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Creepy or Cool? A View of Connected Health in 2025

One of the fun aspects of my job is research.  I get to research the Connected Health trends to understand where the market is headed and how to then prepare healthcare organizations for those changes to capitalize off of the advantage of public health meets good timing meets technology.  I typically chart the trends out through the next ten years.  Some recent information that caught my attention include this infographic by Bupa and a study by Thomson Reuters IP & Science.  Want to know what the world of Connected Health will look like in ten years?  There will be four major themes:

the-futureMicro Mobile: The biggest net delta to be seen in the world of Connected Health between now and 2025 will be in the form of mobile technology.  Mobile capabilities will continue to be provided in smaller form providing the Healthcare industry with opportunities to, for example, use contact lenses that can take pictures of the retina to identify early symptoms of diabetic retinopathy. Sensing capabilities from fiberoptics are currently being used within telehealth in the form of smart carpets that relay signals from footstep patterns.  These capabilities are forecasted to innovate into a form that could signal the possible onset of diseases such as skin cancer when applied to human skin.  Mobile capabilities imbedded in shoes, socks, and baby diapers will impact our ability to monitor weight, fitness goals, hydration, temperature, sleeping patterns, and other symptoms of illness.  Nano tattoos are already used to measure blood glucose levels.  These tattoos, that are half the width of a human hair, are expected to be able to detect precise temperature changes to indicate cardiovascular activity in the future.

Personalized Prevention: Now lets take microscopic mobile and pair it with the more prevalent DNA mapping that will occur in 2025.  Babies born in that year will be tested at the DNA level with full genomic mapping.  We are not talking once or twice.  We are talking continuously tested using nano-probes inserted in the body to identify potential onset of disease.  When it comes to the most costly chronic conditions (both in terms of dollars and hardship), a simple and inexpensive genomics test can be used to help a patient, and their team of clinicians, understand the risk of certain disease states. These individuals can then be given the right treatments and education from the start and throughout life.  Imagine the impact of this level of personalized prevention can have not only for the individual involved but for population health in terms of obesity, diabetes, cancer, and the like.

The Internet of Everywhere: The “internet of things” is defined as an environment where everyday physical objects are connected to the internet and are able to identify themselves to other devices.  We do that at some level today.  By 2025, the internet of things will be everywhere, and everything will be connected.  A report from Thomson Reuters IP & Science states “Thanks to the prevalence of improved semiconductors, graphene-carbon nanotube capacitators, cell-free networks of service antenna, and 5G technology, wireless communications will dominate everything, everywhere.”  What does that mean for Connected Health?  That means your nutrition can talk to you medication because your fridge can talk to your prescription bottles.  Really.

Continuous Data Collection & Instant Reporting: These Connected Health innovations not only provide the ability for healthcare organizations to continually monitor health conditions but also with the ability to collect and report on this data.  This can drive positive behavior change through incentivizing verifiable behaviors.  At the organizational level, this can be used to augment current loyalty programs that rely upon CRM data.  Just imagine the power this also provides to public health research programs worldwide.

Creepy or cool?  What do you think about what is to come in the world of Connected Health?

Smoking Cessation Apps are good. Text programs are even better.

We are big fans of mobile health.  Why?  Because there is 91% US adult adoption of mobile phones.  That same percent keeps their phone with them 24/7.  As a result, these billions of tiny devices the world over create a networked lifeline that can be a critical tool for healthcare.

craving_smokingThat’s why we originally wrote the post, “Texting Bridges the Mobile Health Digital Divide.”  In that piece we highlighted three great text messaging programs that are making a big difference.  Why are text messaging programs so important?  Because, while 91% of the population has a cell phone, only 56% of the population has access to a smartphone (and the health apps that come with it).  Text messaging programs are an inexpensive means to potentially reach almost the entire population if done correctly.

With that in mind, hearing of another mobile health text messaging program with great results, though not at all a surprise, makes me quite happy.  It’s called Text2Quit.  The program works by sending text messages with advice as well as telling users how much money they have saved by quitting (a big correlation to quitting, it seems).  Users can also text keywords, like CRAVE, to receive a tip to keep to their smoking cessation program or SMOKED to communicate a relapse.  The program then gives tips for getting back on track.

