In the September 8-15 edition of Time Magazine, they have a whole article about data and numbers. One of the pages is on which companies have the most cash. Apple is number one and the one you always hear about. As we’ve all seen, there are lots of rumors about Apple, Google, and Amazon and what they’re doing that is health related.
At the same time, I was intrigued to see all the health related companies on the list:
Medtronic – $13.7B
Abbott Labs – $8.1B
Merck – $27.3B
Pfizer – $48.8B
Johnson & Johnson – $29.2B
Abbvie – $9.9B
Eli Lilly – $12.7B
Amgen – $23.1B
Bristol-Myers Squibb – $8.3B
You have several other non-healthcare companies which are doing things in healthcare that are also on the list:
Walmart – $8.7B
GE – $14B
Procter & Gamble – $8.5B
Qualcomm – $31.6B
If you look at the Rock Health recent report, you can imagine how these companies could leverage all this money to really change healthcare. They could fund companies. They could buy companies. They could invest in orphan drugs. They could create new technology standards. They could educate consumers. They could push technologies like the Internet of Things.
As I’m enjoying my time thinking about what’s next, one of the things that I’ve thought a lot about key problem areas in our healthcare system. Obviously obesity is one of them. And, you have lots of companies trying to figure out what to do here.
Build an assessment tool (like Milliman or InterQual) which could be used for assessing patients and creating an evidence-based care plan.
Work with KitchenAid or others to create a branded line of smart devices which used the Internet of Things to do things like re-order healthy foods and suggest menus.
Work with FitBit or other device company and a gamification company to create a kid’s device linked to a game where the key player got fat tied to their activity level and where they opened up new levels tied to their behavior (e.g., eating healthy).
Create online communities for people to share stories and experiences (like PatientsLikeMe but moderated).
Work with Healthways and the Blue Zones effort to create a family centric option tied into the schools and focused on getting everyone healthy across generations.
Create a mobile coach using embodied conversational agents (similar to avatars) to drive behavior change and create a location-based prompts (i.e., as I pull into McDonalds).
Work with manufacturers to create a “beyond the pill” approach to obesity drugs that incorporates coaching and behavior change with the pill being the final mile which should drive greater formulary coverage.
Create a detailed patient journey map based on ethnographic research for weight loss with different triggers and create a “Coach certification” that can be used with coaches to certify that they are following best practices.
Work with biometrics companies (e.g., LabCorp, Quest) or clinics (e.g., MinuteClinic) to create an early identification process for obesity and/or metabolic syndrome with a process for them to “prescribe” a specific program.
Research and design ethnic specific obesity related programs for sub-populations within the US. For example, partner with the large Hispanic groups to create a Spanish (language, experience, culturally relevant) programs.
Partner with the ADA and NKF to jointly address metabolic syndrome together.
Work with a grocery store or food company to create an augmented reality process for smart phones or Google Glass that would highlight healthy foods on the shelf and help people shop better.
Work with Medicaid to create a process by which people earned cell phone minutes or lower copays based on activity and participation.
It got me thinking about other mash-ups to get into this space.
What about Pulte Homes working with BCBS of MI, the UAW, Ford, and the Henry Ford Health System to create a long-term retirement community built around an ACO with Medicare included? This could be a great offset for the UAW and Ford to their healthcare liabilities. It could create new provider models for Henry Ford. It would create new building opportunities for Pulte, and it would provide new underwriting opportunities for BCBS.
The other question that this brings up is who else will they acquire…or will others in this space get acquired by Cisco or AT&T or others that want to create this.
I’ve reached out to the Nest founder and some people at Google and Google X. (I don’t know any of them.) This seems really exciting and similar to some of my thoughts. I’d love to learn more.
And, perhaps with the news that some of the Google X people met with the FDA, maybe Google is figuring out a way to get back into healthcare. Hopefully, they don’t overlook the opportunity for patient remote monitoring in the smart home.
In 1998, I wrote my first business plan which was about technology and architecture. At the time, I had graduated from Architecture school and was working with Sprint on a data warehousing implementation. It got me thinking about how to create a series of connected devices and link them to an enterprise system to manage that data for a smart home. At the time, I think people thought I was crazy.
Jump forward 15 years and it all seems to make more sense. For example:
You have remote patient monitoring solutions like Healthsense working on smart beds, toilets, and other sensors that track motion and other activities in the home.
You have smart pill bottles. You have smart pills with companies like Proteus Digital Health.
