Mar. 6, 2015

With the rapid prevalence of mobile devices and various types of social networking tools, along with open data trends, healthcare services in the United States have been riding the waves of big changes. It is getting easier for consumers to access/release healthcare data. For innovators, there are more opportunities to develop cheaper and more convenient healthcare services/solutions. When consumers find healthcare services meeting their needs, they become more aware of their own health, which can push the transformation from sick care to health care in the US healthcare system. While concerns about data security persist, expectations of innovation are mounting.

Healthcare services in the United States are changing to become more open and transparent. There are several factors behind this change, such as the rapid prevalence of mobile devices and social networking tools. As consumers use them to access more information, they expect more sophisticated and higher levels of services from healthcare providers than ever before.

Another factor is the increasing amount and types of data about patients’ health that have become accessible. With the government-led open data initiative, so much critical data, which had never before been public, are now publicly available. Digital health movements, including the accelerated adoption of electronic health records (EHRs) on the healthcare providers’ side, also have made and will make even more data available.

Motivated developers combine the data in unique ways to discover new insights and develop new healthcare services to meet consumers’ evolving needs. These emerging services have gradually made the existing closed healthcare system more transparent, and promote patients’ awareness of their own health. These trends enable a smoother transformation of healthcare systems from sick care to health care.

While more data is collected and made publically available for improving healthcare services, data security is one of the challenges innovators face. Mr. Matthew Holt, co-founder of Health 2.0* , which hosts conferences showcasing the leading cutting-edge innovations for healthcare worldwide, shares his thoughts on the future of healthcare services in the era of big data.

Interview with Mr. Holt

Q.Do you find any similarities/differences in the needs toward innovation in healthcare among different countries?

Health 2.0 conferences first started in the United States and now we hold them worldwide, including in Europe and Asia. In 2015, we will have one in Japan as well. Of course, cultures, healthcare systems, and regulations are all different; however, for every country, there are three things going on. First, everybody is spending more and more for healthcare and looking for a way out. No matter who or where you are healthcare spending is a bigger part of the economy, especially as the population ages. Japan, for example, has one of the fastest aging populations in the world.

Second, in every country, patients are getting better informed and changing the expectations of healthcare; however, the primary and acute care hospitals have poor communications. Even though healthcare facilities have the latest technologies, there is always the issue of interoperability. This big communication gap between primary and acute care hospitals can be obstacles for improving healthcare services based on data usage.

Third, everybody is using the same basic technologies and devices, such as the Internet, smartphones, social media, video, and so they all are learning from each other to tackle common issues.

Q.Do you think data availability is good enough for future innovation in terms of volume and quality?

There are mainly three different data types used for healthcare innovation. The first is data about individuals, including clerical data, administrative data, financial claims, etc. Usually the data about one individual is spread among many different places in data silos, and there are a significant number of attempts in the US to consolidate those data sets in order to make the US more interoperable. Also, data source quality is a very big problem and so a lot of money is spent to address this issue.

The second is health data that have been held privately or collected by the government and held quietly. These data are now being opened up for developers to create theories, correlations, and the like. The US government has been promoting this open health data movement mainly for public health purposes.

The third data set is the new types of data coming into the system, which includes data from new measurement devices in a patient’s home or body, such as blood pressure monitors or vital signs monitors, as well as genomic data. There are many attempts to match genomic data with what is going on with a person’s health and find correlations between them. Now even genomic test kits are commercially available for individuals. While data keep increasing, we are getting better in terms of data usage, but are by no means perfect.

Q.How do you evaluate the US data security regulations and do you think they are an obstacle for innovation?

The US has the federal act about data privacy and security called the Health Insurance Portability and Accountability Act (HIPAA). I think what HIPPA intends to do and how it operates are two different things. HIPAA is intended to protect patients’ rights to access data and control it, and the concept of HIPAA keeping the data confidential but useful is emerging pretty well. In reality, however, it’s been used by the healthcare system to tell patients they cannot access their data.

