#mHealth13, Aging in Place

I got a lot out of this year’s mHealth conference. I skipped last year. That helped with a little perspective.  Two years ago mobile, new treatments and technology connecting to healthcare were the disruptive influences in mind. Now health care reform and readmissions penalties are more significant and real disruptions. Policy changes turned what was unfocused tech excitement to serious betting on emerging business models and realistic expectation that payment streams for mobile/tech are on the horizon.

My review speaks more to what was NOT there. The elephant NOT in the room is interest and knowledge about the realities of long term care managed by families, delivered in homes distributed throughout urban and rural communities across the country and paid for with private dollars. This huge market is so disaggregated it is not on anyone’s mind. This market will grow, it will be connected to big healthcare and it will be lucrative. The mHealth crowd and $ has chosen to ignore this side of the technology/healthcare intersection. mHealth13 was the excited ‘roar’ of one hand clapping.

It is almost as if, to fit into the existing mess, the mHealth world decided to create a new silo intentionally avoiding any cross disciplinary synergies.  There are two sides to mHealth:

1. Big companies know big data is coming to healthcare. New lines of communication are coming among and between medical professionals, providers, systems and payers. New patient connections will monitor, treat and influence behavior. We are talking huge volumes of data. Verizon, AT&T, Qualcomm, Intel, GE, Johnson&Johnson, Walgreens, CVS, United Health, Kaiser Permanente, Microsoft, Pfizer and other big players expect to get pieces of  the pie. They will. The pie IS that huge.

2. Small companies, startups, entrepreneurs, inventors are there in droves. HUNDREDS. Literally. They pick a problem and build an app, product or software to solve it. It was hard for me to see the differentiators. I imagine there are nuances I missed. Most hope to land a demonstration  project with a bigger player, use that to leverage more and get acquired. Most will fail. That is the nature of startups, venture funding and tech R&D.

The big companies know this scale and quality of R&D is too expensive and difficult to explore  in house. Instead they support incubators where countless ideas are generated in hopes some entrepreneur will come up with the next great thing. The big players will benefit by transporting data, improving health, saving money, reducing costs.

Two stories emerged in my mind as I engaged in many great conversations on the exhibit floor and in and following sessions.

A. When mom is in the hospital and needs an IV or something they don’t hand her caregiver daughter three names and tell her to do some research. They get the IV! But that is what happens in homes. People are given, info, made aware and educated about what might exist and given phone numbers to do the research. This impossible management approach wears caregivers out and wreaks havoc on the business and agencies trying to provide service in community. Families don’t need info and awareness. They need trustworthy help making decisions.

B. We are told about sensors that track all kinds of things, like when a refrigerator is out of milk. This data goes to the overworked sandwich generation daughter who is either putting the kids to bed or preparing for a meeting when she gets the text message. She doesn’t need data. She needs the milk delivered.

Come on! Are we really saying that the lunar explorer quality sensor in that home cannot order milk from across town when, from almost anywhere in the world I can order, pay for and track the printing, packaging shipping and delivery of my new business cards to almost any address in the world in a few days?

My advice to both sides of mHealth? Do some homework. Hospitals need to discharge people into real world communities that have reliable long term care systems supporting the MILLIONS of families who pay out of pocket for services in homes. Families need coordinated systems that provide services and products. Study what is really going on, what is needed, not what is technologically possible. Build what is needed and will work. Profits await you.

Three more observations.

i. I met some really nice, smart folks from Europe, Asia and Africa. None of them can figure out our cockamamie health payer system. They are dumbfounded by it.

ii. Bright SPOT. The passionate advocates working for NGOs in countries where people have mobile phones but not running water or electricity. These folks are doing some great design thinking to improve healthcare delivery by learning from their clients. This is not such a novel idea…asking your clients what they want and how they want it to work. Pay attention!

iii. The piece of information cited most often was how few apps are downloaded more than a handful of times. Don’t waste time building something no one wants or really needs.

This week I am headed to the Long Term Care Quality Alliance conference. I hope my comments about another side of our housing and care future are better.