Want more information?  You can read about the program here and here and here.

#TexasHIMSS: Mobile Health at Rockdale Medical Center

At Texas HIMSS today I was able to view a use case for Enterprise Mobile.  That’s the term I use to describe the use of mobile devices internal to a healthcare organization.  In this case, Rockdale enabled a single point of workflow across disparate data sources and care locations to enable physicians via a mobile platform.  This platform involved native mobile OS BYOD, medical device drivers, SSO, and Security.

Infographic-Doctors-Prescribing-More-Mobile-AppsWhat drove the adoption of this mobile technology?  There were three main reasons.

  1. Supports compliant workflows: They learned that doctors were using their cellphones to take pictures of images and then texting them to other physicians that were not onsite to get their opinions.  This obviously gave compliance officers a heart burn.  So, they wanted to make the right thing the easy thing by providing a high quality mobile platform that was HIPAA compliant.
  2. Improves care coordination: Data silos are a problem.  We all know this.  This mobile platform provided physicians with access to data in a single application.  They had this access no matter where they were when they needed this data.  This expedited the speed of care in emergency situations.  I’m sure it also answered the common call from physicians: “I go from room to room to room all day. If it is not on my mobile device, then I don’t care about it.”
  3. Encourages engagement: There is 91% US adult adoption of mobile technology.  As a result, these mobile platforms leverage the use of equipment that physicians are already familiar with.  This fact encouraged engagement and interest in the program.   For those of us that make implementation of technology in healthcare a habit, easy physician adoption of technology is pretty awesome.

Analytics have shown that the technology is highly utilized by Rockdale physicians.  It has also provided a competitive advantage in their provider heavy location of Atlanta.  Among other goals, Rockdale’s next steps are to partner with their local EMS and establish objectives to improve the quality of patient care in the Emergency Department.

The Three G’s of Mapping….Is Healthcare a Leader?

Ok, it’s true.  I’m a closet geek.   I think no one knows how much I love maps. (Lesli Adams, my colleague at Perficient, often describes herself as a geek so this is homage to her).  There are so many different kinds of maps, so which ones do I favor, you ask?  I think the best maps are the three “G’s”,

  1. geospatial,
  2. genomic and
  3. geocaching.

Let me show you how all of these have relevance to healthcare:

Let’s start with geospatial. 

shutterstock_56289301I am fascinated by the heat maps of disease prevalence, patient engagement and demographics that have started to electrify Healthcare.  Duane Schafer, Director of Microsoft Business Intelligence for Perficient, recently revealed a great demo at HIMSS, based on Population Health statistics from ProHealth in Wisconsin.  Using basic tools from the Microsoft stack, Duane was able to visually map important population health statistics from ProHealth and present that data in a way that entices the viewer to explore deeper.  It allows the organization to see, at a glance, major population demographics in their region.  This can then be combined with additional analytics to determine trending of disease in the area, frequencies of patient visits to the Emergency Departments over time and correlations of missed appointments to care gaps in specific chronic disease management.   Geospatial mapping even hit the news recently when a contamination at Lake Champlain caused concern about the risk of spreading disease and therefore assisted with facilitating a rapid Public Health response in this  situation. Of course, there are many more examples but you get the idea. Read the rest of this post »

A Love Letter to Meaningful Use – #HIMSS14

It seems appropriate on Valentine’s Day to write love letters.  This is my letter of adoration to Meaningful Use.  In the past, I have written about how much time and productivity is wasted in the average physician’s office handling phone calls about prescription refills.  My physician’s office has successfully implemented their EMR software, and the patient portal is very, very handy for all of the right reasons.  I could wax poetic about the ease of checking on appointments and reviewing lab results.  The source of my real happiness is the ease of asking for refills and having the ability to route the request to the right pharmacy.  It was love at first click.

A Love Letter toInstead of calling the doctor, waiting on hold to talk to the nurse, fretting about getting the medication name and dosage right for the refill, it was magic.  I signed into the patient portal in a secure fashion, clicked on medication refills, and there was a correct list of my medications!  I selected the ones I needed refilled including a suggested number of days like 30 or 90, selected the pharmacy of my choice and Voila!  Several hours later, I received an email confirmation from the pharmacy that they were processing my order.  Now honestly, I didn’t have to see what went on behind the curtain in the doctor’s office to review my request, but I’m sure they like the elimination of potential communication errors on medications, too.

