How Consumers Will Fix The Healthcare System, Part I

By Yuri Teshler - August 18, 2015
Two weeks ago, my wife and co-practice lead, Jeanne, wrote an article about a topic you don’t see much in the Tech space. It generated a great deal of interest and shares, so we know it resonated with Forbes readers. She listed the several ways we, as a society, have become fatter and less healthy. Jeanne and I will be tag-teaming articles in the Health Consumerization practice at Moor Insights & Strategy and here on Forbes. So I’ll be the first of the two of us to tell you that I don’t think we have a health care problem that can’t be solved. It will be technology, particularly the emerging Human Internet of Things (HIoT), that helps us make meaningful changes. Companies like Apple, Garmin, Fitbit Inc. and Withings are already household names integral to the IoT and HIoT, so it wouldn’t be a stretch to see them arming consumers in the coming revolution in health care delivery. consumer-healthcare-1127x1940 Photo Credit: Illustration by Yuri Teshler with image © As the title of this article suggests, I believe that consumers will be the ones to fix the health care system. And consumers are going to do it in two distinctly separate, but equally important, ways:
    1. Consumers will use technology to improve their health.
    2. Consumers will use technology to force efficiencies and improvements in the delivery of health care.
Today I’ll talk about how consumers are using technology to improve their own health. I’ll discuss how consumers will force efficiencies in health care delivery in my next column. As Jeanne noted in her article, a lot of the problems we have in health care are self-inflicted. We simply are getting sicker. More than 25 million Americans have diabetes – 8.3 percent of the population – with another 79 million Americans estimated to be pre-diabetic, according to the American Diabetes Association. I haven’t even touched on the other big health care issues: heart disease and chronic obstructive pulmonary disease (COPD) the remaining two of the Big Three health care crises in the U.S. today. Unless people start to become healthier, our health care system is going to be overwhelmed very quickly. There will be too many patients for the system to handle the way it is designed today. There will not be enough money to care for everyone who is sick, and there isn’t a way for the health care system to influence consumers to change their habits. What’s exciting about technology, especially wearables and wireless monitoring devices, is how they empower consumers to make meaningful changes and improvements to their health, on their own. Even better, this current generation of wearables can empower those with chronic conditions to better monitor and manage their conditions. In the last five years with the invention of devices from innovators like Fitbit and Jawbone, the market is rich with monitors that track our movement and activity. Moov Now, Garmin, Withings, Misfit, Xiaomi and even Swarovski have entered the game. We have seen an explosion of other consumer health and wellness electronics like digital bluetooth scales, glucometers, blood pressure and EKG monitors, along with tens of thousands of health-related apps that allow us to get real-time information and insights about our health and fitness conditions. How important is this? For the first time we’re able to get a baseline of how active we are and how our bodies are responding to the food we eat and the exercises we are doing. This is part of the problem with our current health care system: Until recently, we had no way of understanding how our body is performing unless we visited the doctor. The acceptance and use of wearables is a huge step in helping people understand, through technology, the way that they can achieve a healthier lifestyle. These HIoT devices are giving us personal insight that can allow us to change our behavior. I bought a Jawbone Up in 2012 and put it on my wrist 24/7 for a month without changing my behavior to establish a baseline of my daily activity. I was shocked to discover that I averaged only 3000-4000 steps per day. This device gave me insight as to why I was gaining weight every year. For the next month, I used my Up to help me hit a 10,000-step mark. I started taking conference calls away from my desk, pacing back and forth and walking around the office. When the weather was nice, I would walk conference calls outside. Just by changing my behavior, I was able to add 5000-7000 steps more per day. This wrist instrument changed my behavior for the good, as it has done for millions of other individuals. For the first time I was able to get measurements of my body and use those measurements to improve my health, and, magically start losing weight. Today I frequently hit over 20,000 steps daily, and since 2012 I have lost over 25 pounds and it has stayed off. How important is human instrumentation? In the early day of the automobile there were few instruments guiding the driver. In fact, the 1908 Ford Model-T had no speedometer, fuel, oil, or temperature gauges. Today, a modern automobile has 200-400 sensors, giving us a wealth of information in real time: how fast we are going, how far we can go before we run out of fuel, and even alerting us to real and potential mechanical and safety issues. Body sensors, intelligent measuring devices and a multitude of apps are the human instrumentation that will assist consumers in achieving or maintaining better health. The new crop of 2015 devices is way smarter than the first generation and they can help consumers accomplish more than attaining a health goal. Today I wear an Apple Watch. It is a huge leap forward in health insights. (But I’ll talk about that more a future article.) What’s great about this new group is that they are combining multiple sensors to gain greater readings of our bodies. So rather than having to wear, say, a heart rate monitor, a step tracking device and a GPS enabled device, we are compressing wearables into multi-function devices.

Intel Basis B1 Band combines an optical heart rate engine, 3-axis accelerometer, skin temperature, and galvanic skin response, for a richer data set. Samsung Simband includes an accelerometer, gyroscope, ECG, galvanic skin response sensor, multiple optical sensors to measure pulse/heart rate, and a skin surface thermometer. All the data can be transferred wirelessly via Bluetooth 4.0.

iFixit’s teardown of the Apple Watch has revealed that the sophisticated heart-rate monitor used is actually capable of acting as a pulse oximeter, allowing it to calculate the oxygen content of your blood by measuring how much infrared light is absorbed. This data would be useful for health and fitness monitoring, but the functionality is not currently enabled in the watch. Equally important to helping consumers achieve health and/or wellness goals like better fitness or weight loss, these new generation wearables are also capable of helping people do a better job of managing their chronic conditions. The same technologies that are measuring our oxygen level, heart rate and pulse for fitness activities can be used by a diabetes, heart disease, or chronic obstructive pulmonary disease patient to help monitor critical readings that can help users make instant decisions about whether to seek immediate medical attention. Much like the “check engine” light in a car, the presence of an out of range reading can alert the user to seek answers. Not only can these devices bring needed security and comfort levels to patients (and their caregivers), it could potentially save the health care system billions of dollars and countless hours currently lost to inefficient management of patients with chronic conditions. Imagine combining these devices with the cognitive compute power of technology like IBM Watson. We could start teaching people how to manage their conditions in entirely new ways. Human instrumentation, in its current iteration of wireless, continuous monitoring and ease of use, is here to stay. Consumers are buying, and buying into, the promise of these devices: We can help you reach your goals. Combined, Fitbit, Jawbone and Nike, for example, owned 97% of the fitness tracker market in 2013, according to Mobile Health News. And the fitness trackers category made up about $238 million in sales in that same timeframe, they note. It is impractical to expect the health care system—which engages with the average consumer of less than five days per year—to solve the national health crisis that is being caused by behaviors that are occurring for 365 days per year. The promise lies in the sensors and instrumentation that, for the first time, allow consumers to become much more engaged and aware of what’s happening to their bodies in real-time. Human instrumentation from stallwarts Apple and Fitbit Inc. and startups we have never heard of yet can and will change human behaviors for the better. I’ll discuss the reality of a consumer-led health care revolution in my next column. And the technology winners in this revolution may just surprise you.
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