Mike Kirkwood. â Healthcare discussion Mike@polka.com
Focusing on the space of a âMe serviceâ for the healthcare industry
Includes âHealth Journalingâ app for itunes
Thereâs personal health records
Took engine that was user focused, and offered it to the providers.
Weâre training them to figure out how, rather them having to open up a personâs file, putting it into a record repository that the patient controls.
Finding that the record doesnât change that often
CFP2 â Robert Wood Johnson released as a way to share observations âacross the wallâ in a clinical setting and have them integrated into other test results and validated
Itâs a big deal
Sean Bohan â says that the big things are conformance (using your meds right)
40% of the problems is adherence
and 10% is fatal combination.
Sean â the other side is disease managementâ¦ Healthcare providers will offload patient management to small companies that would outcall
Payer is struggling with bad disease management because too many people are ending up in the ER which is the most expensive way to do disease management.
So the providers and payers want to incent people to take care of themselves so they donât end up in the critical phase.
Project Health Design â has a call to papers. Told clinical teams that if they can get a system to log daily livings, they will a system that will work.
This system would be part of the service delivery solution.
Can put HealthVault or Google Health in the middle.
So there are other players in the mix.. like the hospital or the doctor.
They would solicit the patient maintained data
HIPAA and HL7 data privacy issues had prevented this stuff from happening before.
Can add glucose monitor, heartbeat monitor (an Observation Engine) will then publish to the provider
Mike asserts that this sort of system should adhere to the 10 points that Joe brought up in the User Controled User session.
How is it secured. How is the data disposed of.
E.g. What does Blue Cross want? (not necessarily the clinician)
Once you collect it, you can assign filters (provider view, Payer view, my view) Realistically, the way data is exchanged betweenthe participants is hopeless. They just donât sync.
So the payer might foot the bill for the solution just to know whether someone is adhering to the drug administration requirements.
Adherence might be a little dicierâ¦ âCan it answer âdid he take his medsââ
Sean talks about the Persistence Curveâ¦ in terms of the revenue to the Pharma companyâ¦ People who take their meds all the time have fewer incidence of medical treatment
Sean â you still need the education.
Observation â 70% of the pills advertised directly on TV are prescribed.
What weâve learned in the past few months is that the Apple App Store has broken the back of the monitoring business. There are lots of apps for people to monitor their activity
Jim Morris says â the medical profession feels like they are controlling us with the ânon-complianceâ issues.
If there was ever a case where user empowerment this is it
Joe asks â have you looked at the data rights issues especially when it gets to âin aggregateâ reporting.
A: in the Polka view, you should be in control of both your data and âin aggregateâ.
If you can get 50 people to go into the T-test and get 10 of these. Then we will have 30-50 people to prove out. They think they can get statistically valid results with this population.
The control should be imposed for both individual and aggregated data
Clinical team can say what they want from the person.
Give them an iPhone and the app for monitoring their activity.
De-identivcation needs to take place right behind the Observation Engine.
Q: who would this be targeted at. Everybody out there to monitor both healthy and unhealthy activity so you can judge what to sell them and what to charge. Also figure out whether the rest of the family is involved.
Then there are people in the Disease management group who wouldnât want the data to be made available.
Then thereâs the idea of monitoring peopleâs behavior or whatever on Twitter or Facebook in order to determine what they would want to market to them.
The Use case is to validate the heart teamâs protocol. To prove that the tools that are out there and fun to use. âObservations or daily livingâ Also have them call on the phone in order to measure str
Asa- You can set up the stream to determine that âyou pay this side and charge that sideâ.
The incentive is you might get an iPhone and a Watch to get people to participate.
The real dividing line is between the collection of the info and then having control over how it is disseminated and who âknows itâs me.â
Insurance companies already say that they give you a better rate.
The weakness is that âpeople donât input data consistentlyâ
A: Beckton Dickinson has added Bluetooth to the devices that collect blood samples and all that
Joe â you would set this up so people would do it because they are doing something else â a point of sale dynamic
Mike â we had tracking on an iPhone (if people put in the data)â¦ So we added a public/private Twitter like microblog (140 characters)
Added a Type and in-depth object Added location
The Tweet describes the situtation
Then can add tags with Diet info and it gets mapped to the diet tool or whatever.
Sean â need a perpetual carrot.
Can also package it as a game.
Itâs not the game device. Itâs the game dynamics and the participatory nature
Thereâs a tweet-what-you-eat service
Q: does this scale. Or what percentage of the population will be tweeting or not.
Mike: You get monetized by the providers who will share the savings and they will publish a list of what apps are covered by a pyement provider.
Info will go through the observation engine where it will become part of the aggregate.
Then they will start to incentivize users in ways that make it âcompulsoryâ
Joe â thereâs an insane need to understand the 5% of the people who bother to tag. But youâre going to want to reach people when they are fully engaged. And when youâre fully engaged youâre not tweeting.
Sean â this idea of journaling (tracking) you do when youâre training for a marathon.
Thereâs a book called âFlowâ where they gave people pagers, and you have to write down what youâre doing. The pager prompted them to âtweet nowâ at specific intervals.
The system must be hardened against going down. E.g. when you put the healthcare in the middle (like when someone has a needle in a vein)â¦
One of the things we started implementing, included location (named, address or lat/long)
We learned that âhealth is untouchableâ because of HIPAA and that sort of thing.
Location is the same thing. People want to protect it. âI donât want people to know my health status (until I do) or my location (til I do). Health emergencies break that mold.
Joe recommends watching âSubsidized Fateâ â¦
Because people that want to use our data will use game design to add the dynamics and participation that we require.