Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Tuesday, February 06, 2018

The Economist Weighs In On Digital Health. It has Not Gone Well In The Past But They Think This Time Will Be Different.

There are a Leader and 2 articles in this week’s issue on Digital Health.
First we have:

Data and medicine: A revolution in health care is coming

Welcome to Doctor You
Feb 1st 2018
NO WONDER they are called “patients”. When people enter the health-care systems of rich countries today, they know what they will get: prodding doctors, endless tests, baffling jargon, rising costs and, above all, long waits. Some stoicism will always be needed, because health care is complex and diligence matters. But frustration is boiling over. This week three of the biggest names in American business—Amazon, Berkshire Hathaway and JPMorgan Chase—announced a new venture to provide better, cheaper health care for their employees. A fundamental problem with today’s system is that patients lack knowledge and control. Access to data can bestow both.
The internet already enables patients to seek online consultations when and where it suits them. You can take over-the-counter tests to analyse your blood, sequence your genome and check on the bacteria in your gut. Yet radical change demands a shift in emphasis, from providers to patients and from doctors to data. That shift is happening. Technologies such as the smartphone allow people to monitor their own health. The possibilities multiply when you add the crucial missing ingredients—access to your own medical records and the ability easily to share information with those you trust. That allows you to reduce inefficiencies in your own treatment and also to provide data to help train medical algorithms. You can enhance your own care and everyone else’s, too.
Vastly more here:
First we have this article:

Apple and Amazon’s moves in health signal a coming transformation

The world’s biggest tech firms see a rich opportunity in health care, which could mean empowered patients, better diagnosis of disease and sharply lower costs
Feb 3rd 2018
THE past decade has seen the smartphone become a portal for managing daily life. Consumers use their pocket computers to bank, buy and befriend. Now this array of activities is expanding into an even more vital sphere. Apple has spent three years preparing its devices and software to process medical data, offering products to researchers and clinical-care teams. On January 24th it announced the result. The next big software update for its iPhone will include a feature, Health Records, to allow users to view, manage and share their medical records. Embedded in Apple’s Health app, the new feature will bring together medical data from participating hospitals and clinics, as well as from the iPhone itself, giving millions of Americans direct digital control of their own health information for the first time.
Apple’s fellow tech giants are also on the march into medical services. On January 30th Amazon announced a partnership with Berkshire Hathaway and JPMorgan Chase to create a not-for-profit health-care company for their own employees that promises to employ technology to provide cheaper care than conventional health insurers offer. For the past year, the e-commerce giant has also been exploring a venture to use its logistical prowess to start selling drugs online.
Alphabet, Google’s parent, has just launched a third health-care firm, Cityblock Health, to operate alongside Verily, a subsidiary based in San Francisco, and DeepMind Health, an arm of its London-based artificial-intelligence (AI) firm (a fourth company, Calico, is working to extend human lifespans, but does not provide health-care services). Alphabet already claims to be able to use AI to predict possible deaths of hospitalised patients two days earlier than current methods, for instance, allowing more time for doctors to intervene. Facebook and Microsoft are preparing to add health care to their core businesses of social networking and software.
Lots more here:
This is a great article that show how much is underway down in the weeds but also recognizes in the last few praagraphs:
This time may be different
It is worth remembering that the prospect of technology firms transforming health care has been heralded in the past, only to disappoint. Google started a health-records initiative in 2008, but shut it down by 2011, citing poor adoption. Microsoft made similar efforts with similarly low take-up. Yet ten years on, the centrality of the smartphone, with its potential to give patients access to their data whenever they want and wherever they are, changes the game.
So too does the inexorable logic of the data economy. Data sets that contain information about human health are hugely valuable. At a time when health-care budgets around the world are stretched, payers are desperate for insights that might enable them to cut costs while maintaining quality. The more data the tech firms can handle, the more they will learn about human health, and the better the services they can offer will become.
That raises some familiar concerns. Privacy is an obvious one: the tech world’s mindset of “move fast and break things” works less well when it comes to health data. And the same competition issues that dog Google’s search business and Facebook’s social-networking service would arise in health care, too, if a particular AI diagnosis platform, say, were to became dominant. DeepMind’s work in Britain is already on the radar of the EU’s competition watchdogs. Meanwhile, Amazon’s partnership with Berkshire Hathaway and JPMorgan Chase will lure in huge quantities of patients’ data, leading to continual improvement of its services and, potentially, fears about dominance.
Apple’s entry into the field offers some answers to these worries. Its efforts in health so far have been cautious. The only patient data it processes now come from its partnership with Stanford University, and in future the firm is likely only to analyse medical information from those patients whose trust it has fully secured. Its services will be opt-in; patients who find themselves in hospitals working with Alphabet’s DeepMind, by contrast, are offered opt-out consent mechanisms.
Earlier attempts by Google and Microsoft to offer patients a home for their digital records obliged people to consider whether they trusted the two companies enough; many decided the answer was no. If they only have to decide whether their own iPhone is sufficiently secure, many will believe that it is. Apple has so far lagged behind other technology giants in earning revenues from the booming market for data. It may yet strike gold in the most sensitive personal-data category of all.
Saying ‘this time it’s different’ is of course often the prelude to it not being so we need to stand by!
Lastly we have this on Medication Management and Digital Therapeutics and Apps:

