For those that are part of the Quantified Self movement, this is just a natural extension. You can now measure your different sports.
Swingbyte – a sensor that clips to your golf club to monitor speed, acceleration, arc, and other stats.
94Fifty Smart Sensor Basketball – a sensor embedded in a basketball to track shot speed, arc, and backspin along with dribble speed and force.
FWD Powershot – a sensor that fits into the handle end of a hockey stick and measures speed, angle, and acceleration.
Zepp Baseball Sensor – a sensor stuck to the knob of a baseball bat that tracks the speed and plane of the swing and the angle of impact.
There’s also the Babolat Play which is a smart tennis racket.
On the one hand, this stuff is fascinating and amazingly cool. On the other hand, who even knew that dribble force was something for me to be coached on. It will be interesting to see how athletes and coaches adopt these technologies and how they help improve sports over time. Will they increase the stress for the average athlete who was never going to be great and was just playing for fun? Will they improve everyone and help players and coaches really focus where they can make a difference?
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!
A few weeks ago, I had a chance to follow-up with Martha Wofford, the VP of CarePass about their latest press release. This was a quick follow-up interview to our original discussion. As a reminder, CarePass is Aetna’s consumer facing solution (not just for individuals who they insure) which integrates mHealth tools and data to help consumers improve their engagement and ultimately health outcomes.
“Many Americans have a lower quality of life and experience preventable health issues, adding billions of dollars to the health care system, because people do not take their prescribed medications. There are a myriad of reasons why medication adherence is low and we believe removing barriers and making it easier for consumers to take their medications is important,” said Martha L. Wofford, vice president and head of CarePass from Aetna. “As we continue to add new areas to CarePass around medication adherence and stress, we seek to provide people tools to manage their whole health and hopefully help people shift from thinking about health care to taking care of their health.” (from press release)
As part of this update, we talked about one of my favorite topics – medication adherence. Obviously, this is a global problem with lots of people trying to move the needle. In this case, they’ve included the Care4Today app from Janssen. This tool does include some functionality for the caregiver which is important. It also links in charitable contributions as a form of motivation. We talked about the reality that adherence is really complex, and people are different. This may work for some, but adherence can vary by individual, by condition, and by medication. But, they hope that this is a tool that may work to nudge some people.
I was also glad to see them taking on the issue of stress by adding the meQ app. This is a key struggle, and Martha pointed out to me that 1/4 of adults are either stressed or highly stressed.
“When people are under chronic stress, they tend to smoke, drink, use drugs and overeat to help cope. These behaviors trigger a biological cascade that helps prevent depression, but they also contribute to a host of physical problems that eventually contribute to early death…” – Rick Nauert, PhD for National Institute of Mental Health, 5/2010
She mentioned that they’ve gotten a great reception to this program, but they have a lot more to learn. They’re still in the early period of getting insights and interconnecting all of their efforts. We also talked about some of the upcoming opportunities with the caregivers (or the sandwhich generation). I personally think the opportunity to improve aging in place through a smart home strategy with remote monitoring is going to be huge of the next 10 years.
I did interview the Janssen people as a follow-up which I’ll post separately, but I also thought I’d include this video interview of Martha that I found.
Happy New Year! 2013 has been an interesting year in healthcare with 2014 promising many more exciting developments. A few of the biggest stories from 2013 include:
Healthcare.gov – the politics, the drama, and the missteps
Healthcare transparency and costs – new companies, new revelations, and an entire Time magazine focused on it
Healthcare engagement – ongoing focus on how to get consumers to engage
mHealth and QuantifiedSelf – apps and devices proliferate
Investment – a huge jump in VC and angel funding for healthcare
ACOs – do they work or not
Big Data – so much data…so many opportunities
Here’s my predictions for 2014:
Transparency – The race to bring cost data to the forefront of the consumer mindset will move from a radical concept to an expectation. With increased out-of-pocket costs and HDHPs, consumers will expect access and information to cost data. They will look for systems that can predict what they need and push data to them in a timely fashion using location based services and predictive algorithms.
Exchanges – With big companies trying the private exchanges and moving their employees to the federal exchange, we’ll see the market holding its breadth to see what happens. If this drives success on both sides of the equation – employers and payers, you can expect a large jump in this direction later in the year.
