Hey can that robot make me live forever?

Robots, nanobots, human-looking robots…the race is on. It’s not a race to market. It’s actually a race to immortality. The Japanese pioneered the robot development as early as 2005…with RI-MAN: 

But the evolution has gone much further and, like so many things, is accelerating.

As the author, Peter Nichol says on CIO.com: Medical nanotechnology is expected to employ nanorobots that will be injected into the patient to perform work at a cellular level. Ingestibles and internables bring forward the introduction of broadband-enabled digital tools that are eaten and “smart” pills that use wireless technology to help monitor internal reactions to medications.

Robotics for healthcare are classified in three main categories of use:

  1. Direct patient care robots: surgical robots (used for performing clinical procedures), exoskeletons (for bionic extensions of self like the Ekso suit), and prosthetics (replacing lost limbs).  Over 500 people a day loses a limb in America with 2 million Americans living with limb loss according to the CDC.
  2. Indirect patient care robots: pharmacy robots (streamlining automation, autonomous robots for inventory control reducing labor costs), delivery robots (providing medical goods throughout a hospital autonomously), and disinfection robots (interacting with people with known infectious diseases such as healthcare-associated infections or HAIs).
  3. Home healthcare robots: robotic telepresence solutions (addressing the aging population with robotic assistance).

Why is this hot?

  • Robotics, pioneered by the Japanese as early as 2005 (RI-MAN above) is fast moving to nurses with human features and AI ability to do Q&A. They are already in research and university hospitals.
  • While the 3 categories are a general framework, the nanobot itself crawling through your bloodstream, checking for cancer cells, knitting your arteries, oxygenating our blood, preventing them from hardening and causing heart disease.
  • For those of you under 30 who think your immortal, you may have a chance.

I leave you with a forward-looking TED TALK on this topic from January, 2017:

 

What is better? Doctor as authority or shared decision-making?

The Wall street Journal ran a piece this week about the power of shared decision-making and the impact it has on patient satisfaction, cost savings and healthier outcomes. While it was a simple and positive report, the findings are radical in that it is another herald of the transforming healthcare system.

Why is this important? Take Mass General, rated the #1 Hospital in the entire U.S. last year. They are not just doing one thing right to make the healthcare system work better for all, but they are doing neatly everything right. The hospital — and many others — have come to realize that the old model of “Doctor-as-authority-figure” does not really work any more — patients don’t feel in control, they often regret decisions, and last, they often end up NOT following the doctor’s orders and stop taking their medication, the impact of which is said to be over $200 billion in lost productivity every year.

Enter shared decision-making, which has had a radical impact on patient satisfaction. This visual aid is used to help patients make cancer treatment decisions:

Why is this hot? Because this heralds a major shift in a decades-old communication model, one that the entire U.S. society incorporated into their medical relationship with their doctor and thus, their health. This shared decision-making is not a mandate, but common sense; but even common sense in this case is a disruptor of the doctor-as-authority, which is how doctors are trained and inculcated into their own mindset. Radical that the doctor cedes this control; radical that the patient engages in complex decisions and comes away satisfied.

So, for Mass General, the results have been dramatic:

 

 

 

 

For Healthcare, empathy is THE strategy in a cynical customer-centric world

HCP empathy 2.19

Empathy is considered one of the high attributes of emotional intelligence; it is the foundation of strong relationships. These days, great brands work hard to align their message to provoke some emotion — joy, aspiration, sadness, outrage — but the hardest emotion to communicate is empathy. While it is used as a means to bond with a brand, it usually is packaged with cause-related marketing like raising money for a disease research.

What more apropos industry to embrace empathy as a differentiating strategy than Biopharma and healthcare? It is an industry that ranges from high science to high emotion. Why not use empathy to say to patients, “We get you. We care. Trust our medication. Trust our hospital.” What’s more is the government is rewarding doctors and hospitals on empathy.

Let’s go through some examples of how technology is creating the path to applying empathy as a business strategy. In fact, at many hospitals, they are training doctors to be mor empathetic. Patient satisfaction scores are now being used to calculate Medicare reimbursement under the Affordable Care Act. And more than 70 percent of hospitals and health networks are using patient satisfaction scores in physician compensation decisions.

