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Is Fitbit a Digital Health Solution?

Posted on January 6, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As I’ve been making the rounds of Digital Health at CES (technically the show officially starts today), I’ve run into an extraordinary amount of digital health sensors and tracking devices. Some of them are me too copycats of the already flooded fitness trackers. Others are doing really incredible stuff around ecg, muscle mass, respiratory, heart rate, and much more.

One conversation that I’ve had multiple times is that Fitbit and Fitness trackers like it really aren’t a digital health solution. This isn’t really said as a knock to Fitbit. Almost always this statement is proceeded by a comment about how Fitbit has done some really great things. However, the question really revolves around whether Fitbit is a healthcare application or whether it’s just a fun consumer device.

There’s no argument that Fitbit has been extremely successful. It’s also created mainstream interest in tracking your health. As a consumer application it’s been a big hit. The numbers don’t lie. However, many would equate what it’s accomplished in healthcare to something like the Wii Fit as opposed to something that impacts clinical care like a medical device. It’s more of a game that provides some health benefits than it is a clinical device. I even heard one person take it as far as to compare it to running shoes. If you did a study, running shoes probably improve the health of many people since it makes it easier to exercise. Does that make it a health solution?

Like I said, I don’t think anyone is arguing that what Fitbit is doing is bad. I also can’t remember Fitbit ever really claiming to influence clinical care. It’s the rest of the world that’s drawing that conclusion for them. Countless are the number of articles that talk about a patient sharing their Fitbit data with their doctor.

In response to those articles doctors have generally responded, why do I care about their Fitbit data? I think the reason doctors react this way is because the Fitbit data is limited and really doesn’t affect the clinical care for most people. Maybe there’s some isolated cases, but for the majority of Americans it wouldn’t change the care they receive.

While this is true for Fitbit, there is a wave of other tracking devices that could (and I believe will) impact clinical care. It’s easy to see how a continuous ecg monitor that’s FDA cleared (ie. Doctors trust the data) could impact clinical care. This is actually true clinical data that doctors will care about seeing.

At this point I think it’s true that majority of doctors don’t want to get your Fitbit data. It’s not clinically relevant. However, that’s going to change rapidly as health sensors continue to evolve. Maybe Fitbit will find some clinical relevancy in the data they produce. If not, a wide variety of other vendors are going to create clinically relevant data that doctors will not only want in their EHR, but they’re going to demand it.

The only question I have now is, should we be building the highways for that data now so that we can easily turn on these new sources of clinically relevant data?

Side Note: I’ll be doing a Digital Health video blab from CES 2016 if you’d like to join.

My First Look at Digital Health at CES

Posted on January 5, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Last night was the official press kick off of CES (Use to be called the Consumer Electronics Show) with a press only event called CES Unveiled. In past years CES Unveiled has been somewhat of a disappointment. Too crowded. Little food. Not very many interesting companies. However, you’d find 1 or 2 companies that really caught your eye and it was also good to see generally what some of the trends of the industry were.

This year felt different. The variety of interesting technologies that were on display was quite exciting. Here’s some mostly healthcare related observations from CES Unveiled.

The number of healthcare wearable copycats is exploding. I’ll be following up on this when I hit the full show floor. I’m going to do my best to make a list of all the companies that are doing health wearables at CES and which ones they’re doing. Needless to say, you’re going to have a lot of choices the next time you want to buy a fitness watch, blood pressure cuff, ekg, connected scale, etc. If I’ve already seen this proliferation at CES Unveiled (which has like 100 companies) I can only imagine how many more there will be on the CES show floor. Plus, there’s at least a few companies talking about invisibles which track the same as wearables but you don’t wear them. More on those later.

The digital health solutions I found are very international. I was impressed by the large number of international players that were developing digital health solutions. I saw solutions coming from China, Netherlands, France, and Italy to name a few. It makes sense that health matters around the world. I just hadn’t seen all these international players in the digital health space at past CES. Some of them haven’t even thought about the US market. However, they’re considering it in the future.

I also came across a smart desk solution from Humanscale that shows promise for employee wellness. I’ll be exploring these solutions more, but they have a sit-stand desk and sensors that track how long you’re sitting or standing and have created software to encourage you to move around more if you’re not moving enough. They even have employer dashboards that help a company evaluate their employee’s wellness from an ergonomic standpoint.

The home is being digitized. A simple example of this is the ICON Home Panel. Imagine having an iPad or Android device on your wall. That’s basically what they’ve done. They’ve started with having it control the temperature of your house the way your current temperature gauge can do, but now that you have a full Android device on the wall, it opens up a whole new world of opportunities.

My family got an Amazon Echo for Christmas this year and that’s opened my eyes to the future. If you haven’t seen or used the Amazon Echo, it’s basically a voice controlled virtual assistant. Kind of like Siri for your home. Now imagine that technology available in the Android home panel I just talked about. Pretty powerful stuff.