Mobile – The traditional member website will continue to die a slow death without mobile optimization in place. More and more consumers will access the healthcare system through a smart phone or device like an iPad. This will drive healthcare companies to figure out how to embrace user design and member experience in new ways as they strive to provide the sustainable app that consumers use more than a few times.
Providers – Providers will continue to cautiously embrace pay-for-performance, value-based healthcare, and models like ACOs and PCMHs. They will want them to work, but they will continue to look for the Tipping Point in which their overall panel is part of these programs. Providers will also begin to modify their workflows using technology based on Meaningful Use and the ubiquity of technology.
Engagement – Consumer engagement in healthcare will continue to be the elusive Holy Grail. Companies will try behavioral economics, incentives, and mass personalization to try and get consumers to understand healthcare and take actions to improve their health. There will be more shifting to include caregivers and embrace social media (e.g., Facebook) and peer-to-peer networks. We will start to see documented case studies and results in terms of improved outcomes.
Devices – While 2013 was the year of device proliferation, we will see the number of people (early adopters and QuantifiedSelf groupies) maxing out. I expect some further consolidation and a dip in adoption rate as we move into the period of disillusionment. Devices will be less about a standalone solution and look at how they integrate with the smart phone and existing systems (at work and home). Like smart pills and smart clothes, this will lead to increased data and integration into daily life. This will require collaboration with providers and employers to figure out how to come through this period.
Value-based – CMS will continue to be a big driver in pushing new payment models around healthcare as they struggle to figure out how to slow the tidal wave of costs coming in Medicare and Medicaid. This will meet up with some of the progress in the commercial space with ACO and PCMH models leading to an evolving path in terms of how drive value. This won’t be the breakthrough year, but we’ll see meaningful progress.
Investments – I don’t see any slowdown in healthcare investments. Our health issues aren’t going away in the US or abroad. China is just emerging with a long list of health issues and technology is creating new solutions in 3rd World countries.
Pills Plus – With pharma struggling with how to reinvent itself, they are going to look at new solutions like Merck is doing with Vree Health. This will cause them to look at many of these trends and how they wrap services, technology, and incentives around their medications.
Specialty Care – Specialty pharmacy will continue to be a big growth driver with novel innovations coming down the pipe. But, these pharmacies will realize that they can’t work in a vacuum. They have to do a better job at integrating care management into their services and partnering with Case Management companies to holistically treat the patient.
Metabolic Syndrome – The overall global issues of obesity and diabetes will become a huge weight around the shoulders of the healthcare system. While the focus will continue to be on the complex cases requiring massive dollars, the majority of people will be struggling with a chronic disease. Metabolic Syndrome will become a big focus for payers, employers, and health services companies as they try to find ways to prevent further complications.
Prevention – While I don’t expect a huge shift here, I think we’ll start to hear more voices on the perimeter yelling about why we only spend 5% of our dollars on prevention. They’ll point out other models outside the US spending more with better outcomes. Health Reform will begin to enable some change here, but it will be slow.
Community Based Care – With more people coming back into the healthcare system with Health Reform, there will be a greater need for location based access to healthcare. This will involve clinics but will be much broader. Companies will need to look at how they embrace community resources like churches to engage the disengaged and poor who don’t trust the system and have limited access to the traditional channels.
I always tend to see the glass half full so when I see a problem then I often want to rush in and try to fix it. With that said, here are 10 things that I’ve thought about that I’d like to fix or see as big opportunities:
1. The healthcare experience. While this is the third leg of the Triple Aim, it often seems like the one that is so hard for healthcare companies to get. The system is so fragmented that the patient often is forgotten.
2. Device integration. While devices are better and integration is possible, there is still a huge lift to integrate my data into the typical clinical workflow. This is only going to get much worse with ubiquitous use of sensors and will be the limiting factor in the growth of the Quantified Self movement. (See my post on FitBit)
3. Intelligent phones. This is something that people carry everywhere. They often live life through the phone sometimes missing out on reality. The phone has tons of data as I’ve described before. We have to figure out how to tap into this in a less disruptive way.