My doctor has shared with me about the financial burden of casting out his first EMR investment and starting over with a better EMR software.  I have to say that from my point of view, he clearly chose the right one and it actually fulfills the basic tenets of Meaningful Use, particularly from the patient’s point of view.  I plan to share my enthusiasm for the patient portal with him including the secure messaging that allowed me tell him that his changes in my medications worked and improved my quality of life.  This secure messaging was another plus for productivity, and patient satisfaction, because those positive responses got lost in the challenges of telephone communication in the past. Read the rest of this post »

App Annie Ranks #mHealth

app_annieFrom the fun-loving portal chap that brought us Find a Provider tools that don’t make babies cry (read: Mark Polly), I bring to you a ranking of Mobile Health apps by App Annie.  App Annie a ranking app that uses app store analytics and market intelligence to rank and visualize an app’s download, revenue, ranking, and review data.

But first some mobile health statistics:

  • 91% of US adults have adopted mobile technology (Source: Pew study)
  • 91% of adults keep their phones within arms reach 24/7 (Source: LeadersWest)
  • 75% of US adults even bring their phones to the bathroom (Source: Digiday, 2013)

As you can see, people really like their cellphones.  This love has brought us a bounty of mobile applications, and healthcare is no exception.  Here, I have listed for you, a ranking of those mobile health apps brought to you by App Annie.

Health & Living

Here we are looking at just Heath and Fitness.  Health insurance companies have been investing a great deal in this space for good reason.  As you can see, there are four large health plans that show up in the top 100 apps.  Who else is ranked in the top 50?  Think apps like Nike Fitness Club, Weight Watchers, Fitbit, Period Tracker, Baby Bump, and White Noise Lite.

Screen Shot 2014-02-11 at 2.57.56 PM

 

Medical

Switching over to the medical category we, not surprisingly, have Epic’s MyChart ranked #4, which is primarily charged by all of their healthcare provider customers that offer the MyChart app to their patients.  As shown below, the Mayo Clinic shows up at 106. There are 105 other medical apps more popular that the venerable Mayo Clinic.  These apps include WeedMaps, FRWeed, Epocrates.

Screen Shot 2014-02-11 at 3.02.56 PM

 

Other applications that are ranked higher in this category include:

  • #201: Novant Health
  • #369: Cleveland Clinic Today
  • #730: Spectrum Health
  • #818: Florida Hopsital ER Wait

The Bottom Line

So, what does this mean for hospitals and health plans considering mobile apps?  If you are a health plan, then you likely need a mobile app in order to take advantage of location services for pharmacy, find a provider, etc.  If you are a major health system, then you can also leverage the large number of potential users by providing a mobile application.  Others might consider specialized mobile applications that are specific to tasks like requesting appointments, refills, location based facility mapping, or information on specific diseases or chronic conditions.  With all of the data pouring in on the success of text messaging programs for health, you should be looking into these programs as well.

Healthcare Gamification: Avoiding Chocolate Covered Broccoli

UntitledLast week, at IBM Connect, I met an individual with the coolest title in all Profession Land: Global Lead for Serious Games.

Her name is Phaedra Boinodiris, and after sitting in on her Birds of a Feather chat, along with a post chat dinner filled with good eats and new friends, I wanted to open up the conversation a bit for all to grow and learn from the gaming knowledge stored in this firecracker of a talent.

I’ll start you off with some stats Phaedra shared:

  • Average age of a gamer:  34
  • Games designed for women: 43% of PC games and 33% in general
  • Households that play video games multiple times per week: 67%

Today your average gamer is not just some young guy locked in his mother’s basement.  Your average gamers include employees, analysts, mothers, and business professionals named Phaedra and Melody.  As Phaedra pointed out, the first game advertising, for Atari, was aimed at the whole family.  Then there was a massive shift that aimed advertising exclusively towards boys.  However, once Nintendo Wii came out you started to see advertisements for the whole family again.

