Last week, RIoT hosted a gathering to discuss personalized healthcare. The premise is that digital technologies, wearables and advanced analytics will lead to a paradigm shift in how we approach managing our health.
Neal Shah, founder and CEO of CareYaya reminded the audience that for most of human history, we have managed our health in our own homes. Doctors made house calls and most medicines and physician tools were portable. Last century, there was a pivot to facility-based care, based primarily on advancements in diagnostic equipment that became centralized in hospitals and doctor’s offices.
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Most of this equipment is not portable, and because it is extremely expensive, the unit economics for facility profitability only work out when patients are aggregated into large groups. Rural areas suffer due to insufficient population size to make investment in rural hospitals affordable. With the increasing efficacy of wearable health monitors and smart-phone driven AI insights, the reliance on large, specialized equipment (and the facilities in which it resides) is reduced. And in cases where this remote monitoring and AI analytics indicates that a real problem exists, it clearly justifies a 4-hour drive to a city hospital, versus the past paradigm of deciding whether to make that drive because “maybe” a diagnostic evaluation makes sense.
Accessibility is a huge issue. Shah pointed out that in the US, the poorest half of our population account for only 3% of healthcare spending. This is in direct contrast to the actual health situation in poor communities. The current paradigm is enormously expensive and simply not accessible for a majority of Americans. The low cost and ubiquitous nature of using wearables and AI, versus high cost of specialized care already has behaviors changing in the consumer space. In Shah’s words, digital technologies let us “burn the system down and rebuild it for accessibility.”
Steven LaBoeuf, founder and president of Valencell pointed out that “chemistry is fast, but biology is slow.” The understanding helped him to realize that our understanding of health requires lots and lots of measurement over long periods of time. Today, Valencell’s non-invasive optical sensing technologies are in half of the wearables on the market.
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Most recently, Valencell collected more than 40,000 clinical trial data sets on 20,000 people around the world, proving that digital measurement from a smart watch or smart earbud can measure blood pressure as accurately as the traditional inflatable cuff. Suddenly we have the potential to see how our blood pressure fluctuates during normal, day-to-day activities, rather than a periodic measurement at a doctor visit, which for many is itself a stress-inducing activity.
OpiAID, a Wilmington-based company founded by David Reeser, is solving a problem that simply wasn’t getting solved in hospitals and other specialized clinics. Specifically, OpiAID is working on substance abuse disorders, and more specifically on opioids. Reeser explained that scheduled visits to a treatment facility (the current paradigm) lead to a successful outcome less than 1/3 of the time.
Approaching the problem differently, OpiAID has partnered with Samsung to build technology into a smart watch that takes health measures every 5 minutes. By analyzing that data, they are able to predict when someone in recovery is acutely at risk of relapse and can intervene in real time.
But the paradigm shift won’t happen overnight. The federal government is deploying millions of dollars to combat the opioid epidemic. But politicians and policymakers are still wed to an old way of thinking, not yet ready to directly deploy that money to these new digital tools. There is still faith in the “facility-system” of healthcare. Thus, to get to market, OpiAID has taken a strategy to integrate their digital analytics into the facility, improving the facility outcomes, rather than operate completely outside the existing healthcare system.
It will be interesting to see if consumers decide to abandon the existing over-expensive and under-performing healthcare system or not. With rapidly aging baby boomer and Gen-X demographics, there simply are not enough facilities for everyone to receive adequate care. And most of the aging population wants to age at home anyway.
Without question, the technologies available today can replace a tremendous amount of the capabilities in hospitals, clinics, urgent and elder care facilities. And there is little doubt that persistent, real-time data collection means a better understanding of our biology, leading to more insightful recommendations on how to stay healthy, how to recover from health issues and how to manage chronic conditions. LaBoeuf warned that there is still a lot of R&D to be done. But the foundation is solidly in place.
The shift is already beginning with lower-income people who, by any practical measure, are unable to participate in the current system anyway. And there are early adopters at the high end of the income scale, who are augmenting digital technologies with their priority (i.e. $$$) access to facilities and experts. What remains to be seen is if the positive impacts – and the potential for the management of your health to return to your home – swing a much larger population. In other words, will we “burn it all down” and re-invent personalized, home-based healthcare for all?