What does a smart panel and Amazon echo have to do with healthcare? It’s all part of the mesh of connections that will be needed to help you monitor and improve your health. Amazon Echo already has what they call the 7 minute workout. You just say “Alexa, start my 7 minute workout” and the Amazon Echo will start walking you through a workout. Think about the Humanscale sensors mentioned above. Could the wall mounted “brain” connect with sensors around your house to let you know that you’ve been in front of the TV for 4 hours? I don’t see it shouting out at you to get off the couch, but there could be ways to use this data to motivate you to be more healthy.

From a security and privacy perspective, I was really impressed by the Qkey. In many cases, CES Unveiled was a progression of existing technologies. However, I’d never seen anything like Qkey. The Qkey is basically a key size device that you can plug into any computer. You can then run a web browser (one they developed) and securely surf the internet. It also has a number of other interesting security features like securing storing your credit card info so that you don’t have to hit any keystrokes. Not only is that convenient, but it makes it so keyloggers can’t capture your credit card info either. I’m planning to stop by their booth and get one that I can use. So, I’ll report back on it more later.

The one challenge with the Qkey for health care is that it runs a custom web browser. I’d be interested to know if it works with the web based EHR out there or not. However, that doesn’t really matter since you can’t run any of the client server applications like Cerner, Epic, or MEDITECH on it. So, it’s not really an option for a large portion of healthcare. From a patient perspective, it could be a great way to access their health info. I love that Qkey is looking at security and privacy from a very different perspective though.

There’s a few of the things I saw that caught my eye. Along with these there was an interesting mix of drones, 3D printers, Virtual Reality (VR), accessories, and new input devices. Some of the new input devices get me excited. Unfortunately, they’re all focused on things like gaming and music right now. However, that tech will no doubt leak over into all of our computer interfaces in the future.

Mark Cuban’s Suggestion to Do Regular Blood Tests

Posted on April 24, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve been really intrigued by the tweets from Mark Cuban and the response from many to his tweets from those in the healthcare IT community. Here’s a summary of the 3 tweets which ignited the discussion:

  1. If you can afford to have your blood tested for everything available, do it quarterly so you have a baseline of your own personal health
  2. create your own personal health profile and history. It will help you and create a base of knowledge for your children, their children, etc
  3. a big failing of medicine = we wait till we are sick to have our blood tested and compare the results to “comparable demographics”

My friends Dan Munro and Gregg Masters have both been writing a lot about the subject, but there are many others as well. They’ve been hammering Mark Cuban for “giving medical advice” to people when he’s not a doctor. I find these responses really ironic since many of the people who are railing against Mark Cuban are the same people who are calling for us to take part in the quantified self movement.

What I think these people who rail against Mark Cuban want to say is: Don’t misunderstand what Mark’s saying. More testing doesn’t always improve healthcare. In fact, more testing can often lead to a lot of unneeded healthcare.

This is a noble message that’s worthy of sharing. However, I think Mark Cuban understands this. That’s why one of his next tweets told people to get the tests, but don’t show the results to their doctors until they’re sick. In fact, Mark even suggests in his tweets that the history of all these tests could be beneficial to his children and their children. He also calls it a baseline. Mark’s not suggesting that people get these blood tests as a screening for something, but as a data store of health data that could be beneficial sometime in the future.

How is Mark Cuban storing the results of a bunch of blood tests any different than him storing the results from his fitbit or other health sensor?

One problem some people have pointed out is that if you’re doing these blood tests as a baseline, then what if the blood tests weren’t accurate? Then, you’d be making future medical decisions based on a bunch of incorrect data. This is an important point worth considering, but it’s true of any health history. Plus, how are we suppose to make these blood tests more accurate? If the Mark Cuban’s of the world want to be our guinea pigs and do all these blood tests, that’s fine with me. Having them interested in the data could lead to some breakthroughs in blood testing that we wouldn’t have discovered otherwise.

Along with improving the quality of the data the tests produce, it’s possible that having all of this data could help people discover something they wouldn’t have otherwise seen. Certainly any of these possible discoveries should go through the standard clinical trial process before being applied to patients broadly. However, researchers only have so much time and so many resources to commit to clinical trials. Could all the data from a wide swatch of blood tests better help a research identify which research or clinical trials are worth pursuing first? I think so.

For me it all goes back to the wide variety of health sensors that are hitting the market. A blood test is just a much more powerful test than many of the health sensors we see on the market today. So, the warning to be careful about what you read into all these blood tests is an incredibly important message. However, with that fair warning, I don’t see any problem with Mark’s suggestion. In fact, I think all of the extra data could lead to important discoveries that improve the quality of the tests and what measurements really matter.

