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The Future of Mobile Healthcare is Like a Warm Marshmallow

As we look towards a new year, we thought it was time for a few predictions:

  • Patient satisfaction will be the most important focus of the Triple Aim
  • Patient reported outcomes will be combined with full-body scanning for key signs
  • Emotional health will be as important as physical health, and mobile health companions will focus on both
  • The standard 10-point pain measurement scale will still be in active use
  • Mobile healthcare will move on its own, and even fly

Big Hero 6 logoHow do we know this? Big Hero 6: Disney’s treatise on the future of healthcare delivered by robots. Okay, maybe it’s about the bond between brothers and how ordinary brilliant scientists can become superheroes but given that one of the main characters, Baymax is a personal health companion, we believe Disney is also trying to tell us something about the future of healthcare.

Baymax is a huggable robot and personal health companion who can scan, diagnose, and treat humans and cannot be ‘turned off” until his patient is “fully satisfied with his or her care.” Baymax takes the patient satisfaction pillar of Triple Aim to the extreme. He can also do kung-fu, packs a mean punch, and can fly.

Baymax: I fail to see how flying makes me a better healthcare companion.

Hiro Hamada: I fail to see, how you fail to see that it’s awesome!

Baymax is activated when he hears someone say “ow” and uses a standard 10-point pain scale to first identify problems. Given his ability to review vital signs by scanning, we have to assume he’s asking this question for the emotional benefit of patient rather than a real data point.

Baymax: Hello. I am Baymax, your personal healthcare companion. I heard the sound of distress, what is the problem? On a scale of 1 to 10, how would you rate your pain?

Baymax Big Hero 6

Like a futuristic country doctor, Baymax understands that a patient’s health and well-being is affected by his or her emotions. At one point he tells his young charge:

Baymax: “It is all right to cry, crying is a natural response to pain.”

While he is only activated in response to injury, once Baymax is caring for a patient, he anticipates future issues, and is aware of what’s happening before the patient.

Baymax: “You have sustained no injuries. However, your hormone and neurotransmitter levels indicate that you are experiencing mood swings, common in adolescence. Diagnosis: puberty.”

He is also prepared for health emergencies.

Baymax: “My hands are equipped with defibrillators. Clear!”

Unfortunately, in this situation, the patient was using a figure of speech about having a heart attack, and this is one central problem with this future mobile health: Baymax is naïve and doesn’t understand human emotion. As well, in his desire to help he asks his young patient if certain activities will make him feel better even though they are potentially ill-advised. Baymax 2.0 will need to have some situational learning skills and not confuse patient satisfaction with the “customer is always right” motto.

However, like a real healthcare provider, Baxmax has taken an oath not to hurt humans and he fuBaymax hug Big Hero 6lfils this to the best of his ability, even when the humans try to get him to do otherwise.

So what is Disney trying to tell us about the future of mobile health? Based on the example of Baymax, we’d say in the future it needs to be:

  • With you when you need it
  • Focused on the needs of the patient
  • Summoned by the patient
  • Comprehensive
  • Focused on patient satisfaction
  • Huggable

The last one can’t be underestimated. One of the great appeals of Baymax besides his childlike naivety, is that he looks like a giant marshmallow. Mobile health needs to be patient-friendly and approachable. People don’t like to be reminded that they are sick and medical apps with medical names too often do this. For us at Wellpepper, we have a dog as our logo for this reason. We want to be approachable, friendly, and supportive to patients. We’re going to be with them on their mobile devices so they’d better want to have us there with them, just as Hiro has Baymax.

Happy Holidays from all of us at Wellpepper! All the best for 2015.

Posted in: Behavior Change, Healthcare Technology, Healthcare transformation, M-health

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Will 2015 Be the Breakout Year for M-Health?

While on the one hand, many are proclaiming 2015 to be the year that M-Health finally becomes mainstream (and certainly CMS’s announcement that they will pay $42 per month for remote care for chronic diseases helps with that), the opening day keynote at  the M-Health Summit last week at the Gaylord National Harbor Convention center, seemed to suggest we are in the trough of disillusionment.

In particular Walgreens Chief Medical Officer Harry Lieder and Partner’s Center for Connected Health Director Joseph Kvedar were pragmatic to almost pessimistic about how mobile health would be adopted by consumers, healthcare systems, and payers. While being realistic about how mobile health can help, who can benefit, and who will actually pay for it is a conversation we all need to be having, the tone of the opening day keynote was not so much about celebrating successes but shoring up the audience to continue the good fight.

Walgreens CMO, Lieder outlined four areas where he thought that M-Health could have an impact across the care continuum:

  • Health, fitness, and well-being
  • Self-diagnosis
  • Acute care
  • Chronic care

Source: M-Health Summit

He then went on to debunk the myths of the quantified-self, that is that consumers will take their health in their own hands if presented with information. He also talked about why wellness is not popular with insurers and employers: the impact of wellness programs is generally only in the long-term, for example 10-20 years, and most employers and insurers hope that any individual won’t be their problem for that long. Taking the short term approach, Lieder said there were really only two ways to have a successful m-health startup today: enable people to bill for an existing CPT code or show significant cost savings to the healthcare system in 12-18 months. This is the current reality of the healthcare system, but certainly not how we’re going to drive change. CPT codes are backward looking not about new ways of delivering care, and while ROI needs to be forthcoming, managing patients over their lives needs to be the goal of the healthcare system.

So with this grounding in the somewhat depressing realities of today’s situation, Lieder then announced that Walgreens has partnered with MDLive to offer in-store telemedicine visits. Their recognition that consumer health alone doesn’t change behavior and that patients need support prompted the introduction of this new service, Lieder said “We need people available behind the device to change behavior.” If you can’t fix the system, reinvent it! One speaker called pharmacy the “last mile” that is, the patient loses connection to the health system at the pharmacy so brining the health system to the pharmacy might be the solution.

Joseph Kvedar of Partners.org asked if 2015 would be m-health’s coming out party but said that until applications hit certain key criteria we won’t see widespread adoption. He asked that application builders make m-health apps usable, social, personalized, and with relevance to everyday life. From a patient’s perspective applications should know the patient, engage the patient on his or her terms, and empower the patient. Kvedar did not seem to think that applications had nailed these things yet, especially in the area of usability and that we don’t get this right (and soon) m-health will “go down as another tech bubble.”

Joseph Kvedar

Source: MHealth Summit

M-health has had a lot of hype, and while this keynote provided some grounding in the reality of the market today, it seemed that this might have been a better keynote for the second or third day. Day one, it would have been nice to hear some success stories. After this keynote, I attended a session where one medical researcher spent most of the time explaining how she knew better on how to build good software than anything out there. We m-health entrepreneurs definitely need to get better at telling our success stories. It seems the press to date has been too much hype and not enough clinical substance and ROI to make our case.

At Wellpepper, we predict that if m-health companies can show real clinical evidence, tell real patient stories, and find partners in the ACOs and other organizations that are passionately trying to change healthcare in this country, then 2015 really will be the breakout year for M-Health, and next year’s keynote will see us out of the trough of disillusionment and firmly into real value.

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