Why Innovation Requires Letting Go to Drive Change

This year’s 2nd Annual Digital Health Conference put the spotlight on efforts to advance healthcare innovation in New York and beyond. While the big apple is home to some of today’s biggest name celebrities like Tina Fey and Alec Baldwin, talk of progress on health information exchanges and the secure sharing of data, as well as new mHealth and telemedicine tools, was top of mind at the conference.

Featured over the two-day conference were keynotes with Dr. David Brailer, Chairman of Health Evolution Partners, and often referred to as the ‘grandfather of health IT’, and Stephen Dubner, journalist and award-winning author of Freakonomics and Superfreakonomics, as well as breakout sessions on some of today’s hottest topics in healthcare.

One of the most well attended and thought provoking sessions was the ‘mHealth Innovators Panel’ with Ben Chodor, CEO of Happtique, as moderator and Leonard Achan, Vice President and Chief Communications Officer at The Mount SInai Medical Center; Wendy Mayer, Vice President, Worldwide Innovation at Pfizer; and Martha Wofford, Vice President, Head of CarePass at Aetna as panelists. By addressing the goals, perspectives and challenges of using mHealth for care delivery, this hour-long panel offered key insights on mHealth’s potential to revolutionize the healthcare ecosystem from the key players in the market including hospital providers, physicians, patients, pharma, payers and programmers.

Q: How do you convince the C-suite that innovation is important?

Wendy: My team drives innovation platforms with a focus on transforming digital to support business and develop capability tools across the organization. With digital, you can innovate more quickly. Pfizer is still working towards a corporate digital strategy but has come a long way.

Q: How has innovation changed?

Martha: There’s been an explosion of applications. Now it’s more about navigating the ecosystem and connecting the best pieces brought to market.

Leonard: We’re further along now. Once you get the C-level support and get past the threshold of change, then you build trust and it’s easier to move forward.

Q: What’s the best innovation out there?

Wendy: Accessibility to healthcare beyond the local environment and the global implications of providing care and extending care more broadly.

Q: What’s the best thing about CarePass?

Martha: Allowing people to see a different future with data and get them there. We’re excited about all the things you can plug into mobile. You can revolutionize access to care around the world.

Leonard: The $7 trillion impact of mobile in low and middle income countries across the globe. A lot of more simple technologies will be transplanted from countries around the world.

Q: Why do people say they want mHealth but not everyone is using it?

Wendy: The existence of mobile technology in places where there is no alternative of care allows for quick adoption. Here in the U.S., the alternative is the person, the doctor. We have an immense amount of data from the traditional care delivery approach and less reliable evidence and data to allow doctors to let go and feel more comfortable with mobile. Mobile as a new means of communication is difficult to assess the impact.

Q: What advice would you give to startups?

Wendy: Do your homework around issues that pharma is dealing with. Vendors come in and talk about solutions that don’t connect to our business strategy. We’re looking for ideas that address our challenges and solve real problems.

Leonard: You have to do a lot of research ahead of time. We used to let everyone in. It was a disaster for entrepreneurs pitching to executives and not doing their homework. It’s important to understand the business goals. If you’re going to save lives and money, you have a chance but you really have to differentiate yourself.

Martha: CarePass is attracting developers with new solutions. We’re working collaboratively with other organizations to inspire innovation. We may be further along but not yet attracting the best and brightest. We want to create a community for developers to help us innovate and drive change. https://developer.carepass.com/

 

Innovation Gamechangers

This past week, SBR had the chance to sit down with Boston Children’s Hiep ‘Bob’ Nguyen, MD, Director of Pediatric TeleUrology, and his research fellow Chad Gridley to discuss some of the projects underway that are innovating care delivery. Bob, recently named a Champion of Healthcare by the Boston Business Journal, is a real game changer who is always at the forefront of revolutionizing care through the utilization of new technologies to better facilitate communication and engage patients.

Q: How is Boston Children’s innovating today?