Healthcare at Play

Games are great at explaining complex systems.  There are fewer places one can find complex systems than in the micro and macro worlds of healthcare.  In healthcare we’ve seen games of multiple types.  Here are some great ones:

  1. Games that help modify user behavior: Phaedra pointed out Humana’s pioneer stance in the world of serious games in healthcare with their Horsepower Challenge.  Using the craze the followed games like Dance, Dance, Revolution, Humana used “exergaming” in 2009 to challenge 20 members of Congress and 2,000 5th and 6th graders nationwide as they “raced” across the country by taking steps with a pedometer.  She also harkened back to a healthcare game I mentioned in a post back in 2011, namely Re-Mission.  In Re-Mission, a nanobot named Roxxi is injected into the human body to fight particular types of cancer at the cellular level. Those playing the game are also asked to monitor the patient’s health and report any symptoms to the fictional Dr. West.  Each level of the game informs the player on a variety of treatments and on the importance of staying compliant with medical protocol.  HopeLab trial studies, that were published in peer-reviewed journals, revealed that playing Re-Mission led to more consistent treatment adherence, faster rate of increase in cancer knowledge, and faster rate of increase in self-efficacy. Most notably are blood test results, that showed the measured level of chemotherapy drugs in blood to be higher in players versus the control group.
  2. Clinical learning labs: These are the types of gaming environments where practitioners can train in virtual learning labs on an avatar.  A great one is foldit: Solving Puzzles for Science.  foldit, funded through a University of Washington grant, is an attempt by game developers to crowdsource scientific research.  Within a few paragraphs of texts, the gamer is educated on what proteins and amino acids are and why their shapes, and what those shapes fold into, are important.  The goal is to have human “protein folders” work on proteins that do not have a known structure.  Scientists can then take folding strategies that human players have come up with while playing the game and automate those strategies to make protein-predicting software that can fight HIV and cancer more effective.  Beyond protein prediction, protein design has even more direct implications to disable a virus.  Thus far there are not many automated approaches to protein design, so foldit’s human folders are a great source of research.

This is all gamification, right?

Gamification is the term we use to describe serious games that go beyond strictly trying to entertain.  They have a “higher purpose”, so to speak.  Designers use game techniques to get players to do something not game-like at all.  The possibilities in healthcare, as shown above, are truly limitless.  However, this has brought us an industry that is absolutely flooded with games.  However, as Phaedra points out, they are crippled by one false assumption created within the foundation of many of these games.  That is:

A gamified experience includes scores, leaderboards, and badge systems.

Let’s be clear.  Games can include scores, leaderboards, and badge systems.  However, not everything that includes scores, leaderboards, and badge systems can be called a game (at least not an effective one).  Instead, they are often just Chocolate Covered Broccoli.  A user will try it out, realize this is not what they ordered, and spit it back out again.

If you want to develop a serious game that works, you must, better than anyone else, understand the purpose of your game.  You must know to whom your game is targeted.  You must devote a lot of time to figuring out what motivates your intended audience.  That understanding must be crystal clear before you even consider how the game should be designed.  Document, in detail, what your experience needs to communicate with the gamer.  What kinds of puzzles best match this experience? Then consider what type of game genre matches these puzzles.  Lastly, consider what platform would need to be used to help the gamer bring action to play.

Building a game that is based on what motivates your audience is what makes a serious game a game.  Otherwise, all you have is Chocolate Colored Broccoli.

If you are interested in gaming, a source you can check out is Phaedra’s new book “Serious Games for Business: Using Gamification to Fully Engage Consumers, Employees and Partners”, which includes contributions by another great mind I met at IBM Connect, namely Peter Fingar.

Digital Experiences Critical to Healthcare Industry Success


The healthcare industry continues to undergo dramatic change due to regulatory reform including Meaningful Use Stage 2, which stipulates requirements and feedback on what a patient portal should be. As a result, we see a challenging dynamic between patients, providers and payers.

An exceptional digital experience is one way to help each stakeholder get through the regulatory transition.

portal

Our principal of portal and social solutions at Perficient, Mike Porter, says “The patient portal may be the most complicated portal one can build due to government regulations, physician requirements and patient needs.” Porter is presenting at IBM Connect 2014 this week. He says about IBM technologies, “Fortunately, the IBM toolset gives us the agility to get around the complications and create great experiences for customers.”