4. Consumer preferences. I’m a big believer in preference-based marketing. But the question is how do I disclose my preferences, to whom, and are my preferences really the best way to get me to engage. What would be ideal is if we could find a way to scale down fMRI technology and allow us to disclose this information to key companies so they could get us to take actions that were in our best interest. (see old post on Buyology)
5. Benefits selection. I’ve picked the wrong benefits a few times. This drives me crazy. As I mentioned the other day, the technology to help with this exists and all the data which sits in EMRs and PHRs should allow us to fix this problem.
6. The role of retail pharmacy. This is one of my favorite topics. With more retail pharmacies than McDonalds and a huge problem of access, pharmacies could be the key turning point in influencing change in this country.
7. Caregiver empowerment. Anyone who cares for an adult and/or child knows how hard it is to be a caregiver and take care of their own needs. This becomes even harder with the people being geographically apart. With all the sensors and remote technology out there, I see this being a hot space in the next decade.
8. The smart house. As an architect, I’ve always dreamed of helping create the intelligent house where it knows what food you have. It manages your heat and light. It tracks your movements and could call for help if you fall. I see this being an opportunity to empower seniors to live at home longer.
9. Helping the disenfranchised. For years, we’ve all seen data showing that income can affect health. The question is how will we fix this. Coverage for all is certainly a critical step but that won’t fix it. We have a huge health literacy issue also. Ultimately, public health needs a program like we had to get people to wear seat belts. We need yo own our fate and change it before we end up like the humans in the movie Wall-e.
10. A Hispanic healthcare company in the US. With 16% of the US that speak Spanish, I’m shocked that I haven’t seen someone come out with a health and wellness company that is Hispanic centric in terms of the approach to improving care, engaging consumers, and providing support.
At the conference last week, I was talking about the opportunity for retail pharmacy to play a broader role as the patient’s medical home. As part of that discussion, I tried to create a vision of a digitally connected location. Here’s my summary of that…
Imagine that the pill bottle you use is now a smart object (expanding on the RxVitality concept). It now knows when you are running low on pills. Since it’s connected to your WiFi signal and to your smart phone, as soon as you’re low, it does the following:
Send a new refill request to the pharmacy (or to your physician if you’re out of refills)
Puts a reminder in your phone for you to pick up the prescription (action item list, calendar) and updates that once it gets confirmation on time from the pharmacy
As you’re driving by the pharmacy, your smart phone reminds you to pick up the Rx as it knows where you are based on GPS.
When you enter the pharmacy, it has a system to capture information from your devices or phone about your sleeping habits, what you’ve been eating, and your exercise. All of this information is important for them to actively manage your health. Additionally, as you enter the pharmacy, they use a technology like FaceDeals to recognize you and do several things:
Alert the pharmacy that you’re in the store so they can pull your prescription
Pull up your CRM (customer relationship management) profile so they pharmacist and tech can great you by name and link back to other information (i.e., Hi George. Are you here to pick up your prescription? By the way, how did those crutches work out?)
Offer you a coupon on some new OTCs or medical supplies based on your chronic disease(s)
While you’re shopping (at a grocery or big box pharmacy), you’re linking your smart phone to the smart cart which is helping you navigate the store. As it confirms your identify via fingerprint or facial recognition, it opens up a link to your medical data. This allows the cart to help you navigate the store and scans everything you put into the cart to look for drug-food interactions (e.g., grapefruit juice). It also helps to steer you to better food options (eat this not that) based on your diagnoses (i.e., for a diabetic, I would suggest this other cereal). All of this is happening on your screen to protect your privacy.
By the time you get to the pharmacy, you stand in front of the register which has a scale embedded in the floor so they can instantly know your weight and compare that to your last measurement. Since they are now tied into your medical data, the Point of Sale technology also gets relevant alerts that they can talk with you about (e.g., Did you know that your health coverage has changed? Did you know that you have access to a health coach to discuss your condition?).
As you leave, all of the data they collected is integrated and pushed out to both your personal health record (PHR) along with the electronic medical record (EHR) that your physician uses. Any new risks identified are also shared with your caregiver or others in your social circle that you’ve identified and opted-in to receive information. This social connectivity helps to create the village necessary to drive change.
Scary or fascinating? I prefer to think about this as a fascinating way of leveraging technology and data to make my experience better and improve my outcomes, but I know not everyone will feel that way.
I was reading the mHealth Trends and Strategies 2013 by netcentric strategies, and I thought I would share a few things from the report. Of course, I like the acronym SMAC which I re-used in the title and in a recent presentation.
