Innovation has long been a driving force in health, wellness, and pharma. In this age of progressive medicine, forward-thinking physicians and patients look to technology for answers, insight, and support.
Health, Wellness, and Pharma
The ground beneath health and wellness is shifting. While it seems logical that health and wellness (prevention and maintenance) and healthcare (treatment) go hand in hand, the money we spend on the former versus the latter indicates a disconnect. It’s far cheaper to deliver preventative care to patients than it is to treat them when they’re already sick. Although there is a significant preventative care / wellness movement afoot in health care, the system like any large bureaucracy, is slow to change. In response, health and wellness startups as well as small task forces within larger health organizations, lighter on their feet and hungry for change, have been appearing in spades.
Perhaps not coincidentally, some incredible advances are happening right now in health tech. This, combined with the rapid dissemination of health and wellness research across major media outlets (newspapers, health magazines, IFLS, etc.), has created an interest in and market for the newest gadgets, supplements, and treatments. Rock Health reports that in the first 6 months of 2014, $2.3B venture capital dollars were invested in HealthTech, excluding biotech. There are bands that can track heart rate, movement, and calories burned. People can map several generations of their DNA. A smartphone can be used to measure blood sugar. Vitamin supplements are delivered in tailored packs.
Powering many of these initiatives is Big Data, providing insight to otherwise flat and passive tools. Giving people a fuller picture of their health with one-to-one correlative data (e.g., caffeine intake to mood), allows them to make informed decisions about the way they live their lives.
And this is just the beginning.
The Quantified Self
With the convenience of modern life comes its attendant hazards: sitting too much, fast and pre-packaged foods, pesticides, allergens. We retaliate with exercise, organic fruits and vegetables, and obsessive label reading. It’s a lot to keep track of. The quantified self argues that nearly everything about a person–physical, mental, and spiritual—is measurable and therefore analyzable. While the concept is nothing new (it’s essentially the scientific method), the tools certainly are. Mobile apps have made it incredibly easy for people to track everything from the chemicals in the food they’re eating to their mood to their sleep.
But not all tools are created equal. Offering consumers a way to track is one thing (“I slept 6 hours last night”). Showing them the data in an attractive way, another (“Plotted out on this beautiful graph, you’ll see your average sleep for the last 14 days is 7.14 hours”). Giving them actionable insights is the only thing that matters (“Six or less hours of sleep is correlated to eating more than 2800 calories a day”), and this is where many of these tools fall short–they lack the data piece that informs and inspires change.
One aspect of the Quantified Self movement that’s been widely criticized is: What’s the point? In other words, while it may be useful for you, personally, to know how many steps walked in a day or calories ingested, there’s no larger application for the data; it’s essentially a body diary. Enter Apple’s ResearchKit, an open source toolkit that will allow developers and researchers to build apps for research studies.
With the iPhone’s reach, ResearchKit will also make easier recruiting study participants — one of the biggest challenges in medical research. Many believe ResearchKit could also help lend some much needed diversity to medical studies, which historically have employed male subjects.
Some words of caution: ResearchKit has yet to be fully vetted. Because apps represent a brand new way of collecting data, concerns surrounding privacy, accuracy, and feasibility abound.
“Fitness trackers are useless without real-time, personalized data.”1
Unfortunately, when it comes to self-reporting, humans are terrible at making accurate estimates. No doubt this has something to do with the popularity of fitness tracking devices that users can put on and forget about. Still, the market shows no sign of slowing down and is expected to reach $8.3B by 2018 (Markets & Markets, 2013). Expect upcoming generations of fitness trackers, to do more with increased accuracy as well as to go beyond the band (OMsignal). Some will augment with human intervention, such as GOQii, which pairs its data tracking with personal training advice. Look also for other devices in the quantified self revolution like Scanadu. As this market gets more crowded, issues are sure to emerge–chief among them: People won’t likely want an entire body full of wearables; they’ll want one that meets most or all of their needs.
Furthermore, with ⅓ of all wearable users abandoning their devices within six months of purchase, there’s also a serious retention issue (Endeavor Partners, 2014). Many point to poor apps, little to no integration across devices and software, weak data, and awkward design as the culprits — perhaps a function of the hardware being too ahead of its time. Everyone’s eyes were on Apple’s Watch to change this, with its promised bleeding edge sensors that were set to make it a wearable apart — but Apple has recently had to pull back on those sensors, as they were plagued with usability, battery, and FDA-related issues. So where to turn now? Withings released its Activite watch, whose Swiss-made innards,“fine calf leather band,” and lack of a touchscreen makes it a bit of a throwback. Motorola and Huawei have both released Android Wear watches that are being well received for their looks and their utility.
