BLOG STARTUPS, VENTURE AND THE TECH BUSINESS

Digital Wearables Can Help Both Sick And Healthy People

[This post first appeared at blogs.forbes.com/toddhixon on November 26, 2014.]

Dr. Robert Glattner’s recent post “Wearable Technology And Digital Healthcare Strategies Should Shift Focus To Chronic Medical Illness” underscores a big resource allocation tension in healthcare: between helping those who are sick, and helping those who are well avoid becoming sick. He points out that, today, most of the users of digital health wearables (DHWs) are young, healthy people who often have strong interest in fitness, but the people whose health status could improve most by using DHWs are those suffering from and managing chronic diseases.

DHWs have big potential to help both groups. The technology platforms could be largely common, but product design and system implementation need to be fundamentally different. I think it is hard to say which is more important: helping those who are sick today, or helping those who are not yet ill live longer lives with less burden of disease. Providers can do more at far less cost to keep people healthier at a given stage of life if they can influence patients to adopt healthy behaviors. Behavior makes 4x more difference than medicine to a person’s health status.

And, interventions with both groups are highly cost-effective. Preventing disease is almost always the best treatment: both lower cost and better result. For those who need medical care, digital wearables can both improve care — by monitoring patients more closely and engaging patients in their own care — and reduce its cost by reducing the need for provider office visits and reducing ER visits and hospitalizations.

The need for system change is another common factor between helping chronically ill and healthy people: in regulation, regulatory process, reimbursement, and provider behavior. A patient may weigh herself every day with an internet-connected Withings scale (an existing product), and the technology to transmit that data to her provider is trivial, but there are big hurdles: is the scale a measurement device on which the provider can rely (in fact it’s better than my provider’s scale), is this “standard of care”, where does reviewing this data fit into the provider’s workflow, if the data indicates an urgent problem is the provider now liable for failure to react quickly, how does the provider get paid for this new work and risk?

Moving health management via DHWs forward is the key thing: both chronically ill people and still-healthy people will benefit. Changing the system is the biggest hill to climb, as above. Consumer/patient education is a big hill, too: the links between consumer behavior and long term health need to be communicated in the most powerful way possible to help consumers and break out of the idea that we can do what we like and then, when we are ill, the doctor should cure us.

A National Initiative for Virtualized Medicine (which would encompass utilization of DHWs), which Dr. Glattner advocates, makes a lot of sense to me. The incentive paid to providers to implement EHRs seems to have worked. Virtualized Medicine could be a next step. Technology for DHWs is coming along nicely, and we can count on entrepreneurs to devise business models and launch products, once the barriers are down and the economic incentives are aligned. The private sector can do a lot here once government and the medical establishment get on board.

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