Tag Archives: Digital Health

Digital Health: What’s Next?

My most recent “Last Words” article published in Health Information Management & Communications Canada magazine:

A good friend and former work colleague often remarks that once you have worked as a market analyst, you will always think like a market analyst. This observation rings particularly true around New Year’s when I feel the irresistible urge to offer my prognostications on what’s next for digital health.

This year, rather than offer specific predictions, I offer an overview of three major drivers that I believe will influence digital health priorities and direction in the near future.

Meaningful Use

In what might turn out to be one of the most significant announcements of 2016, Andy Slavitt, Acting Administrator of the U.S. Centers for Medicare and Medicaid Services (CMS), declared:

“The Meaningful Use program as it has existed, will now be effectively over and replaced with something better.”

According to healthIT.gov (a web site operated by the U.S., Office of the National Coordinator for Health Information Technology), Meaningful Use is defined as “using certified electronic health record (EHR) technology to:

  • Improve quality, safety, efficiency, and reduce health disparities
  • Engage patients and family
  • Improve care coordination, and population and public health
  • Maintain privacy and security of patient health information

Speaking at the J.P. Morgan Annual Health Care Conference on January 11, 2016, Mr. Slavitt identified what he referred to as the four “themes guiding our implementation” of a Meaningful Use replacement:

  • Reward healthcare providers for the outcomes they achieve using digital health technologies rather than simply for use of these technologies.
  • Customized goals that allow solutions to be tailored to practice needs. Slavitt stated that “technology must be user-centered and support physicians, not distract them.”
  • Levelling the playing field for start-ups and new entrants. This objective will be achieved by requiring open APIs in order to “move away from the lock that early EHR decisions placed on physician organizations” and thereby “allow apps, analytic tools, and connected technologies to get data in and out of an EHR securely.”
  • Mr. Slavitt proclaimed “we are deadly serious about interoperability” and put technology companies that attempt to “practice ‘data blocking’ in opposition to new regulations” on notice when he stated that such practices “won’t be tolerated.”

Each of these themes reflects issues and challenges that have hampered the effective use of digital health technologies by both healthcare providers and the general public.

While the Meaningful Use program does not apply to Canadian healthcare organizations, it did have and its eventual replacement will have a significant influence on the digital health landscape in Canada.

Digital Health Investment

In their year end review for 2015, Rock Health, a venture fund dedicated to digital health, stated that venture funding for digital health companies in 2015 raised $4.5B.  This level of funding was an increase over the record breaking level of digital health investments in 2014 and, according to Rock Health, represents a compound annual growth (CAGR) from 2011-2015 of 32%.

Rock Health noted in their year end review that while “overall venture funding showed a slight dip in 2015, digital health continues to hold a healthy 7% of total venture funding.”  They also remarked that investors continue to show their interest in digital health companies and observed that there is a “growing tail of investors who participated in at least one deal.”

This steady level of funding and growing investor interest leads Rock to declare that “digital health is no longer a novelty.”

Rock Health identified three particular digital health categories that exhibited noticeable growth in funding in 2015: personal health tools and tracking, care coordination, and life sciences technologies.  They commented that “as the industry faces growing pressure to cut costs, digital health will play a key role in enabling engagement with the end-user and improving communication and coordination.

Digital Everywhere

Computing technology, once the nearly exclusive realm of geeks and hobbyists, is now an integral part of everyday life for most people.

According to comScore, a global media measurement and analytics company, an average of 29.4 million Canadians per month accessed some form of on-line service during the fourth quarter of 2014.  Based on Statistics Canada figures, this on-line community represents just over 80% of the Canadian population.

Not only are a majority of Canadians engaging in some form of online activity, comScore notes that they are increasingly doing so across multiple devices including desktops, laptops, tablets, and smartphones. The number of Canadian mobile subscribers grew 5% from December 2013 to December 2014, with just over 80% of these subscribers owning a smartphone capable of accessing a variety of online services.

The pervasiveness of digital technology is changing how digital health solutions are perceived by end users.  Neither patients nor health providers need to be enticed to use digital technology; they do so in most other aspect of their lives. They need only be offered digital health solutions that are both useful and usable.

Summary

By clearly communicating its priorities and future direction, CMS is providing investors with insights that will shape their investment decisions.  This investment, if focused more on addressing user needs and less on certifying compliance with meaningful use guidelines, will likely produce digital solutions that end users will embrace and use.

What are your thoughts on digital health trends and drivers?  Please share your thoughts with me at michael.martineau@avenant.ca or on my blog at ehealthmusings.ca

The rise of digital health platforms

Apple has gained a well-deserved reputation for disrupting industries. Witness the impact of the iPod on the music industry, the iPhone on the cellphone industry, and the iPad on the computer industry. Apple’s announcement this past June that iOS 8 (the next release of its mobile operating system) will include tools to manage personal health information has many analysts, journalists, and other pundits debating whether the company can have the same disruptive impact on the health sector that it has had other industries.

You can check out the remainder of this article at Technology for Doctors

Mike

Tugging on Superman’s Cape – Contrarian Views Applied to the Digital Health Agenda

I have teamed with my friend and mentor, William Pascal,  to write a series of articles challenging conventional wisdoms about the Canadian digital health agenda.  Here is the first article in the series which sets the stage for the remainder of the articles

“Time spent arguing is, oddly enough, almost never wasted.” ―Christopher Hitchens, Letters to a Young Contrarian

Introduction

What if we do not need new funding for the digital agenda in Canada? What if we no longer need a Canada Health Infoway or similar bodies such as eHealth Ontario? What if we are less concerned about privacy and more concerned about delivering better care? What if the private sector manages all back office operations for the health sector? All these statements are contrary to conventional wisdom, but are they wrong?

What is conventional wisdom? It can be defined as ideas so accepted they go unquestioned. Think about the Wright brothers. If they had listened to conventional wisdom, they would never have even tried to build a flying machine and our world would be a very different place. Think about the impact on society today if Alexander Graham Bell had been discouraged and gave up when he was told that his invention of the telephone had no inherent value by Western Union.

Too often we accept what’s conventional thinking without trying to see what’s possible and available. The real problem with using conventional wisdom as a guide is that we will constantly be behind the curve, safe with the general masses but missing the opportunities to think independently and create something new or change an existing way of thinking. Ten years ago, who would have thought we’d be spending more money renting software than purchasing it?. Fifteen years ago, mobile devices were not viewed as a key enabler of care when we created an eHealth strategy for Canada.

New ideas or ways to address difficult issues almost always challenges conventional wisdom. Inspired by this reality, we have embarked on a quest to challenge, through a series of articles, some of the conventional wisdom that we believe underlies the approaches to the public policy thinking that is driving the digital agenda in Canada.

This paper, the first in our series of articles challenging Canadian digital health conventional wisdoms, provides a high level overview of the challenges facing the health care system, a description of the digital agenda in the healthcare sector, the status of this agenda in Canada, some observations on this journey, lessons to be drawn from experiences in Canada and Internationally and a suggested list of contrarian possibilities that draw into question conventional wisdom. Subsequent articles will explore these suggested different future states.

You can read the remainder of this paper here.

Mike