“The Internet of Things (or IoT for short) refers to uniquely identifiable objects and their virtual representations in an Internet-like structure. The term Internet of Things was proposed by Kevin Ashton in 2009.[1] The concept of the Internet of Things first became popular through the Auto-ID Center at MIT and related market analysis publications.[2] Radio-frequency identification (RFID) was seen as a prerequisite for the Internet of Things in the early days. If all objects and people in daily life were equipped with identifiers, they could be managed and inventoried by computers.[3][4] Besides using RFID, the tagging of things may be achieved through such technologies as near field communication, barcodes, QR codes and digital watermarking.[5][6]
Equipping all objects in the world with minuscule identifying devices or machine-readable identifiers could transform daily life.[7][8] For instance, business may no longer run out of stock or generate waste products, as involved parties would know which products are required and consumed.[8] A person’s ability to interact with objects could be altered remotely based on immediate or present needs, in accordance with existing end-user agreements.[3]
According to Gartner there will be nearly 26 billion devices on the Internet of Things by 2020.[9] According to ABI Research more than 30 billion devices will be wirelessly connected to the Internet of Things (Internet of Everything) by 2020.[10] Cisco created a dynamic “connections counter” to track the estimated number of connected things from July 2013 until July 2020 (methodology included).[11] This concept, where devices connect to the internet/web via low power radio is the most active research area in IoT.”
“More objects are becoming embedded with sensors and gaining the ability to communicate. The resulting information networks promise to create new business models, improve business processes, and reduce costs and risks.”
Of course, the key is a core infrastructure that manages all of this data and starts to create algorithms for how to use it. Image being able to log in and get information about your house, your kids, your community, and your health. Some things are already out there and being developed.
Mother is a technology that summarizes all of this data and pulls it together for people to use and monitor.
Twine monitors your home and provides you with information such as your garage door is left open.
Ninja Sphere is another solution for controlling your home devices.
Thing Worx is another solution focused on this connected house.
Qualcomm and Verizon and others are getting into the health space, and you have companies like ADT or Time Warner that are already in the home and could expand into the health space.
The other thing that all this data drives is the need for insights. It’s no good to have data without the ability to turn it into knowledge. This is again something that Google knows a lot about. Imagine having a connected team of physicians that monitor your health based on your sleep patterns, your adherence, your exercise, and other key metrics such as blood pressure. Imagine a dietician that monitored your food and gave you ideas about how to eat better. There are lots of ways for the data to be used in an obviously Big Brother way, but if that could be turned on and off, then we could gain the insights without having to give up all our privacy.
But, in general, many people are willing to trade privacy for insights. That’s what we do every day.
This idea of the Smart Home or Connected Home or Intelligent Home got me thinking over the holidays. I even emailed Pulte Homes and Lennar Homes to see if they were doing anything in this space. (They didn’t respond.) I did stumble upon Home For Life Solutions which seems to be thinking about some of this and was talking about this back in 2009 in an article about Smart Homes and Aging in Place. I was talking to a friend on Friday, and he shared with me some very cool things that The Villages in Florida is doing to incorporate health into their community.
I can see so many opportunities here especially around the concept of Aging in Place. Imagine all the Baby Boomers getting older and wanting to stay in their homes. I’m not sure what Calico is going to do, but this could be an opportunity for them.
In a recent issue of TIME, Page discussed how Calico will treat aging and related diseases. He didn’t reveal much about the methodology, but stressed that Calico’s team will “shoot for the things that are really, really important.” The goal for Calico’s research according to Page, is to help prevent many diseases and have a greater impact on public health than drugs that target individual diseases. (from MedCity News)
Imagine if this community existed. You would be able to create your own insurance company. You could offer discounts. You could do the same with life insurance. It could be like the Snapshot from Progressive.
And, there is so much more opportunity:
When you drive into your driveway, why can’t your garage door recognize you. Why do you have to press a button to open the garage?
Why can’t my purchases at the store be tracked online so I always know what I have and what I need?
Why can’t a smart cookbook recommend a recipe for tonight based on what food is at home, what food’s about to expire, and what I ate for lunch to create a balanced menu and caloric mix?
Why can’t my devices order my prescriptions for me when I’m low?
Why can’t my calendar automatically reschedule my doctor’s appointment when something else comes up?
Why can’t my running shoes automatically order a new pair of shoes when the cushioning gets low due to too many miles?
One day, this will all happen where our house will be smart. It will understand what I like in terms of lighting, shows, and music. It will tap into my devices. And, I’ll be able to get monitored and insights that improve my life. And, best of all, this will be done in a sustainable way that improves the environment and our quality of life.
So…maybe I can get Google or someone else excited about this idea! It will take someone with a big vision to change the world, but I think it’s a huge opportunity!
NOTE: The opinions expressed here are those of the author and are not reviewed in advance by anyone but the individual author. They represent personal opinions not the opinions of any employer.
September 2, 2014 
Enabling Healthy Decisions 