The Future Of…Healthcare Innovation

Posted on March 17, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the #HIMSS15 Blog Carnival which explores “The Future of…” across 5 different healthcare IT topics.

Innovation is a fascinating concept. Historians and philosophers have been thinking and investigating the key to innovation forever. I’m not sure anyone has ever found the true secret sauce to innovation. Every innovation I’ve ever seen has been a mix of timing, luck, and hard work.

Some times the timing is not right for a product and therefore it fails. The product might have been great, but the timing wasn’t right for it to be rolled out. Innovation always requires a little luck. Maybe it was the chance meeting with an investor that helps take and idea to the next level. Maybe it’s the luck of getting the right exposure that catapults your idea into a business. Maybe it’s the luck of the right initial end users which shape the direction of the product. Every innovation has also required hard work. In fact, the key to ensuring you’re ready for luck to be heaped upon you or to test if your timing is right is to put in the work.

The great thing is that it’s a brilliant time to be working on innovations in healthcare. We’re currently at the beginning of a confluence of healthcare innovations. Each one on its own might seem like a rather small innovation, but taken together they’re going to provide amazing healthcare innovations that shape the future of healthcare as we know it.

Let me give a few examples of the wave of innovations that are happening. Health sensors are exploding. Are ability to know in real time how well our body is performing is off the charts. There are sensors out there for just about every measurable aspect of the human body. The next innovation will be to take all this sensor data and collapse it down into appropriate communication and actions.

Another example, is the innovations in genomic medicine. The cost and speed required to map your genome is collapsing faster than Moore’s law. All of that genomic data is going to be available to innovators who want to build something on top of it.

3D printing is progressing at light speed. Don’t think this applies to healthcare? Check out this 3D printed prosthetic hand or this 3D printed heart. If you really want your mind blown, check out people’s work to provide blood to 3D printed organs.

If you think we’ve gotten value out of healthcare data, you’re kidding yourself. There are so many innovations in healthcare data that are sitting there waiting in healthcare data hoards. We just need to tap into that data and start sharing those findings with a connected healthcare system.

The mobile device is an incredible innovation just waiting for healthcare. We are all essentially walking around with a computer in our pocket now. We’ve already started to see the innovations this will provide healthcare, but it’s only just the beginning. This computer in our pocket will become the brain and communication hub for our healthcare needs.

I’m sure you can think of other innovations that I haven’t mentioned including robotics, health literacy, healthcare gaming, etc. What’s most exciting to me about the future of healthcare innovation is that each of these innovations will combine into a unforeseen innovation. The most powerful innovations in healthcare will not be a single innovative idea. Instead, it will come from someone who combines multiple innovations into one beautiful package.

The most exciting part of innovation is that it’s usually unexpected and surprising. I love surprises. What do you see as the future building blocks of innovation in healthcare?

The Future Of…The Connected Healthcare System

Posted on March 11, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the #HIMSS15 Blog Carnival which explores “The Future of…” across 5 different healthcare IT topics.

As I think about the future of a connected healthcare system, I get very excited. Although, that excitement is partially tamed by the realization that many of these connections could have been happening for a long time. A connected healthcare system is not a technological challenge, but is a major cultural challenge for healthcare.

The Data Connected Healthcare System
Implementation challenges aside, the future of healthcare absolutely revolves around a connected healthcare system. In the short term these connections will focus on sharing the right data with the right person at the right time. Most of that data will be limited to data inside the EHR. What’s shocking is that we’re not doing this already. I guess we are doing this already, but in a really disconnected fashion (see Fax machine). That’s what’s so shocking. We already have the policies in place that allow us to share healthcare data with other providers. We’re sharing that data across fax machines all day every day. Over the next 3-5 years we’ll see a continuous flow of this data across other electronic channels (Direct Project, FHIR, HIEs, etc).

More exciting to consider is the future integration of consumer health device data into the healthcare system. I’m certain I’ll see a number of stories talking about this integration at HIMSS already. These “pilot” integrations will set the groundwork for much wider adoption of external consumer health data. The key tipping point to watch for in this is when EHR vendors start accepting this data and presenting the data to doctors in a really intuitive way. This integration will absolutely change the game when it comes to connecting patient collected data with the healthcare system.

What seems even more clear to me is that we all still have a very myopic view of how much data we’re going to have available to us about a person’s health. In my above two examples I talk about the EHR patient record (basically physician’s charts) and consumer health devices. In the later example I’m pretty sure you’re translating that to the simple examples of health tracking we have today: steps, heart rate, weight, blood pressure, etc. While all of this data is important, I think it’s a short sighted view of the explosion of patient data we’ll have at our fingertips.

I still remember when I first heard the concept of an IP Address on Every Organ in your body reporting back health data that we would have never dreamed imaginable. The creativity in sensors that are detecting anything and everything that’s happening in your blood, sweat and tears is absolutely remarkable. All of that data will need to be connected, processed, and addressed. How amazing will it be for the healthcare system to automatically schedule you for heart surgery that will prevent a heart attack before you even experience any symptoms?