The practical problem is a lot of data is in cloud-based systems, so a copy of a patient’s data can be accessed anywhere and it may be downloaded to a computer that may not be encrypted. Now thousands of peoples’ data have been potentially exposed, and there have been huge problems at the organizations who are liable for the data. For example, Dr. John Halamka, CIO of Beth Israel, says that he spends 50% of his time on data security and protection, instead of innovation. With more understanding of how the data are moving around, I believe we are moving to a world where there are more consumer controls on data.

Q.What do you think of crowd intelligence trends in healthcare innovation?

There are many innovation contests worldwide to encourage developers to create new healthcare applications/solutions. Of course, selected innovations by peer voting cannot always become successful in the market, but crowd intelligence allows people to access and contribute innovative ideas, and I think it is very powerful.

Another strength is that it changes the current top-down model of information. For example, patients in online communities learn about a tremendous amount of information that doctors never told them by exchanging information about medical treatments, such as how to deal with side effects. It is a valuable movement, because the more involved the patients are in their care, the better the care tends to be. However, this can get wildly off the rails. For example, you have these anti-vaccination movements of those who think some vaccinations cause other healthcare issues, and now you have measles outbreaks in some cities. So of course there is always a risk in crowd intelligence.

Q.How do new innovative healthcare services, which make healthcare more open, challenge the traditional systems?

There has been a big shift toward new ways of organizing care and moving toward universal care. New innovative services that are more transparent and convenient for consumers are changing the way healthcare and services are provided as well as the doctor-patient relationship.

Traditionally, if one catches a cold, the healthcare delivery is only a 15-minute office visit with information and diagnostics being provided. Now we are just at the point where virtual visits are becoming very well known. Patients can see healthcare professionals wherever they want and with whatever devices they use. Not only innovative startups, but also leading healthcare providers, such as Kaiser Permanente, and many healthcare insurance systems have started to provide this service.

We’ve already started seeing retailers entering the market including Walmart, and I think more participants other than traditional healthcare providers will begin providing innovative healthcare services to meet consumers’ needs. We are just at the starting point of that wave, and I think it is going to be pretty fast.

Q.How does the implementation speed of Obamacare impact innovation in healthcare industries in the US?

The Affordable Care Act came to law in 2010 and since then there have been many issues. However, it has caused a large change in insurance reform, focusing on changing the way the providers get paid. And we know it’s coming. Healthcare organizations are changing the way they operate. Obamacare necessitates better information services across the board, better connection with patients, and better interoperability. In addition, since The Health Information Technology for Economic Clinical Health (HITECH) Act passed in 2009, $25 billion of government money has been spent for healthcare IT, including EHR adoption by US doctors and hospitals. It is a significant change. The world of IT in healthcare had been pretty small before then. So even though there may be a slowdown in Obamacare implementation, the movement toward digital health has already started, and that is not going to stop.

Q.What types of technologies or services will make a big wave in 2015?

I think online coaching is going to be very big. It is kind of happening already, but more companies last year have started this type of service. In online coaching, clinicians or healthcare professionals provide healthcare management advice/coaching along with social support. Some are volunteer-base services, but some are directly purchased by consumers. Online coaching could be covered by insurance, because insurance companies think encouraging healthcare management is going to save money at the end of the day. We expect that online coaching will shift the focus of healthcare services from sick care to health care.

In terms of innovative technologies, it is worth watching the possibilities of wearable devices. People are interested in how it is going to be used in healthcare, other than collecting an individual’s vital signs, and how that collected data is used. However, now more than 10% of the population is using wearable technologies, which are available in most retail stores. In January, there were more than 50-60 new smart watches displayed at the Consumer Electronics Show (CES). So wearable technology is already here, and although it’s not going to be an early adoption, once it is adopted by the healthcare industry, it is going to be a mass adoption.