Mobile phone use for health information reached 75M in 2012.
Tablet activity for healthcare reached 29M in 2012.
50% of people will download mHealth applications (prediction).
“mHealth is not a separate industry, but rather it’s the future of a healthcare industry that’s evolving to care for patients differently, putting them first to deliver services better, faster, and less expensively.” quote from David Levy, MD, Global Healthcare Leader at PwC
Only 27% of MD actively encourage patients to manage their own health through mHealth applications. (problem)
13% of MDs actively discourage mHealth participation.
There is a whole section on remote patient monitoring with some good points about the system and the financial case. There is another section on preventative technology talking about adherence and compliance. It makes a key point which I believe is that technology will be welcomed by the 7M long-distance caregivers.
And, if you haven’t heard the term yet – BYOD. This stands for Bring Your Own Device which is about letting the user chose the device / interface that works for them but being flexible in terms of normalizing the data and using it within the workflow that you develop.
Have you seen the new “What’s Your Healthy?” campaign? Here’s a few shots.
BTW – My healthy is keeping up with my kids in sports and moving down a belt notch.
As many of you know, I consider Walgreens and Aetna to be two of the most innovative healthcare companies today (out of the big, established players). [And, full disclosure, I own stock in both.] I’ve talked about Walgreens (see Walgreens post on innovation) several times along with Aetna (see Healthagen post).
That being said, the new campaign along with the press caught my attention. I was glad that I was able to get some time with Martha Wofford who is the VP and head of CarePass.
“We want to make it easier for everyone to engage in their health and hopefully shift from thinking about health care to taking care of their health,” said Martha L. Wofford, vice president and head of CarePass from Aetna. “CarePass helps consumers connect different pieces of health data to create a fuller, more personalized picture of their health.”
I spent some time talking with Martha and team about their initiative. Here’s some highlights that stuck out to me.
There use of goals was really easy and intuitive. If you log-in to the CarePass site and get started, you have 3 options or you can create your own (see below). We spent some time talking about the importance of making these relevant to the individual not focusing on “healthcare goals” like adherence or lowering you blood sugar. Most of us don’t think that way. As they described them, they picked “motivation centric goals”.
I was also really interested in how they picked which apps to recommend. There are so many out there, and many of you know that I’ve been fascinated by the concept of curating apps or prescribing apps to people. They had a nice, simple process:
Which apps are most popular?
Does the app have “breadth”? (i.e., national applicability)
They also spent more time pre-screening apps which collect PHI to understand them before listing them on the site.
They’re using the consumers goals to recommend apps to them.
The other big question I had is why do this. It certain helps build the Aetna brand over time, but there’s not direct path to revenue (that I see). They described their efforts as “supporting the healthcare journey” through connected data. Ultimately, it’s about making Aetna a preferred consumer brand which may be very relevant in the individual market and exchange world in the not too distant future.
I like the idea of companies being “app agnostic” as I call it. Walgreens is doing this. Aetna is doing this. I plan on doing this in my day job. This allows the consumer to pick the app that works for them and as long as the data is normalized (or can be normalized) and the app provides some type of open API (application programming interface) it’s much easier to integrate with.
We talked a little about what’s next. Metabolic syndrome is something they brought up. This is something that Aetna’s been talking about in several forums for a while now. They launched a new offering earlier this year. (I still hate the term metabolic syndrome from a consumer perspective, but it seems to be sticking in the healthcare community.)
We also talked about new goals to come around smoking cessation, medication, and stress.
Another discussion I have with lots of people is how this data gets used. (see a good article about what’s next for QuantifiedSelf) I personally really want to see my data pushed to the care management team to monitor and send me information. (Eat this not that type of suggestions) Martha talked about how the data belongs to the member and they have to choose to push it to the coach. She also talked about how they’re integrating with their PHR (Personal Health Record) first and then looking at others. (see old interview with ActiveHealth)
In summary, CarePass is a nice additional to your #QuantifiedSelf toolkit. As you can see from the screenshots below, the GUI (graphic user interface) is simple. It’s well designed. Integration with your apps is easy. It provides you with goals and motivation. They help you navigate the app world. And, it helps you bring together data from multiple sources. Once it can pull in all my Rx, medical and lab data along with my HRA data and my device data, it will be really cool! But, I know that I’m a minority in that effort. I’m really intrigued by the lifestyle questions they ask and wonder how those will ultimately personalize my experience.