First, Healthloop, an App that is in beta but has great promise. Hospitals in the post-Affordable Care Act world, have new metrics for both reimbursement and are rated (yes, up to 5 stars!); Biopharma companies are being judged by insurers on Outcomes (did the treatment actually work?) — it all comes down to being gaining competitive advantage for doctors, hospitals and even Biopharma.

This video for Healthloop says it pretty well:

Next is Ginger.io…a mental health support App. This is an amazingly human digital experience; unlike so many (abandoned) Apps, this one actually covers a 360 degree view of your day-to-day mental health. It stays relevant. It offers contact and human contact; advice that is simple, exercises that are based in cognitive behavioral sciences.

Giiger io HS 2.19.16

Calm down kit HS 2.19.16

The Calm down Kit (above) is the best! How human can you get? If I were in a depressive funk, “watching cute puppies” may seem frivolous but it is reinforcing the need for positive thought.

Why is this hot? For CXM, how do we account for this? How do we understand that this is core emotional driver for patients in choosing hospitals and doctors — even treatments. Technology and good UX is finally enabling the ability to deliver an emotional experience. But all good strategies need measurement for validation and optimization: Do we need to evolve the definition of ROI? Should it be ROI which accounts for Empathy and UX? Return on Empathy? Can we measure this? Is this the ultimate Engagement metric? Healthloop caring, helpful content and interaction is reminding us who really cares. The patient testimonial on Healthloop says it all:

HL HS tstiminal 2.19.16

Ransoming my health data? Wearable’s and Cyber security

According to a recent Forrester Report on Cybersecurity, hacking health records, devices and wearable’s and using the information to ransom — yes, ransom — people’s health data is on the rise. On the face of it, it seems odd, after all why would anyone want my health data and what would they do with it? Aren’t these criminals satisfied with my credit cards or Social Security number? No. A credit card can be cancelled, your health records are permanent.

This was the headline on MedCityNews after they read the Forrester report:

The biggest cybersecurity threat for 2016 could be hackers holding patients ransom for the use of their medical device

Seems dramatic? Maybe not. Ask the 4.5 million records hacked from UCLA Medical Center — they suspected it was criminals looking for celebrities health records.

H sauce 11.19 hospital breaches

Ask the 80 million people who trust Anthem and had their information hacked.

H Sauce cyber Hack UCLA 11.19

At the heart of this disturbing trend is the rise of Ransomware, a form of malware.  FastCompany wrote about the Ransomware trend recently (http://goo.gl/bDlelc): Symantec estimated conservatively that upwards of $5 million is ransomed every year. How do they prefer to get paid? Bitcoin the favorite currency of choice.

H Sauce 11.19 hacking RansomWhy is this hot? Because as the explosion of Electronic Health Records, wearable’s, devices and the looming Internet of Things all coalesce, we see that the healthcare industry has lagged far behind others in putting proper measures in place to protect the most intimate information of all. The prevalence of the malware is accelerating faster than the security measures of the industry. Data is growing exponentially, yet protection of it is in its infancy.

H Sauce wearable growth 11.20

As Eric Cowperthwaite  the CEO of Core Strategy a security firm said: “…if the health care data stolen from these breaches was ever combined with the data stolen from the Office of Personnel Management, it would be the Holy Grail of electronic data on almost all people with government clearances,” Cowperthwaite said.

Imagine this message: “We know you suffer from major depression? How would you like the world to know?” Or if you failed a drug test, or had a preexisting condition that could hurt your job prospects. This is so scary, it just gets darker the more you think about it. Stay tuned for what the security industry reaction is.

Let Doctors be Doctors! So says Rapper Dr. Zubin (With Over 1 million views!)

HSA 11.6. Dr Zubin photo

This post is about the Affordable Care Act. Or maybe it is about one doctor, Doctor Zubin. Like all major legislation, the ACA is complex and has it’s detractors and advocates. In some cases, one person can be both. Case in point: nearly all healthcare professionals agree that it is great that eventually the entire healthcare system will be tied together electronically — which will help lower costs, create healthier more empowered patients and allow doctors and others to coordinate patient care at a level no one could ever imagine.

That at least is the theory. The reality is that Electronic Health Records — the first step in Connected Health (my post of last week) — are a debacle. Hospitals and doctors offices keep installing and then throwing them out. One major criticism is the User Experience — but that goes beyond the interface. UX in this case is that doctors are trained to observe and engage with a patient, not look away and peck on a laptop keyboard. In other words, EHR’s are getting in the way of doctors being doctors.