Perficient has developed best practices for implementing exceptional digital experiences for patient and member portals that include the core functions each healthcare organization must implement to succeed

  • compliance
  • integration
  • personalization
  • mobile access
  • physician location information

Read the rest of this post »

Connected Health Trend Countdown: #4 Reaching the Mobile 91%

Top Ten

Quick, grab your mobile phone. It’s pretty close at hand, I’m guessing. Hence, our next trend in the 2014 Connected Health Trend Countdown:

Trend #4: Gamification, Quantified Self, and the Internet of Things

You are undoubtedly part of the 90% of the world’s population that is covered by a commercial wireless signal.  According to Pew research, there is 91% U.S. adult adoption of mobile technology and 56% adoption of smartphones.  This behemoth adoption rate means a couple of things for the healthcare industry:

  1. In any attempt to reach as many consumers as possible it is necessary to be where consumers are in order to “get into the conversations they are already having in their head” as we say in marketing speak.  There is no easier way to reach 91% or more of the population using one medium.  I dare you to find one.
  2. In a world with severe healthcare resource constraints, mobile technology can be a major “force multiplier” by empowering both patients and clinicians with the information they need to make informed decisions that range from  healthy living habits to the monitoring of a disease state.

With a cellphone in almost every hand, the expansion of wireless networks presents  us with an opportunity to reach those who are currently isolated by distance and lack of communication.  How amazing is that?

Now to some definitions.  If you haven’t heard of them before, then here they are:

Care Everywhere

A report titled Gaming to Engage the Healthcare Consumer points to three trends driving healthcare organizations, and health plans in particular, towards gamification.  These include:

  • the trend toward value-based care
  • the increasing role of the patient as consumer
  • the millennial generation as desirable health insurance customers.

As mentioned by mobihealthnews in Four Factors Driving Gamification in Healthcare, a fourth trend, namely the increased proliferation of smartphones and tablets mentioned above, was not mentioned in the report but does underscore the conclusions in the report.

Another study ranked the top ten patient groups that reported the highest adoption of mobile health solutions, which you may find interesting:

  • Cystic fibrosis
  • Growth hormone deficiency
  • Acne
  • ADD/ADHD
  • Hepatitis C
  • Migraine
  • Crohn’s disease
  • Chronic kidney disease
  • Generalized anxiety disorder
  • Bipolar disorder

Mobile Preventative Health

My personal favorite topic in the area of mobile health is preventative medicine.  A comprehensive review of mobile health studies, including those created by CINAHL, PubMed, EMBASE, MEDLINE, and PsycINFO between January 2005 and August 2010, focused on the effectiveness of mobile health to impact preventive health behaviors.  Study results show that app and text messaging interventions resulted in reductions in body weight, waist circumference, body mass index, sugar-sweetened beverage intake, and television screen time. You can check out more details on the effectiveness of text messaging programs in a post that I wrote entitled “Texting Bridges the Mobile Health Digital Divide.

A really interesting growth area for both mobile and preventative medicine comes in the area of “wearables”.  These are all of those digital devices, FitBits, JawBones, etc. that consumers, as the name implies, wear.  Juniper Research projects that the wearable technology market will be worth $19 billion by 2018. There is ongoing debate over whether mobile health applications and wearables should be governed like traditional medical devices.  Anyone who knows anything about the medical device industry knows that there is barely a movement that can be made without compliance lawyers getting involved.   The FDA issued final guidance on the topic stating that they intend to exercise discretion for the majority of mobile apps since they pose minimal risk to consumers. However, the FDA intends to focus its regulatory oversight on the subset of mobile medical apps that present a greater risk to patients if they do not work as intended.   These are defined as apps that:

  • are intended to be used as an accessory to a regulated medical device – for example, an application that allows a health care professional to make a specific diagnosis by viewing a medical image from a picture archiving and communication system (PACS) on a smartphone or a mobile tablet; or
  • transform a mobile platform into a regulated medical device – for example, an application that turns a smartphone into an electrocardiography (ECG) machine to detect abnormal heart rhythms or determine if a patient is experiencing a heart attack.