Boston Children’s is a very forward thinking hospital. They recognize the capabilities of current technologies and are doing a great job of utilizing them. I think they’ve done an especially great job of creating mobile device apps. For example, hospitals are known for being difficult to navigate. The hospital has created a free app that is downloaded to your phone that helps patients and their families get to anywhere in the hospital.

Q: What are the challenges in innovating?

The most challenging aspect is trying to advance multiple projects simultaneously. The hospital has a wealth of innovative staff and given our close proximity to world-class educational institutions, there is never a shortage of startups wanting to collaborate with the hospital.

Click to watch interview

Q: How is video communications shaping innovation in care delivery? Why is this important?

Video communication is bringing patients and healthcare providers closer together than ever before. The process of getting a child ready, driving to the hospital, and sitting in the waiting room can take the better part of the day. For many parents, this is a great burden and sometimes isn’t even an option. By utilizing available technologies, patients can more easily reach their physician from their own home. This has the potential for increasing patient satisfaction as well as increasing patient follow up.

 

Guest Post: The Potential for Telemedicine to Monitor and Improve Public Health

Today’s contributor, Charlotte Kellogg, has contributed a post about the ability for mhealth apps and telemedicine to monitor chronic illnesses. This blog has previously discussed potential drawbacks in telemedicine and Kellogg has built upon that by layering in a comparison of potential benefits and known drawbacks.  Kellogg is a writer and researcher for an public health education resource that offers information about public health certification, classes and programs.  

The Potential for Telemedicine to Monitor and Improve Public Health

The need for quality, consistent healthcare is growing in nearly every corner of the world. Modern scientists are finding new ways to treat conditions every day, but finding ways of bringing that care to the people who need it most is often logistically challenging—not to mention tremendously expensive. New developments in telemedicine, including mhealth, seek to bridge these divides.

Integrating technology into existing healthcare frameworks has the potential to help doctors and other medical providers work faster, more effectively, and with greater accuracy. More patients than ever before can be reached, and information that is centralized on a cloud-based server has much less of a chance of getting lost or overlooked, and can ensure more efficient coordination of care.

The cost savings alone are often substantial. For example, telemedicine has the potential to lower costs from preventing unneeded trips to the emergency room through reliable, real-time video communication between doctors and patients. Telemedicine also reduces the number of routine visits as doctors can effectively monitor a discharge patient from the comfort of their own home. This is especially pertinent for patients who live far from medical centers, as they will not need to travel to an office unless it is absolutely necessary.

Still, providers should be wary of jumping in too deep, too fast. The mobile health landscape is still very much under in the nascent stages of development, and improvements are needed before new technology will be able to fully manage chronic conditions and other public health concerns.

Benefits to Public Health

Health care providers across the board are finding tremendous success using telemedicine in the treatment of chronic conditions like congestive heart failure, diabetes, and HIV/AIDS. Doctors can equip patients with remote tracking devices, which allow for monitoring of blood pressure, glucose levels, and other vital statistics without requiring an in-person visit. Medical providers can also use technology to track pharmaceutical prescriptions and send patients personalized reminders of when and how each drug should be taken.

Telemedicine promises improved care to those living in rural or otherwise remote locations, as well. Patients are increasingly able to check their symptoms through mobile phone apps or online database systems, and also speak to physicians and other members of the care team through web-based video conferencing. This saves time and, increasingly, lives as patients become more empowered and are able to more readily determine when an injury or illness is something that should be waited out or needs immediate attention.

Potential Threats to Public Health

As advanced as many aspects of telemedicine are, the field is nevertheless still quite young. Providers and developers remain in the throes of figuring out how to tighten up on the platform’s accuracy and usability. In many cases the technology is very new and prone to have bugs in the code, and because these technologies are protected intellectual property, many of these bugs are not caught before the programs hit the market.