HS EHR Use 11.6.15One doctor — Dr Zubin — is sick of it. What has he done? Gone on YouTube and taken on the broken healthcare system in musical rap videos and is trying to ignite a cause campaign to change healthcare. He has over a million views. As he states on his YouTube channel about his most recent video:  “EHR’s suck. Let’s make ’em better. Go to http://LetDoctorsBeDoctors.com and tell the IT and government folks what’s up. And check out http://zdoggmd.com for lyrics, behind-the-scenes dopeness, and all our other videos. Please SHARE…or the machines win.”

Why is this hot? First, it is radical that a doctor would create such a cause and bring it to life so creatively and publicly. Second, his use of social media, YouTube, multi-channel integration, is brilliant. Last, kudos for his boldness. He is taking on his entire industry and profession and broken many unspoken rules in his profession — decorum, keeping opinions private, even going against his own hospital employer! But I think his own video on October 19th on EHR’s speaks for itself:

 

Can Twitter really tell you which hospital offers the best care?

Healthcare and Social is a fast-changing landscape. While Biopharma manufacturers have been slow to adopt social strategies and presence many hospitals use Twitter aggressively to engage with their patients, and influence hospital choice through seeking satisfaction comments. This is certainly true with “Likes” on hospital Facebook pages. But a “Like” in some ways is more passive than a posted Tweet. The Tweet is often a more immediate post hospital care reaction and has a ripple effect. Amazingly enough, as of early 2015, nearly half of all U.S. hospitals have Twitter accounts.

Twitter hospitals H Sauce 10.30

 One study, which was published this month in the journal BMJ Quality and Safety, (http://goo.gl/dkkmB7) examined whether Twitter could be a reliable, real-time indicator of hospital quality. The study, researchers crowd-sourced U.S. hospital Tweets to determine whether their overall sentiment could denote quality of care.

The study found a positive sentiment correlation to the use of Twitter.  They also observed that smaller hospitals in more rural settings had deeper engagement, which makes sense as a local issue. But a true disconnect was unearthed: Twitter sentiment was not associated with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings but just having a Twitter account was. So, while positive engagement helps the hospital brand equity and reputation, the government’s own ratings do not yet measure it. So why have a Twitter account? Simple: engagement drives business in a world of customer-focused healthcare insurance.

Another study concluded that Twitter had a very positive impact on the overall goal and metrics the hospitals use. From “Tweeting and Treating: How Hospitals Use Twitter to Improve Care.” (http://www.ncbi.nlm.nih.gov/pubmed/26217995), Dr. Frederick, July 2015.

“Savings opportunities are generated by preventing unnecessary office visits, producing billable patient encounters, and eliminating high recruiting costs. Communication is enhanced using Twitter by sharing organizational content, news, and health promotions and can be also a useful tool during crises. The utilization of Twitter in the hospital setting has been more beneficial than detrimental in its ability to generate opportunities for cost savings, recruiting, communication with employees and patients, and community reach.”

As it turns out, Twitter is also a pretty good gauge of hospital quality. The study found that “hospitals that people liked on Twitter were also doing better at not having patients come back within 30 days – one of the indicators of care quality.” Twitter logo h sauceWhy is this hot? Adoption of Social in Biopharma manufacturers is far behind that of hospitals. Also, hospitals are being held to ever-increasing quality-of-care metrics – these metrics act as badges of honor but are needed to attract patients to their services. If they keep patients from being re-admitted to the hospital within 30 days, the Affordable Care Act rewards them with higher reimbursement. Also, hospitals are pioneering what sort of content engages patients and community. Look at Mayo Clinic, they have 1.23 million Followers. True, they are a world-class brand, but it shows what is capable and a hunger for connection. Biopharma should watch hospital Twitter experiences very carefully.

In terms of content, an expert on the topic weighs in…

Alicia Daugherty, who works with the Advisory Board’s Marketing and Planning Leadership Council, points out several key strategies for hospitals that are trying to maintain vital, active Twitter feeds: “It’s all about relevancy–the care experience prompts patients to follow the hospital, and then it’s up to the hospital to sustain their attention with interesting, useful content,” Daugherty says. She separates hospitals’ most engaging tweets into three common categories:

  • Practical health advice: Daugherty notes this is easy to offer, although Twitter is somewhat saturated with health tips and tricks.
  • Unusual or counterintuitive information: These tweets can be more interesting, but harder to provide on a regular basis.
  • Content that sparks a conversation: However, the most active discussions may center on controversial topics–and that’s “usually best avoided” for hospitals, Daugherty concludes.