Mobile medical apps that undergo FDA review will be assessed using the same regulatory standards and risk-based approach that the agency applies to other medical devices.  One such app is BlueStar.   BlueStar is a prescription only diabetes app that provides reminders for nutrition and medication adherence.  The app works on computers, smartphones, and tablets.

The private market has also generated a Health App Certification Program named Happtique. Happtique has been around for several years, and the program intends to complement the work of the FDA.  They have introduced a set of standards for health apps that fall into that “not so risky” medical app territory.   

Are you still there?  Good.

Getting patients to engage with their practitioners and medical protocol isn’t just some luxury we should all aspire to.    The price tag associated with the disengaged consumer has cost too much for too long.  Now there are great options like gamification that help make adhering to better health practices attractive to consumers.  Whether is it making it easier for the already exhausted cancer patient to follow complicated medical protocol or letting a child win a cartoon monster for taking their asthma medication on time, mobile health provides cost effective options for healthcare’s most expensive problems.

 

Connected Health Trend Countdown: #7 Care Knows No Bounds

Top TenToday’s entry in the 2014 Connected trend Health countdown takes us far away from home:

Trend #7: Care That Knows No Bounds

It wasn’t so long ago when the general consensus amongst healthcare leaders was ripe with uncertainty regarding the returns to be had from telehealth and remote patient monitoring investments.  It’s only a year or so later and these same telehealth programs are now becoming well established at health systems across the country (and around the world).  It seems that the very concerns holding telehealth back in the not so distant past are the same concepts that are driving it forward today.  As mentioned by Gienna Shaw of Fierce Healthcare, telehealth is saving money and extending the mission of better health.

Life Saving Decisions Made from a Distance

Children’s hospitals across the country have been the fastest adopters of mobile health technology.  Children’s of Philadelphia and Boston Children’s Hospital are considered thought leaders in this area.  However, it was a west coast provider that recently got my attention.  In mid-November, I happened upon an article in the Business Journal about how the telemedicine program at Oregon Health & Science University (OHSU) saved a baby’s life.  7 month old MaLea Fox had a very high fever.  Blood work revealed that she had a virus, but after returning home MaLea’s mother was unable to wake her after four hours.  The on duty physician at Columbia Memorial Hospital in Astoria was able to call for a telemedicine consultation with OHSU’s Dr. Jennifer Needle, a pediatric intensivist.  She exambined the child using a two-way communication system with a “robot-like” device.  Dr. Needle was able to see MaLea’s symptoms, which made her look like a burn victim. MaLea was diagnosed with Memingococcemia, which is a life threatening bacterial infection.  Needle advised having a breathing tube inserted before sending her to Portland by helicopter.  Weather made the transport a challenge, which made intubation a lifesaver in this case.  MaLea spent 111 days in Portland and had her leg amputated above the knee.  She is now doing much better and has no memory of the trauma.

Online Medicine Means Big Business

One area of strong growth in telehealth is the area of online medicine, which is more popularly dubbed “virtual visits”.   According to the Pew Internet and American Life Project, 88% of US adults with Internet access research health information online and 60% say the Internet info influenced a decision about how to manage a health condition. Going online is no longer a one-way stream of information from computer to patient.  We are now in the era of web 2.0, which is empowered by social networking. Patients go online to find meaningful engagement with other epatients and, becoming more and more common, with their providers via secured access patient portals.

The results have shown promising enough to elicit private investment.  Time Warner Business Class recently announced it was venturing into the world of virtual medicine through a partnership with the Cleveland Clinic.  The program is part of Time Warner Cable’s Home Health Monitoring network that was designed to connect healthcare providers to patients in their homes.  It will provide  for secure, encrypted, two-way video conferencing between patients and Cleveland Clinic providers.  

We now live in a world where the local hospital is competing with national leaders.  However, the wonder that is social technology has historically favored David over Goliath.  I’m very interested in seeing where this trend leads us throughout the coming year.

 

Swallowing Sensors Gives New Meaning to the Quanitifed Self

You’ve heard of wearables in healthcare technology, but have you considered swallowables? Swallowing a piece of electronics is something that people are actually willing to try.

