Health VRM

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Mike Kirkwood. – Healthcare discussion Mike@polka.com

Focusing on the space of a “Me service” for the healthcare industry

Includes “Health Journaling” app for itunes

There’s personal health records

Took engine that was user focused, and offered it to the providers.

Kaiser Healthnet

We’re training them to figure out how, rather them having to open up a person’s file, putting it into a record repository that the patient controls.

Finding that the record doesn’t change that often

CFP2 – Robert Wood Johnson released as a way to share observations “across the wall” in a clinical setting and have them integrated into other test results and validated

It’s a big deal

Sean Bohan – says that the big things are conformance (using your meds right)

40% of the problems is adherence

and 10% is fatal combination.

Sean – the other side is disease management… 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 don’t end up in the critical phase.

Project Health Design – 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 don’t 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 dicier… “Can it answer ‘did he take his meds’”

Sean talks about the Persistence Curve… in terms of the revenue to the Pharma company… People who take their meds all the time have fewer incidence of medical treatment

Sean – you still need the education.

Observation – 70% of the pills advertised directly on TV are prescribed.

What we’ve 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 – the medical profession feels like they are controlling us with the “non-compliance” issues.

If there was ever a case where user empowerment this is it

Joe asks – have you looked at the data rights issues especially when it gets to “in aggregate” reporting.

A: in the Polka view, you should be in control of both your data and “in aggregate”.

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 wouldn’t want the data to be made available.

Then there’s the idea of monitoring people’s 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 team’s protocol. To prove that the tools that are out there and fun to use. “Observations or daily living” Also have them call on the phone in order to measure str

Asa- You can set up the stream to determine that “you pay this side and charge that side”.

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 “knows it’s me.”

Insurance companies already say that they give you a better rate.

The weakness is that “people don’t input data consistently”

A: Beckton Dickinson has added Bluetooth to the devices that collect blood samples and all that

Joe – you would set this up so people would do it because they are doing something else – a point of sale dynamic

Mike – we had tracking on an iPhone (if people put in the data)… 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 – need a perpetual carrot.

Can also package it as a game.

It’s not the game device. It’s the game dynamics and the participatory nature

There’s 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 “compulsory”

Joe – there’s an insane need to understand the 5% of the people who bother to tag. But you’re going to want to reach people when they are fully engaged. And when you’re fully engaged you’re not tweeting.

Sean – this idea of journaling (tracking) you do when you’re training for a marathon.

There’s a book called “Flow” where they gave people pagers, and you have to write down what you’re doing. The pager prompted them to “tweet now” 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)…

One of the things we started implementing, included location (named, address or lat/long)

We learned that “health is untouchable” because of HIPAA and that sort of thing.

Location is the same thing. People want to protect it. “I don’t want people to know my health status (until I do) or my location (til I do). Health emergencies break that mold.

Joe recommends watching “Subsidized Fate” …

Because people that want to use our data will use game design to add the dynamics and participation that we require.