Of course, we haven’t even talked about genomic data which will be infiltrating the healthcare system as well. Genomic data use to take years to process. Now it’s being done in weeks at a price point that’s doable for many. Genomic medicine is going to become a standard for healthcare and in some areas it is already.

The connected healthcare system will have to process more data than we can even imagine today. Good luck processing genomic data, sensor data, device data, and medical chart data using paper.

It’s All About Communication
While I’ve focused on connecting the data in the healthcare system of the future, that doesn’t downplay the need for better communication tools in the future connected healthcare system. Healthcare data can discover engagement points, but communication with patients will cause the change in our healthcare system.

Do you feel connected to your doctor today? My guess is that most of you would be like me and say no (Although, I’m working to change that culture for me and my family). The future connected healthcare system is going to have to change that culture if we want to improve healthcare and lower healthcare costs. Plus, every healthcare reimbursement model of the future focuses on this type of engagement.

The future connected healthcare system actually connects the doctor’s office and the patient to treat even the healthy patient. In fact, I won’t be surprised if we stop talking about going for a doctor’s visit and start talking about a health check up or some health maintenance. Plus, who says the health check up or maintenance has to be in the doctors office. It might very well be over a video chat, email, instant message, social media, or even text.

This might concern many. However, I’d describe this as healthcare integration into your life. We’ll have some stumbles along the way. We’ll have some integrations that dig too deeply into your life. We’ll have some times when we rely too heavily on the system and it fails us. Sometimes we’ll fail to show the right amount of empathy in the communication. Sometimes we’ll fail to give you the needed kick in the pants. Sometimes, we’ll make mistakes. However, over time we’ll calibrate the system to integrate seamlessly into your life and improve your health based on your personalized needs.

The future Connected Healthcare System is a data driven system which facilitates the right communication when and where it’s needed in a seamless fashion.

Your Brain on Exercise

Posted on December 24, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s Christmas Eve, so I thought I’d keep it short and sweet. This is a cool tweet with a really interesting image of a brain scan while sitting and one while exercising.

Pretty cool stuff. In the future we’ll have real time access to data like this from all parts of our body. That really excites me. Now time to stop sitting and go do something physical (does eating count?).

What Value Does a Healthy Patient Get from a PHR?

Posted on November 11, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In my previous post about a Patient Controlled Medical Record, I asserted that such a thing would be a challenge to get to work in the US, but that there was a lot of potential internationally. I did provide one caveat when it came to chronic patients where I think there is potential in the US as well. Although, some argued against even that group being interested in the comments.

Let me further expound on why I think the patient controlled medical record fails for a healthy patient (and this includes people who think they’re healthy, or at least relatively healthy…ie. they don’t go to a doctor for any chronic condition). In many respects this is my talking from my own personal perspective as a young, healthy adult (although I guess all of those descriptors could be argued).

The problem for someone that’s healthy is that their medical record basically has no data. The reason you want a patient controlled medical record is so that you can extract value from the data. I don’t need to look at my online medical record to see that I don’t have any drug allergies, that I had a cold or flu 3 years ago, that I got my flu shot 4 years ago, and that when I was 15 I had a hernia operation.

The point being that my medical record is so short that there’s so little value in me trying to aggregate that record in once place. What value do I get from doing so?

I think there could be value in doing so, but not today. For example, if by keeping a patient controlled medical record I could avoid filling out the crazy stack of paperwork that’s given you at every new doctor you visit, I and every other patient would want to keep an online patient record. This should be a solvable problem, but I won’t go into the hundreds of systemic reasons why it’s not going to happen anytime soon. Although, we’ll start with the doctor preferring your allergies to be in the upper right corner in red. Now scale that request up to 700,000 doctors.

Similar to the above item, there are other ancillary functions (ie. appointment scheduling, prescription refills, message your doctor, etc.) that could be tied to your medical record that would make people want to use a PHR or other similar system. However, most people would use it for the ancillary functions and not to be able to control their medical record in one place. For many of the ancillary services this portal will need to be tethered to a PHR.

One trend that I hope will change my description above is the wave of new health sensors that are hitting the market. As those health sensors get better I believe we’ll see a new type of portal that is attractive for even a “healthy” person to visit. This concept coincides with what I call Treating a Healthy Patient. All of this new sensor data could make it worth my time as someone who thinks I’m healthy to check and aggregate my data in one location. The volume of data available would be much more than what I have stored in my memory and so it will make sense for me to visit somewhere that stores and processes my whole medical record.

How these portals full of health sensor data will work with doctors is a topic for another blog post. Until then, I’ll be surprised how many healthy patients really get on board collecting their patient data in a patient controlled medical record.