As an example, just look at what the Cleveland Clinic has on it’s page today…education, help, hope.

Cleveland clinic Twitter 10.30

Breaking down the healthcare walls: TEMPLE adds Digital Health Center.

A hospital with a Digital Health Center? A surgeon who creates Apps? This may be a first for the industry and a harbinger of things to come. This new Digital Health Center was created by one of TEMPLE’s leading thoracic surgeons — who in turn has a company that creates that partners with the hospital to create a wide range of Apps, the first of which has been hugely successful for their COPD (Chronic Obstructive Pulmonary Disease) patients.

Clearly, both this surgeon and the TEMPLE Hospital system is taking a step out of its comfort zone and venturing into unknown territory. Or perhaps, they are creating a new model that turns truly embraces the entire digital health system. Doctor Criner explains it all in this short video interview:

 Why is this hot? The U.S healthcare system is over a trillion dollars in revenue, costs, development, investment…and more to come. The acceleration of change in the entire system is an outcome of the Affordable Care Act. While medical innovation in surgery is at the heart of what hospitals do, individual digital innovation is not.

For clients in Biopharma who have been slow to embrace their own Digital Transformation, this is the sort of news that would get a smart CEO to pick up the phone and say: “How can we work together?”

Just look at the company (http://www.hge.healthcare/) Doctor Criner has created; it has a profound Mission statement, and serves up proof through the effectiveness of it’s COPD patient App:

HGE Mission H Sauce 8.7H Sauce TEMPLE HGE COPD 8.7.15

Doctor Criner may not be alone — in fact Cleveland Clinic, Mayo Clinic and others are working hard to develop technology infrastructure. This is different. This is a doctor and a hospital that seems to get that “digital” is a philosophy not a laptop. To truly serve patients, control costs, and embrace the future, it starts with developments like this. Doctor Criner and TEMPLE “get it”: the future is here. Grab it. the early adopters have a better chance at market advantage as hospital systems compete against each other.

Interoperability, the Holy Grail of the ACA, is when every hospital, EHR, medical record, remote tele-health, can all communicate and share medical and patient records. In some ways, Doctor Criner has moved the world an inch closer by creating a link between innovation at the hospital and in the hands of patients.

“That’s how much that hospital charges? I’ll go somewhere else!”

We all know the hospital/cost/insurance makes no sense from a consumer perspective — I know someone who got a $30K bill for a gall bladder operation, only to be told a week later he only had to pay $3K. What happened? What deal was made? Where did that $30k come from and why did it go away? As of today, we have no view into the arcane health system cost structure.  With high deductible plans, the ability to chose your own hospital, transparency is critical to have to make informed decisions.

Sensentia is about transparency of medical costs and information…will it take off? Patient empowerment is often discussed but rarely delivered; Congress has mandated that eventually — and they keep pushing the date out — hospitals will be required to post ALL their costs for patients to be able to chose which hospital to use. Hot Sauce Sensentia page 1

This week, a report on health care innovation mentioned Sensentia out of the Healthbox incubator in Miami. Not only is this a cross-platform, interoperable User Experience, it is a great Customer Experience in that the combination of easy interface, natural-language queries and how it summarizes complex financial information makes it a great tool for life-critical decision-making.

Why is it hot? One reason: money. Hospital transparency and patient adoption of hospital-related decision tools are being mandated by the government. This natural-language tool crosses devices, platforms and basically connects all the parts of the system — patient, hospital and insurance company. The patient is key — their adoption will accelerate the transparency we need. Perhaps even better, the User Experience is so easy and natural that it removes so many of the complex barriers that surround healthcare costs, making complexity move to simplicity.

Tools like this may be slow to be adopted by the health system, but there are government mandated Star Ratings and other metrics that have been put in place — like Meaningful Use 2 — which financially reward a hospital if they meet milestones and deliver quality care; there are also financial punishments if they do not adopt such technologies and then train patients to use them.

This is about Patient empowerment and how it can shape what is a creaky, deal-making, back-room, mysterious system to one where I, as a patient, can make an informed choice.