One of the biggest problem areas is the degree to which patients may elect to rely on apps or electronic information in place of, rather than in addition to, in-person primary care. “The problem with this kind of gold rush is that it attracts not only the best and brightest but also the fast and furious—IT developers looking for quick profits with minimal investment of resources,” Information Week said in a 2012 article evaluating some of the potential downsides of the telemedicine “revolution.”

There is also a concern when it comes to expectations. Medicine is an immensely nuanced field that often defies easy answers. A simple statement of symptoms can indicate a range of wildly different causes, which can lead patients and providers to overlook some of the most obvious possibilities. Researchers from Good Morning America exposed just how difficult online diagnoses can be when they visited three different telemedicine sites armed with the symptoms of Hodgkin’s Lymphoma—and did not get a correct diagnosis anywhere. “It’s totally, totally upsetting. It reduces medicine to piecemeal work,” Dr. Marie Savard, a medical contributor to the show, said in an article for ABC News.

While the diagnoses on these sites were incorrect, it is important to remember that the root cause of most misdiagnoses is poor communication. While these sites and tools may not be able to necessarily match symptoms with diseases, they can make it much easier for a patient to relay symptoms to a doctor who can then interpret the data.

In most cases, the benefits of telemedicine outweigh the potential risks, but there is still work to be done. The cost and time savings allowed through telemedicine, for example avoiding unnecessary appointments and being able to adjust dosage on prescriptions without needing to travel to a doctor’s office, are tremendous, and are likely to continue to grow in the years ahead. It is already the case that diabetes patients are more conveniently and effectively monitoring their health, something that has saved many lives and millions of dollars – something sure to continue as technology improves and people become more comfortable with telemedicine.

By 2020, expert patients will self-manage 95% of their preventive and chronic care

Patients titrating and administering their own medication? Sounds like some futuristic scene from a sci-fi movie where Doctors no longer exist and patients are in charge of their own healthcare.  But this is actually not so futuristic explains Dr. David Judge, medical director of the Ambulatory Practice of the Future (APF) at Mass General.  Diabetic patients are already successfully self medicating, and David plans to soon pilot similar care modalities for other patient populations such as those with chronic heart disease.

As a featured speaker at yesterday’s MassTLC Executive Summit, an event highlighting innovative technologies and applications and their impact on businesses and consumers today, David detailed how his team is deploying new tools to improve how care is delivered, and at the center of that care are the patients themselves. David’s vision of the patient of the future is a healthier, more informed and empowered patient in control of his/her own health destiny. To enable this vision, the APF is providing patients with tools that enable them to self manage, thereby allowing them to improve their health outcome and quality of life while at the same time allowing David and his care team to focus on spending more time with patients who need their care most.

At the summit, David also highlighted several pilots underway at the APF focused on innovating care delivery for primary care in partnership with the Center for Integration of Medicine & Innovative Technology. Fueled in part by the shortage of primary care providers, these projects focus on the exploration of new models of care delivery and are attempt to utilize all members of the care team to train and empower patients to be more proactive managers of their care. David calls this “patient apprenticeship” and the APFs initial findings are that this is a very successful and effective patient-centered care model. He went on to share his insight on the impact of ACOs, payment for value, culture change, informed patients and the increased demand for technologies to enable prevention and proactive disease management on care delivery.

The patient of the future will be here sooner than we expect explained David, as by 2020 he predicts expert patients will manage 95% of their preventive and chronic care. The patient of the future will be a healthier, more informed and empowered patient in control of his/her own health destiny.

To learn more about David Judge and his work at the Ambulatory Practice of the Future, visit http://ow.ly/dRj6m

 

The Mayo Transform Experience

‘Life changing. Diverse. Awe inspiring. Rejuvenating.’ 

SBR is at this year’s Mayo Center for Innovation Transform symposium to experience the revolution in care delivery. Joining today’s healthcare movers and shakers – innovators, leaders, designers, entrepreneurs, policymakers and business thinkers, SBR is excited to be at the forefront of innovation and design solutions that are reshaping how we think about care.

Follow SBR’s CEO Christopher Herot’s twitter feed for updates throughout the symposium, which runs Sept. 9-11.

