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AMA Startup Pilots the Future of Connected Care

Health2047's CEO envisions a future with plenty of mHealth but perhaps a little less transparency and telemedicine.

By Eric Wicklund

- The American Medical Association isn’t “nibbling at the edges” when it comes to supporting new tools and technology for healthcare. The organization is a founding partner in Health2047, a San Francisco-based innovation studio featuring experts in everything from machine learning and analytics to gaming design.

AMA on telehealth, mhealth

The company’s goal is the transform healthcare in the U.S. over the next three decades, and mHealth is going to play no small role in that transformation. mHealthIntelligence.com recently sat down with Health2047’s CEO, Dr. Doug Given, an internist and infectious diseases doctor and entrepreneur who has founded or run five biotech companies, to take a closer look at the future.

mHealthIntelligence.com: You’re an integrated innovation company launched in part by the American Medical Association – you’re described on your website as “Pirates hired by the Navy.” How does that background help healthcare providers looking for the next great mHealth app or platform? 

Doug Given: Pirates and squids both have deep and valuable expertise in the ways of the sea, but they’re sailing different ships towards the same horizon. By bringing them together, we are able to leverage a bigger, broader knowledge pool and move faster toward the desired destination. Health2047’s multidisciplinary set of experts collaborate with the AMA, physicians and a growing set of innovation partners to develop, guide and chart healthcare solutions that will fully reap the benefits of today’s best technologies.

mHealthIntelligence.com: Health systems have long been accused of dragging their feet in adopting mHealth technology. What can you do – what can the mHealth ecosystem do – to help healthcare become more comfortable with all these new ideas and technology?

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DG: The healthcare industry is one of the very few that has yet to fully capitalize on the promise of technology. While many are quick to say that’s because physicians and health systems are reluctant to adopt emerging technologies, the reality is that the healthcare communities eagerly adopt technologies tuned to make their lives easier, but many mHealth technology solutions aren’t quite tuned properly yet.

In many cases, mHealth tools aren’t “there” yet because both the physician perspective and a systems orientation have been missing from the equation. By connecting with physicians and healthcare providers during the developmental stages of mHealth innovations - and by that I mean collaboratively engaging them in the ideation, testing and implementation phases - we will get more adoptable use cases and set ourselves up for success in scaling mHealth initiatives. I think people want to be involved in positive changes; that’s why we created an integrated innovation company. We can do far more together than any of us could alone.

mHealthIntelligence.com: Where is the innovation happening in healthcare right now? Is there one particular field or specialty that’s become a hotbed for new mHealth ideas?

DG: We see innovation occurring across multiple specialties and areas in healthcare. Moreover, there are exciting developments at almost every stage. In early stage ventures, we are seeing innovations that 1) transform how surgery is viewed, delivered, operationally managed and even taught; and 2) show the potential of mobile as a platform to deliver care differently (e.g., crowdsourced diagnosis, triage and management algorithms).

On the slightly more mature spectrum of innovation, we are seeing tools to help individuals navigate the complicated nature of care delivery, including process transparency, insurance decision support and telemedicine.

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At the larger product companies, we’re seeing innovation around apps and care management tools. We’re also seeing benefits providers and payers leading a push in population risk management. While Health2047 hopes to accelerate efforts across the spectrum of innovation - from de novo to the mature incumbents - it is exciting to see so many new and wonderful ideas emerge from different quarters.  

mHealthIntelligence.com: What are the barriers to mHealth innovation? How can providers and entrepreneurs overcome them? 

DG: I see three main challenges in mHealth innovation:

  1. The solutions being designed and piloted often end up bespoke to a single provider rather than generally useful. To create scalable solutions that can have a national impact on healthcare, you need to start with a system-level view and design from there.  
  2. mHealth innovators often don’t take into account regional differences and thus aren’t able to offer the right market fit. mHealth solutions must support a variety of use cases; this necessitates front-end work to truly understand the desired product market fit.  
  3. The variable and highly regulated nature of healthcare creates complexity for mHealth innovators. To drive meaningful system-level innovations, mHealth technologists must collaborate closely with those who understand at a deep level the complex dynamic at hand.

mHealthIntelligence.com: Wearables have become quite popular in the consumer market, but providers have been hesitant to embrace Fitbits and smartwatches because they don’t necessarily trust the data. How can healthcare finally bridge that gap between clinical applications and consumer-facing wearables?

DG: Bridging that gap will require more integrated data models, measurable functional outcomes and interfaces that integrate and deliver the data in a meaningful way to physicians, providers and individuals alike. Today, we have point solutions that measure metrics absent context and that can prove harmful.  

READ MORE: Canadian Study Finds mHealth Isn't Serving The Right Populations

For providers specifically, I don’t think it’s a lack of trust per se; rather, it’s a lack of actionable data. The delivery of care requires the interpretation of millions of data points in a clinical setting because there are health interdependencies that Fitbits were simply not designed to measure. It’s not that providers think Fitbits and the data they generate are useless, but they don’t know what it means to have walked 2,000 steps vs. 1,500 steps a day. Did the extra 500 steps actually lead to a meaningful outcome or improvement in health, or were other factors at play? There’s no way to know if you don’t have integrated data models, measurable functional outcomes and integrated interfaces - which, at this point, we don’t.

mHealthIntelligence.com: How is game design and gaming technology used in mHealth? What potential does it hold for healthcare providers?

DG: Think about it this way: game design and gaming technology have proven masterful when it comes to altering behaviors. One of the best ways to effectively manage chronic disease is to get individuals to change their behaviors. The power of gaming and design is really the art of 1) quickly understanding the inherent behaviors; 2) adapting use cases and interactions to change that behavior; and 3) continually adapting the game as the behavior evolves. A game designer will talk about the game narrative at a 5-second level interaction model - what will the person using a game be doing at 5/10/45 seconds in the app and how do we affect this to get them to take the desired action? It is brilliant behavioral science and the implications in helping shift behaviors around chronic disease is very compelling.  

mHealthIntelligence.com: Is there an mHealth trend, app or device that you feel will die out? Why?

DG: As with most industries, many early “building block” solutions die over time because their functionality becomes integrated into end solutions that deliver greater value. Here are two “building block” solutions I believe will become extinct (or be integrated into other solutions): 

Telemedicine. It is a brilliant use of technology and delivers a new interaction model, but it is not fundamentally shifting the way care is delivered. Yes, it saves on travel for the individual and potentially alters where and when physicians can interact, but it does not deliver a 10x impact. Where I see compelling promise is in applying telemedicine technology as a building block to distributed asynchronous dashboards that enhance care delivery across multiple members of a care team.

Transparency. In no other market is it seen as revolutionary to display prices. Transparency solutions don’t alter or dynamically shift the prices; they simply provide a static view with relatively blunt force tools to help shape lower-cost behaviors (e.g., reference-based pricing, narrow network structuring). Now, we don’t end up with dynamic marketplaces for care delivery without the transparency movement, but it’s time to move forward because we can certainly do better than what we have today.

mHealthIntelligence.com: What will be the next great thing in mHealth?

DG: Data integration and the solutions of “good hygiene” (e.g., fixing the interoperability problem) open up entirely new innovation opportunities. I foresee new types of intuitive, adaptive and engaging care delivery and healthy living solutions that cross the current data moats separating inpatient, outpatient, home and community-based care.

Putting new mHealth solutions that live in a vibrant connected ecosystem in the hands of physicians and other care providers to deliver more effective care at the right time and place in asynchronous and scalable modalities shifts the landscape of healthcare delivery. What could be more exciting than that?

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