Forrester Research's version of of the famousVitruvian Man

Forrester Research’s version of of the famousVitruvian Man

Just this morning, Intel released results from a very compelling study on a range of consumer interest in electronic “wearables” and monitors. They asked people how willing they are to try:

  • Wrist monitors that can monitor things like respiration, blood pressure, heart rate and more, without a cuff – you’ve seen these in Nike Fuel Band and the FitBit Flex, among others.
  • Toilet sensors – you read that correctly.
  • Prescription bottle sensors
  • Blood pressure cuffs
  • The swallowable sensor
  • and more
Eric Dishman (@EricDishman) of Intel spoke with the Wall Street Journal today about the study by Intel. Watch the video below.
More than 80% of those surveyed said they were willing to share “de-identified data” to help further science and cures, so security of information is as important as ever.

Identity and the Internet of Things – Lessons for Healthcare

Attending Dreamforce in San Francisco last month, I was reminded of an article I read in All Things Digital about the role of Identity and the Internet of Things.  Apparently Marc Benioff, salesforce.com’s CEO, mentioned during a presentation at the Bank of America Merrill Lynch 2013 Technology Conference,  that Phillips, the electronics company long known for staple consumer products like TVs, cameras and audio equipment, was working on a new toothbrush. The toothbrush under development was not just any ordinary toothbrush but included GPS, Wi-Fi and “realtime” feedback on how a person brushes their teeth.  Voila, no more lying to your dentist – self-quantification will rat you out with your own data.

While the concept of “The Internet of Things” like the high-tech toothbrush isn’t new, salesforce.com’s forward thinking CEO was previewing a new trend — connected devices are becoming inextricably tied to identity.  Just like my registration email at Dreamforce using a barcode to speed check-in and attendance at sessions.  My identity Internet-Of-Thingswas tied to a “thing” in the Internet of Things.  Lots of my personal devices are internet-enabled as well, connecting my identity to how far I walk for exercise, where I travel, what hotels I stay at, etc.  In the world of social, devices like the smartphone, activity tracking wristbands, etc. are creating comprehensive profiles of our “real” behaviors like brushing our teeth.

It doesn’t take a big leap to understand the impact of connecting my identity and devices on managing my health or lifestyle.  You can easily imagine a healthcare plan, like Geico does on cars, offering a discounted health plan in exchange for your comprehensive lifestyle profile, or at least lower deductibles for positive behaviors, including taking your medications on time.  The challenge will be making certain that your identity is truly linked to your proper information in healthcare systems and there are clear safeguards in place.  As the article in All Things Digital states

“And to be clear, trust-based relationships with users means that privacy must be accounted for and the right controls must be in place before businesses start collecting and using this data. With the proper opt-in/out privacy controls in place, identity-defining traits like hometown, religious beliefs, relationships status, likes, activities and social graph can be available to marketers and used to drive hyper-relevant marketing campaigns.”

As the list of connected “things” in our lives grows and uses our identity to tie our behavior profile to our healthcare management, the pressure will be increased for outstanding master data management by healthcare providers and healthcare plans.  It is amazingly difficult for healthcare companies to conquer enterprise-level master patient indexes to resolve your one identity and create a combined view of your medical history.  While your smartphone revolves around your Facebook username and password, Twitter log-ins, etc. to know you, the fragmented healthcare system must piece together that you go by your middle name, use a nickname or don’t really know your actual Social Security Number.

Master Data Management and Identity Management for healthcare is literally a matter of life and death, especially for people with medication allergies, chronic conditions like diabetes and people with medical implants like pacemakers.  Dick Chaney took the extreme step of firewalling his wireless connection on his pacemaker, for example, to block terrorists from attacking him based on his device and identity.  While we enjoy the idea of our exercise wrist band taking to our smart thermostat to cool down the house after a run, we need to understand the broader implication of this degree of connectivity into our own safety as patients.

You may laugh the next time that the hospital asks you your name for the umpteenth time or marks the site of your surgery with a marker, but identity matters in healthcare and as that industry becomes more connected like your devices, make sure that your information is correct, up to date and is “real.”  It could literally save your life.