Robert Fabricant of United Healthcare showing data from America’s Health Rankings.

David Ewing Duncan says most people don’t want to live past 80.

Laura Adams on her first medical mistake – Rx had been transcribed 6 times before she got it. Wrong dosage. Death by decimal point.

Dick Gephardt says there is no silver bullet for cutting health care costs. HRCA is probably too big but is a start on the hard work.

John Hockenberry says healthcare must be prepared for unexpected outcomes.

John Hockenberry describes the ‘unexpected outcome’ of his success after a car accident left him paraplegic.

Watch the Transform 2012 live stream here.

 

 

 

How Google’s Nexus 7 is disrupting the tablet market

While Apple has long reigned supreme in the tablet space with the iPad, demand for the Google Nexus 7 has taken the tablet world by storm. Christopher Herot, CEO of SBR Health and a connoisseur of tablets, can speak knowledgeably on the design, quality and function of today’s tablets by big name brands like Apple, Microsoft and Google. At SBR Health, tablets are an essential tool for communication among patients, providers and members of the care team, and Christopher makes evaluating the quality of video interaction on mobile and tablet devices a top priority. In this interview, Christopher shares his thoughts on the Google Nexus and its advantages over Apple’s iPad.

Why the Google Nexus?

The open question with all these things is how will Google deal with the huge lead in the tablet space that Apple established with the iPad. The iPhone got an early start with mobile but there are now more Google phones than Apple phones, so what’s the problem with tablets?

Google did the Nexus tablet because they were impatient with how fundamentally horrible the other tablets were. Some of them really aren’t that bad. Take the Motorola Xoom. It’s not bad for techies but when I have to decide which one to throw in my bag, the iPad is the more pleasant one to deal with. It’s brighter, sharper and has more apps.

What’s the Google experience?

I like my Google phone better than the iPhone. Google engineers felt they could do better so they worked with Samsung to build the Nexus. The Nexus brand is the more pure Google experience, and it’s pretty good. The other reason why I think it’s really interesting is that it’s at a size between the iPad and iPhone.

What are the advantages?

While some might say the Google tablet is an awkward size, I was pleasantly surprised that the screen is large enough to read but can also be used for video calls.

For our purposes, the Nexus is small enough to fit in the pocket of a doctor’s lab coat. Doctors laugh because their pockets are already jampacked. They could make room for a tablet the size of the Google Nexus. While an iPad is more convenient than a laptop, it still is big.

What are your predictions for adoption?

I expect the Nexus will become an unconscious carry device. These are things like a phone, wallet and watch that you carry everyday. You don’t think about these things. When I go on a trip, I bring a laptop. When I’m going to a conference or an event, I bring my tablet. The Google sized tablet is along the same line. There are places where the iPad is awkward.

In the clinical space, the Google tablet easily fits in the labcoat pocket.

There are a number of use cases where doctors may want to give devices to patients. When deciding between an iPad at $800 and the Nexus at $200, Google has an advantage. That price point makes it something they could give to people to accomplish a specific task. With the iPad, you have to justify the price.

What are the disadvantages?

The thing that’s missing from the Google tablet is a wide area network card. It doesn’t work on Verizon or Sprint. You have to tether through your phone or use the wireless LAN. That’s a bit of a limitation. I don’t think that will be a big deal at hospitals because most hospitals are putting up Wifi throughout.

The reason I still carry the iPad is that it has a lot of my favorite apps.

A question for the Google Nexus is will there be a killer app? It used to be that people bought a PC to use a spreadsheet and the Apple for desktop publishing. With the iPod, it was the iTunes store.

Wow Factor?

We can’t dictate to our customers what device to use and want to accommodate what they’re asking for. Right now, they’re all asking for the iPad. But everytime I pull the Google tablet out of my pocket, people go ‘Wow.’ I was at the Apple store buying my wife an iPhone for her birthday and impressed the guy at the Apple store when I pulled out my Google phone to get her account information. The Nexus wow factor is unbeatable.