The doctor is in … your smartphone
The healthcare model is in flux, one foot poised to step forward, the other grounded in a different time. Rising costs, increased patient loads, and changing patient expectations are necessitating new approaches.
The Internet was the first wave driver of significant change. Patients suddenly had unprecedented access to a lot of information, forever altering the doctor-patient relationship. Rather than waiting to be delivered a diagnosis, patients were walking into physicians’ offices armed with their own theories about what could be ailing them.
As in most industries, the next wave of disruption is mobile. Deloitte predicts that over 100M e-visits to doctors will be logged in 2014, saving the healthcare industry $5B2 These visits may be facilitated through traditional healthcare channels, such as in Wisconsin3, while others are transacted through 3rd parties like Doctor on Demand, which connects patients with a doctor via a mobile cam for $40. These e-visits are obviously not meant to replace the doctor-patient relationship, but rather to provide a quick, professional consult for minor ailments. PWC4 notes:
- Almost half of Canadians believe that mobile health apps will make healthcare more convenient in the next three years.
- Nearly two-thirds of Canadians would consider using vHealth options in their own care or for someone they care for.
Physicians, too, are increasingly turning to smartphones and tablets for support. There are apps that can advise on drug interactions, assist with diagnostics, track symptoms, and let them view X-rays. These tools are meant to help physicians save time through faster diagnoses and improve patient monitoring.5 To some, this marks a shift in the role of the physician, allowing them to become decision-based rather than memory-based. In other words, whereas doctors used to make diagnoses in isolation, calling on vast amounts of memorized information–symptoms, conditions, tests, etc.–to make diagnoses, they can now pair their knowledge with these new tools and real time data.
It can be incredibly difficult to form new habits, particularly health-related ones. Conventional wisdom says it only takes 21 days to form a new habit, but this is a gross oversimplification of human behaviour.6 It simply depends on the habit, the person, and, crucially, the support system. For many, this last bit is where things break down, and this is where tech has opportunities to support people in habit formation.
Patient adherence is a pain point for pharmaceutical companies, dragging down the rates of effectiveness of their medications and potentially leading to bad word of mouth. Many adherence issues occur simply because after the initial point of contact (the physician, the pharmacist), patients are sent on their way. When patients don’t adhere to medication instructions, this can impact both their own health and the health of others. A contributing factor to antibiotic-resistant diseases, for example, is people not finishing their courses of antibiotics. Apps can be a great way to facilitate adherence, as they can push simple reminders in whatever intervals necessary. This is particularly useful for medications that require timed or irregular dosing. Apps can also be used to deliver drug information–traditionally served as inserts that patients often throw away, no doubt intimidated by the small print and medi-speak–in a digestible manner.
As data on gym memberships and diets indicates, fitness and nutrition also suffer from adherence issues, even amongst the motivated. Judging by the success of Nike+/Fuel, Fitbit, My Fitness Pal (among many others), tracking, peer support, and gamification seem to be the perfect combination of factors to help people stay on track with their fitness goals. All of these products employ a four-part HOOK methodology to increase adherence: trigger (e.g., the ‘Taunt’ and ‘Cheer’ actions in Fitbit), action (e.g., working out), reward (e.g., hitting activity goal), and investment (e.g., accumulating Fuel points, making the leaderboard).
Some of our work in this industry
- We helped a pharma company build an app to help diabetes patients manage their condition through diet. Working closely with medical professionals and physicians, we developed an app that leveraged gamification and physician support to maximize patient adherence.
- A pharma company asked us to design and develop a tool for physicians whose patients suffered from a chronic illness. This tool allows physicians tracks the severity and duration of their patients’ symptoms over time, helping them recommend the appropriate treatment.
- Richmond, Shane. “Fitness trackers are useless without real-time, personalized data.” Mashable, 26 Jan, 2014.
- Kwong, Matt. “Tech Trends for 2014: Wearebles, phablets, and e-visits.” CBC, 14 Jan 2014.
- Wahlberg, David. “More Madison clinics offering ‘e-visits.’” Wisconsin State Journal, 19 Mar, 2014.
- PWC. “Making care mobile: Shifting perspectives on the visualizations of health care.” Price Waterhouse Cooper, 2013.
- Whalen, Jeanne. “Health care apps that doctors use.” The Wall Street Journal. 17 Nov, 2013.
- Layton, Julia. “Is it true that if you do anything for three weeks it will become a habit?” How Stuff Works, 2013.