Disruptive or not, digital health has to address systemic problems

By Neil Versel
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Neil_Versel_LargeSpeakers didn't pull many punches on the first day of the 10th annual Healthcare Unbound conference in Aurora, Colorado, Thursday, nor did they always agree, either.

"Go forth and disrupt. Go forth and disrupt patient care," instructed health IT consultant Vince Kuraitis, principal and founder of Boise, Idaho-based Better Health Technologies, and a member of the conference advisory board. That was at 8:30 a.m.

By mid-afternoon, the audience at the University of Colorado Anschutz Medical Campus heard this from Shahid Shah, CEO of Silver Spring, Maryland-based Netspective, another IT consultancy: "Nothing you do is going to disrupt healthcare." That is because healthcare is an industry responsible for one-sixth of the U.S. economy. Even $1 billion in improvement is not disruptive to that, Shah said.

However, addressing even a small slice of a $2.8 trillion market can be worthwhile. "Find your tiny, little niche segment of healthcare and do what you do really well," Shah advised. A personal health record, for example, will not work for everybody, but it might work for a population of newly diagnosed cancer patients.

Neal Sofian, director of member engagement at Premera Blue Cross in Seattle, poured cold water on the strategy, popular among payers and large employers, of offering financial incentives to get patients to assess their own health risks, because patients frankly don't care much about such risks. "I think health risk appraisals are absolute crap," Sofian said rather bluntly. "We have beaten the risk horse dead, mercilessly."

Sofian further wondered aloud, "What if Starbucks had to pay you $20 to drink their coffee?"

"Start thinking about what's important in terms of the data we collect," Sofian advised. "It's not about health. It's about risk." And the assumption – an incorrect one, in Sofian's opinion – is that people will act if they are given enough information about risks for their own health.

"No," Sofian said. "It ain't dog food if the dog don't eat it."

In other words, people actually don't pay attention to risk, yet the healthcare industry keeps trying to apply "a medical model" to health, according to Sofian. "People don't care about their health. Why do we keep telling them to care about their health?" Sofian wondered. "What people want to do is lead their lives."

And what motivates them to make healthy choices are life events. "I just finished losing 15 pounds," Sofian said. "Why? Because next week I turn 60."

Think not about risk and disease but purpose and energy, Sofian advised. To this end, Premera has created a new app called Juice, in conjunction with Mindbloom, a Seattle-based developer of apps aimed at improving the quality of people's lives. Juice helps users find correlations between habits and their energy level and encourages adoption of healthy habits.

On the provider side, Dr. Mark Blatt, worldwide medical sales director for Intel, told his fellow physicians to stop asking for technology that fits into their current workflows. "Pardon me, your current workflow sucks. I don't want to enable it," Blatt said.

"Marcus Welby is dead. I became a doctor because I wanted to be Marcus Welby," Blatt added.

Healthcare is a bubble because of runaway costs, according to Blatt, yet so many industry players want to keep on providing a substandard, expensive product. "It's unaffordable," he said. "If you can't afford it, why would anybody make it?"