So, what apps do they share? Here’s a screenshot, but you really should log-in and try the site and see the full list. It’s simple and worth the effort.
As an added bonus, I’m adding a presentation I gave with Aetna at the Care Continuum Alliance two years ago. I was searching for my past interviews with Aetna people and found this online so I added it to SlideShare and put it here.
I’m excited to be presenting in the Fall with Adam Fein and lots of other great speakers at the 2nd Bio/Pharma Retail Strategy Summit to be held September 18-19 in Philadelphia, PA.
I get to talk about one of my favorite topics which is how health reform is driving change in the industry and enabling new opportunities for the pharmacy / pharmacist.
You get to listen to me for 90-minutes so I’m hoping to find some great examples, data, and insights to get you thinking hard about your business and the white space here. I hope to see some of you there. If interested, I’m passing on a discount code they offered to me as faculty.
If you haven’t heard, “sitting is the new smoking” in terms of health status. And, unfortunately, you can’t just get up and exercise for an hour and then go sit all day. That brief spurt of exercise doesn’t change the fact that we sit for 9+ hours a day.
If you think about our shift in work from a very manual work environment to a service and technology work environment, we’ve made activity during the day harder and harder to achieve. Between e-mail and meetings, most of us are stagnant to accomplish our work.
On the flipside, perhaps the person interviewing should really be asking to see their potential boss’ activity data. I’d be as interested in knowing what happens during the day. It would provide a lot of insight into what happens in terms of meetings, face-t0-face activity, and be a good proxy for the real work experience.
Of course, the other option would be to introduce “walking interviews”. People talk about walking meetings. I’ve even done a running meeting going for a jog with a potential partner to discuss how we work together. (It was the only time we could find to meet at a conference.)
Walking interviews would tell you a lot about someone’s health. You could go up some stairs. You could walk a few miles in an hour.
Since we know that health, happiness, and wealth are all correlated, this type of insight for the interviewer and interviewee seems very valuable.
While we are generally a society focused on innovation from start-ups (and now all the incubators like Rock Health), there are a few big companies that are able to innovate while growing. That’s not always easy and companies often need some catalyst to make this happen. Right now, there are four established healthcare companies that I’m watching closely to track their innovation – Kaiser, United/Optum, Aetna, and Walgreens. (Walgreens has made the Fast Company innovation list 3 of the past 4 years.)
I think Walgreens is really interesting, and they did have a great catalyst to force them to really dig deep to think about how do we survive in a big PBM world. It seems like the answer has been to become a healthcare company not just a pharmacy (as they say “at the corner of Happy and Healthy”) while simultaneously continuing to grow in the specialty pharmacy and store area.
Let’s look at some of the changes they’ve made over the past 5 years. Looking back, I would have described them as an organic growth company with a “not-invented-here” attitude. Now, I think they have leapfrogged the marketplace to become a model for innovation.
They got more involved with medication therapy management.
They increased their focus on immunizations increasing the pharmacists role.
They formed an innovation team.
They invested heavily in digital and drove out several mobile solutions including innovations like using the QR code and scanning technology to order refills.
“Today’s announcement marks another step forward in establishing an unprecedented and efficient global pharmacy-led, health and wellbeing network, and achieving our vision of becoming the first choice in health and daily living for everyone in America and beyond,” said Gregory Wasson, President and Chief Executive Officer of Walgreens. “We are excited to be expanding our existing relationship with AmerisourceBergen to a 10-year strategic long-term contract, representing another transformational step in the pharmaceutical supply chain. We believe this relationship will create a wide range of opportunities and innovations in the rapidly changing U.S. and global health care environment that we expect will benefit all of our stakeholders.”
“With this service expansion, Take Care Clinics now provide the most comprehensive service offering within the retail clinic industry, and can play an even more valuable role in helping patients get, stay and live well,” said Dr. Jeffrey Kang, senior vice president of health and wellness services and solutions, Walgreens. “Through greater access to services and a broader focus on disease prevention and chronic condition management, our clinics can connect and work with physicians and other providers to better help support the increasing demands on our health care system today.” (from Press Release)
This is something for the whole pharmacy (PBM, pharma, retail, mail, specialty) industry to watch and model as I talked about in my PBMI presentation (which I’m giving again tomorrow in Chicago). It reminds me of some of the discussions by pharma leaders about the need to go “beyond the pill”.
