margins continuing to be squeezed because of this continued thinning of reimbursement and utilization, and the need to cover more ground with fewer steps and less cost, what products will create the best market demand in 2014?  

Firstly, you can’t have innovation before the infrastructure is ready to support it.  Products that address workflows that are already happening but take steps out of the process are tops on my list.  As an example, consider why healthcare is the only industry that strongly supports pagers anymore – it’s a convoluted way of getting things done.  Eliminating pagers with a more open form of communication that let’s providers see the conversation that is taking place about a patient’s care by the staff will save steps.  If we can do this in a way that securely crosses the provider to consumer continuum, firewall and such then we’ve sped things along by eliminating some steps. 

Secondly, products that push responsibilities for care upstream also take steps out of the process.  We’ve seen a lot of consumer healthcare products with emphasis on tracking, early detection as well as preventive life-styles education over the last couple of years - most have not gained sufficient traction despite elegant and clearly beneficial outcomes.  Just as we saw the abolition of stenographers who would type letters for “Mad Men” era executives by putting word processors on every desktop, we’ll see more of this in healthcare.  Physicians will delegate more to their assistants, nurses and yet to be defined technicians so all can work where there’s more money - at the top of their license. This will cascade down to where today’s patient will be tomorrow’s PCP (Primary Care Person) and products that compress this process by providing the infrastructure to eliminate steps will be the winners.  Home, mobile, remote care and triage products that help the patient decide when to seek medical help and from who will again be the winners.

These are transformative innovations rather than disruptive and have always had a high degree of success.  If new technology does not have an economic benefit as well as patient, physician, staff or procedural benefit it will have a very strong barrier to entry let alone get past value analysis committees. Those who are trying to introduce a completely new method will face uphill battles.