A new sort of health app can do the job of drugs

Smartphones are increasingly delivering verified treatments for diabetes, addictions and ADHD
Feb 1st 2018
LUANN STOTTLEMYER has had diabetes for 23 years, but it was only in 2016 that her doctor prescribed a treatment that changed her life. It has allowed her to bring her blood-sugar levels under control and lose weight. Yet this miracle of modern science is not a new pill. It is a smartphone app called BlueStar.
The program is one of a growing number of apps that America’s Food and Drug Administration (FDA) has approved to treat everything from diabetes to substance abuse. The FDA has encouraged firms to join a scheme that aims to streamline the regulatory process for such treatments. There are many candidates: at least 150 firms globally are developing some form of “digital therapeutic” (“digiceutical” in the lingo), says Mark Sluijs, who advises Merck, a big American drugmaker.
Unlike other sorts of digital health apps, digiceuticals have been tested for efficacy, approved by regulatory agencies such as the FDA and are prescribed by a doctor. Most gather data, either by asking patients for information or by using sensors, and provide real-time guidance. Diabetes apps, for instance, work with connected monitors and use the information to manage symptoms. Apps that help users to stop smoking combine a breath sensor with coaching on how to quit. Addiction-fighting apps can be based on cognitive behavioural therapy.
Vastly more here:

All in all a reasonably balanced but maybe a too optimistic view of the future. Time will as usual tell. Certainly seemingly not focused on the barriers! Definitely worth a read.

The scope and quality of the analysis makes one wonder just how much of all this the ADHA is on top of and how much it is taking account of the obviously swift and profound changes. I can see just no future for the myHR. Patients want to share the health information with their doctors and family - not with the Government!

  The Economist provides 3 articles per issue with free registration and 2 without registration.


Trevor3130 said...

Without reading the articles in The Economist, they seem on a par with editorial in The Age 'Time to lift health's veil of secrecy', which is based on a paper from Grattan Institute 'All complications should count: Using our data to make hospitals safer'.
The common theme seems to be that consumers of health services need only to be given access to all the data, and with the aid of smart apps they will be able to navigate their way through the complexities to better their own health.
If the underlying premise is that ordinary citizens are smart, even wise, then a few minutes spent observing the entrance at the nearest mall should disabuse that notion. About 30% of adults in my postcode are visibly obese.

Dr Ian Colclough said...

Putting all the hubris and marketing hype to one side I concur with your observation David, that whatever the 'barriers' (and there are many) no mention is made of them. Add to that the observation that the 'problem' that 'they' are trying to solve does not seem to be 'clearly' defined (anywhere). This thus leads one to ask on both counts 'Why not?' And if that is not done then where will all this new energy and focus lead to?

Anonymous said...


The comments in the above blog are interesting. Our elders are not to be dismissed, years of experience teaches you a thing or two.

Anonymous said...

@7:06AM. The comment from Dr Hambleton sums it up nicely - it’s not the system it’s your lazy GP if only your GP....... the ADHA must have watching every website known to human mind ready with an army of ‘experts’ to quash any questioning of the belovered machine. This is getting a bit sad to watch.

Bernard Robertson-Dunn said...

Your GP provides the best assessment of the value of myhr. The fact that there are lots of downsides and no upsides to primary care physicians should tell any, well informed, reasonable, unbiased person that this system is going no-where.

Anonymous said...

Anon Feb 07, 2018 7:38 AM. It appears a pattern of seeding stories in the media maybe a strategy. Reading this article this morning I found the last sentence interesting and little to do with the article


By the end of 2018 every Australian will have a MyHR unless they have opted out.

A lot of this ‘marketing will go unrecorded as it will be below the threshold for commonwealth agencies. I will be interested to see who funded the Monash study.

Dr Ian Colclough said...

@7:38 AM It has absolutely nothing to do with "lazy GPs", far from it, they are hard working, diligent and smart enough to use IT when it can help them in the daily grind of practicing medicine. They are also quite capable of discerning when a system on offer will not help but will hinder. This has all the makings of a Shakespearean tragedy; that t were not so.

Anonymous said...

I am not sure that was what 7:38AM intended to convey. Ready the Doctors comments you could interpret to allude to GPs need to pick their game up, you could also interpret it to hint at encouraging a longer visit thus improving the consultation fee. I am sure it was a comment made with the best intentions