This is about how the QuantifiedSelf movement can change your view of the world. Ever since I’ve been using the FitBit (see my review) and focusing on getting 10,000 plus steps per day, I’ve noticed a change in how I view the world.
Here’s some examples:
We got 12″ of snow yesterday. I was immediately thinking about how great of exercise it would be to shovel the snow. I was excited to go out several times and shovel.
When I was flying today, I was thinking “hopefully we’ll get dropped off at a far gate so I can get in some extra steps.”
I’ve been excited to clean the house and get in the steps from cleaning.
I look forward to grocery shopping.
I park farther away in the parking lot.
I’m sometimes intentionally less productive at home to get a few extra sets of stairs in for the day.
When I’m cutting brownies, I’m calculating out how many brownies are supposed to be in the recipe and making sure I cut them to the right size.
When I eat something, I think about how many steps I’ll have to walk (or run) to burn off that food.
When I pick meals at a restaurant, I’m always looking for their nutritional menu or going online before ordering.
It’s a totally different way of thinking about life when you look through these “quantified self glasses” to see the world through a “health lense” about calories, exercise, sleep, stress, and other dimensions.
In the spirit of the Quantified Self movement and in order to better understand how mHealth tools like FitBit can drive behavior change, I’ve been using a FitBit One for about 6 weeks now. I’ve posted some notes along the way, but I thought I’d do a wrap up post here. Here’s the old posts.
The user interface is simple to use. (see a few screenshots below)
I feel like it works in terms of helping me learn about my food habits. (Which I guess shouldn’t be surprising since research shows that having a food diary works and another recent study showed that a tool worked better than a paper diary.) For example, I learned several things:
I drink way too little water.
I eat almost 65% of my calories by the end of lunch.
Some foods that I thought were okay have too many calories.
In general, the tracking for my steps makes me motivated to try to walk further on days that I’m not doing good.
The ease of use and simple device has helped me change behavior. For example, when I went to go to dinner tonight, I quickly looked up my total calories and saw that I had 600 calories left. Here’s what I ate for dinner. (It works!)
But, on the flipside, I think there are some simple improvement options:
I eat a fairly similar breakfast everyday which is either cereal with 2% milk and orange juice or chocolate milk (if after a workout). [In case you don’t know, chocolate milk is great for your recovery.] Rather than have to enter each item, FitBit could analyze your behavior and recommend a “breakfast bundle”. (and yes, I know I could create it myself)
Some days, I don’t enter everything I eat. When I get my end of week report, it shows me all the calories burned versus the calories taken in. That shows a huge deficit which isn’t true. I think they should do two things:
Add some type of daily validation when you fall below some typical caloric intake. (Did you enter all your food yesterday, it seemed low?)
Then create some average daily intake to allow you to have a semi-relevant weekly summary.
The same can be true for days that you forget to carry your device or even allowing for notes on days (i.e., was sick in bed). This would provide a more accurate long-term record for analysis.
The food search engine seems to offer some improvement opportunities. For example, one day I ate a Dunkin Donuts donut, but it had most types but not the one I ate. I don’t understand that since there’s only about 15 donuts. But, perhaps it’s a search engine or Natural Language Processing (NLP) issue. (I guess it could be user error, but in this case, I don’t think so.)
Finally, as I think about mHealth in general, I think it would be really important to see how these devices and this data is integrated with a care management system. I should be able to “opt-in” my case manager to get these reports and/or the data.
The other opportunity that I think exists is better promotion of some things you don’t learn without searching the FitBit site:
They’re connected with lots of other apps. Which ones should I use? Can’t it see which other ones I have on my phone and point this out? How would they help me?
There’s a premium version with interesting analysis. Why don’t they push these to me?
And, with the discussions around whether physicians will “prescribe” apps, it’s going to be important for them to be part of these discussions although this survey from Philips showed that patients continue to increasingly rely on these apps and Dr. Google.
Finally, before I close, all of this makes me think about an interesting dialogue recently on Twitter about Quantified Self.
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.
June 7, 2014 
Enabling Healthy Decisions 