Tag Archives: eHealth

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

eHealth has Jumped the Shark

This past May I attended, as I have every year for the past ten years, the annual Canadian eHealth conference. Held for the first time at the new Ottawa Convention Centre, the Canadian eHealth conference is a networking and educational event that attracts health IT decision makers, thought leaders, vendors, and users from across Canada as well as international delegates. As I listened to various presentations and chatted with people about their reactions to the presentations that they attended, I began to wonder whether eHealth as a concept has “jumped the shark” and is on its way to becoming irrelevant.

Read the rest of the article on Technology for Doctors

Mike

Procurement Meets Moore’s Law

The following is an article that recently appeared in Healthcare Information Management & Communications Canada magazine:

My father, the consummate bargain hunter, has never heard of Moore’s Law.  Yet, on a regular basis, he takes advantage of the falling prices that are one its inevitable consequences.  My father has learned that he need only wait a couple of years after a new technology is announced for the price of products based on that technology to drop to the level he is willing to pay.   Paradoxically, the same rapid changes in technology that benefits consumers like my father may, in the context of long government procurement cycle, stifle innovation and lead to failed health IT projects.

In a 1965 paper, Intel co-founder Gordon Moore noted that “the complexity for minimum component costs has increased at a rate of roughly a factor of two per year” and predicted that this “rate can be expected to continue”.  This prediction became known several years later as Moore’s Law and has been the source constant innovation in the IT sector for more than half a century.

The impact of long procurement cycles on IT related procurement has been evident in the defence and aerospace industries from quite some time.  A 2006 book on C4ISR (Command, Control, Communications, Computers, Intelligence, Surveillance and Reconnaissance) for future naval strike groups prepared by the U.S. Naval Studies Board concludes:

“The current procurement process of the Department of Defense concentrates on buying ships, airplanes, tanks, and so on. Most of these items have lives that are measured in decades, with few major upgrades over their lifetime. Information technology is changing on the time line articulated in Moore’s law and does not fit into such a process.”

Closer to home, an article in Vanguard, a Canadian defence and security magazine notes:

“Today, the emphasis in federal government procurement is on inputs, with detailed specifications of what, in IT, are constantly moving targets.”

This same article quotes Kamel Shaath, chief technology officer of Kanata-based KOM Networks.  Mr. Shaath contends that “procurement even is inhibiting innovation at times because they [government agencies] are not able to take advantage of new technology.”  Mr. Shaath recommends:

“We need to foster innovation and to have procurement processes that allow the government agencies to embrace and adopt new technologies on a much more rapid pace.”

At the 2012 eHealth conference that took place in Vancouver earlier this year, the opening key note speaker, Dr. John Halamka, was openly critical of the processes used to procure health IT systems and claimed that these practices stifle innovation.    In a blog post written soon after the eHealth conference, Dr. Halamka asserts that “Traditional procurement approaches are likely to acquire technology at the end of its lifecycle.”

While procurement reform is certainly a hot topic, it will, by its very nature, take time to happen.  In the meantime, we might want to consider the advice of Chris Gunderson, a Research Associate Professor of Information Science at the U.S. Naval Post Graduate School and a retired U.S. Navy Captain.  Driven by what he call his “frustration at us Good Guys’ inability to get out of our own way when it comes to acquiring and applying to technology”,  Professor Gunderson is devoting the latter part of his career to “co-opt the government bureaucracy to consume my lessons learned about successful distributive, collaborative e-Biz ‘best practices’ in-spite of itself.

In an October 2009 interview with Ubiquity magazine (an Association of Computing Machinery publication) Chris Gunderson makes a similar case regarding the challenges of IT procurement in the face of rapid technological advances as others quoted in this article:

“The downside of all these restrictions is that the time for the government to procure and deliver a major system is easily a decade or more. With the environment of use changing at the rate of Moore’s Law, the delivered systems are almost always obsolete or obsolescent.”

While acknowledging these challenges, he offers hope that they can be overcome:

“I’ve learned that the best way to achieve powerfully disruptive change is by subtly co-opting the existing processes. By “co-opt” I don’t mean anything subversive or underhanded. I simply mean we should introduce more convenient and efficient methods within the constraints of the existing bureaucratic requirements. The improvements will be adopted because they are perceived as both comfortable and useful.”

Mike

Long Live the Narrative Note

Computers that understood the spoken word was a popular theme in science fiction books, movies and TV shows when I was growing up. Consider, for example, HAL 9000 from 2001: A Space Odyssey (“I’m sorry, Dave. I’m afraid I can’t do that,”) or the computer on board the Star Ship Enterprise from the Star Trek series (“Computer, Tea, Earl Grey, Hot.”) Ever since my youthful fling with science fiction, I have long been intrigued by the possibilities of computer software that understands the meaning of what a person says. Imagine, I have often mused, if we could apply this technology to the narrative notes that are viewed by many people to be an anachronism impeding efforts to share and analyze patient health information.

Check out the rest of this article at http://www.canhealth.com/tfdnews0544.html

Mike

 

COACH Board of Director Elections – Vote Today!

COACH is the Canadian association for health informatics professionals.   I am a member and have been  since I first got involved in the Canadian health IT sector.  I volunteer my time on several COACH initiatives and take every opportunity to support the organization.  

Today, I’d like to remind fellow COACH members that voting in now open for the COACH board directors.  22 candidates have been nominated for 5 open positions. There are many excellent candidates, many of who I know personally.   To help them promote their candidacy, I am offering all board of director nominees the opportunity to post their platforms as a guest post on this blog.    Simply reply with your platform as a comment to this post and I will create a new post that contains your platform.

If you are not a COACH member than I suggest you check out the many benefits at http://www.coachorg.com.  

Mike

 

Interest in the COACH Board of Directors is keen with 22 members stepping forward as candidates for the five vacancies for 2012 – 2014. Be sure to “meet” them and learn about their experience and reasons for wanting to join the Board on the Candidate Profile pages along with the Candidate Nomination Summary.

Due to the number of candidates, the summary is provided in lieu of an All Candidates Webinar.   

Online voting will open April 16 and be available to COACH members through April 27. Voting instructions will be emailed to COACH members.

mHealth Rant

Check out my latest article in Technology for Doctors, an online publication for which I write a monthly column.  You can find it here.

I’d like to hear views on whether we need yet another buzzword.  I argue that mHealth will cause more confusion among potential users and divide the health IT community at a time when it should be united.

Mike

 

 

 

2011 in review

The WordPress.com stats helper monkeys prepared a 2011 annual report for this blog.

Here’s an excerpt:

The concert hall at the Sydney Opera House holds 2,700 people. This blog was viewed about 25,000 times in 2011. If it were a concert at Sydney Opera House, it would take about 9 sold-out performances for that many people to see it.

Click here to see the complete report.