News on the Nexus:

Fueled by Tablets, Telemedicine Market to Grow More Than 300% by 2018

Five reasons the Google Nexus beats the iPad

Nexus 7 Sales: Google Tablet Going Fast at Retail Chains

Google Nexus versus other tablets

Hospital networks take key role in healthcare as IT makes further clinical advances

Nexus 7 Sold Out: Google Halts 16GB Shipments, Surprised by Demand

 

 

 

XX in Health: A woman of grace and leader in healthcare

Alexandra Drane goes by Alex, and she is graceful, elegant and full of passion.

In spite of today’s healthcare challenges, Alex is always the first to attack the elephant in the room. Problems big, small, personal, professional, Alex takes them all in stride and doesn’t stop working. In fact, she hasn’t stopped working, and her career is representative of her infinite tenacity. She got her start attending business meetings with her father at an early age and later went on to found several healthcare ventures and nonprofits, and is the current founder, Chief Visionary Officer and Chair of the Board of Eliza Corporation. A mother, daughter, wife, boss, mentor, friend, coach, leader, Alex is an exception to the male majority of healthcare executives. In this interview, Alex shares her motivations and passion for improving healthcare and changing the world.

When did you make the decision to focus on healthcare? 

Sometimes the universe serves something up for you. It just gives it to you and ultimately becomes the greatest gift.

I believe that you should do something everyday that you love, and I want to spend all my time helping people improve their lives. I realize that healthcare is at the core of what makes people healthy and happy.

What goals did you set, and how did you go about achieving them? 

I think there are so many different types of people in the world. There are those who plan and those who don’t. I’ve never been a planner. Wherever I am, I want to have made a very informed, heartfelt and conscious decision. Sometimes the greatest adventures happen in little steps that you build over time.

What are your shortcomings/challenges?

My biggest challenge in life and what keeps me from being successful that I’m incredibly inpatient and care enormously about what I’m doing and the outcomes. That obviously has wonderful benefits but can also be damaging because I bring everything to every moment. That can be overwhelming and dangerous. I work all the time to get myself to relax. Sometimes I do that successfully and sometimes I don’t.

I love getting older, and I’m about to turn 41 in one week and I can’t wait. I love being 40. Forty means I’m legit in that I’m carrying a lot of scars. You naturally become more tempered. If you bring your best foot forward everyday, this enables you to survive. Age doesn’t matter.

How do you define yourself?

I’d like to think that I’m defined by my genuine love for people. I find them fascinating. I want to know what makes them tick, what makes them happy and keeps them happy. What makes them feel good about their place in the world.

What’s on your roadmap of things to do/achieve?

I want to eat at a restaurant by myself. I think it would be bold and brave. All the things that I want to do, I’m doing now. I want the healthcare space to broaden the definition for the things it’s responsible for.

I consider a walk down the street an opportunity to interact. I think as humans we’re obligated to bring joy to others.

It tortures me to think that people are facing real problems that we’re not addressing.

Why are there so few women today in the healthcare space?

I think the right answer is to look at the projector. I think there are increasing numbers of women in the healthcare space, and I think this number will only increase. I believe that the things that kept women from being active in the workplace have changed so fundamentally. We’re only going to see more women in this role. There’s a new generation of women coming through. Women who have the confidence, are role models and have the fundamental belief that they can be successful. These numbers are going to be drastically different five years from now.

What would be your tips to women starting out in healthcare?

My first and fundamental advice is to know the things that make you who are and keep going.

Women have the ability to see the challenges impacting people and really talk to what’s there with grace and make a difference. I think you have to own your scars and share your experiences.

You’re going to have bad days.

Things are imperfect. I think the thing for all women to remind themselves is to find joy in the things you love.

*Note: This post was written to support this week’s XX in Health, which recognizes today’s accomplished women in healthcare. Visit XX in Health to learn more.

 

 

 

 

Blending mHealth and Telemedicine

The World Congress hosted three conferences in one space this week at the Colonnade here in Boston with a great pool of innovators and thought leaders in the mHealth and telemedicine space.

While the three conferences – mHealth, mHealth Innovation Exchange and the Leadership Summit on Telemedicine – were all unique in focus, I think they could have easily been combined into one conference. With discussions on the latest technologies and initiatives transforming healthcare today, it was hard to choose between attending an mHealth or telemedicine sessions, as they are really one in the same.

Alex Nason, Director of Telehealth at Johns Hopkins Medical, summarized the three conferences’ theme well. ‘It’s the connection to health service delivery that matters.’ Both mHealth and telemedicine are services and means for improving the quality and delivery of care. Connecting payers, providers with patients, we’re all in the ‘service’ of innovating care. And it’s a good service to be in.

In case you missed it, here are the highlights:

mHealth: 

-Consumer Trends for Mobile Solutions

-Building Scalable and Sustainable mHealth Behavior Change

-Joslin Everywhere Diabetes Mobile Health Initiative

-Connected Mobile Health Apps and Consumer Engagement

-Intersection of Social Media, Games and mHealth

-Mobile Monitoring for Chronic Conditions

-Global mHealth Perspectives and Challenges

Telemedicine Summit:

-Transitioning to Virtual Care Models

-Telemedicine Funding Opportunities and Current Initiatives

-Pediatric Specialist Care Delivery via Telemedicine

-TelePsychiatry

-Legal Requirements of Telemedicine

-Virtual Care Team Coordination

-Social Media and Telemedicine

-Prescribing via Telemedicine

The Virtualization of Care

This year’s World Congress Leadership Summit on Telemedicine features a great lineup of speakers. Joining innovators from major hospitals and healthcare delivery organizations, we’re excited to hear about the industry-wide interest and demand for telemedicine use in care delivery.

One of the more interesting sessions was the keynote panel discussion on the Joslin Diabetes Center’s ‘Joslin Everywhere’ diabetes mobile health initiative and efforts to virtualize the delivery of care.

Panelists included Chief Medical Officer Martin Abrahamson, Chief Information Officer Ed Charbonneau and WebCare Program Manager Paul Penta. The focus of their panel was on efforts to improve quality, extend their specialist reach by supporting providers at affiliate sites, improving clinical metrics and collaboration with partners in the healthcare field. Through the use of new and innovative tools to train and engage patients to promote better care management, Joslin is establishing itself as a leader in diabetes care and ensuring care anywhere and ‘everywhere.’

Stay tuned for more updates throughout and after the conference.

What’s wrong with telemedicine?

While studies have shown that successful use of videoconferencing and real-time communications can profoundly benefit patients and doctors alike, how do we define success?

Telemedicine has been in use now since the 80’s but due to complexity, specialized equipment, expensive network infrastructure and poor Medicare/Medicaid reimbursement policies, it remained limited to a small number of users. These challenges made it impractical to use televideo technologies for care delivery on a larger scale.

Today, low cost and ubiquitous technologies do exist that can facilitate a world in which videoconferencing has a place on the desk of every doctor, nurse and clinician. However, what is needed at the clinician level are applications designed specifically for the health care industry with televideo as a method of communications.

What does this mean?

As studies have shown that health care outcomes improve when truly collaborative communication takes place among patients, doctors and specialists, televideo is becoming more mainstream. But for televideo to be both successful and effective, televideo technologies must be user friendly, highly secure, low cost and fully customizable.

Is that all?

Fixing televideo goes beyond cost and complexity. While there are a number of innovative televideo technologies, there is still the problem of integrating televideo seamlessly into clinical workflow. The success of any technology depends only 10 percent on the technology and 90 percent on how the technology is integrated with existing workflows.

To deliver care successfully and effectively across the healthcare continuum, televideo must be mapped to existing workflows to improve patient and clinician use experiences and to minimize change management issues.

Change is good but it’s not always great.

To make televideo great, let’s start with improving the usability.