CNN’s visit to Quantified Selfing Land (though not said) is travelogued in a ‘What’s Next’ blog on innovation, with a piece on and by USC’s Center for Body Computing head Leslie Saxon, MD. What is so surprising to this Editor is that the video piece (note: may not be viewable from all countries) is so theoretical and future-oriented. Even though real companies and tech are here–AliveCor’s always smart and dapper Dr. David Albert, Sonny Vu’s Misfit Shine, UnderArmour athletic wear, Zephyr–the glossy way it’s presented is that it’s ‘swell stuff that will transform the future.’ Have our ‘grizzled veteran’ readers heard this song before, let’s say about 2006?
What is more disturbing is how dismissive Dr. Saxon’s article is of evident skepticism and of her own colleagues who are, after all, going to be part of and help drive this change. She dismisses medicine as “working from a 2,000 year old paternalistic doctor-patient model” as if nothing has happened in the past few years. Oddly she juxtaposes a 2007 conference with last week’s Congressional hearings leading with “The reactions interested me because, in my experience, where there is anger, there is also fear and irrationality.” Aside from being an extreme and disparaging view of her colleagues’ (and users) motives (and perhaps some bad editing), it simply wasn’t there in the hearings. Based on reports extensively compiled here, it was exactly the opposite–acceptance. There was justified frustration, as who (FDA? ONC? FCC?) will be handling the tidal wave of mobile health reviews and approvals where needed for public health safety, and when this will be decided. There was eagerness to determine how it will be done, in resolving big issues (like excluding mobile phones per se from medical devices) and in expediting the process. Quotes like “When it comes to digital health products, the prevailing attitude among physicians is still deep suspicion. While many people look at physicians as the drivers of change in digital health, I am in the minority of innovators in this field.” indicate how distanced Dr. Saxon has become from clinical providers–the crushing grind and the regulatory burdens they must bear–and not just doctors but nurses, HIT and all sorts of technicians. It’s also a kind of willful ignorance of the work and advocacy of many health systems (Kaiser, Mayo, Geisinger) and doctor-engaged ventures such as health app vettor Happtique. Perhaps practitioner skepticism is warranted because the last big tech rave, EMRs, continues to complicate matters from large health systems to single practices. (Whither interoperability?) And all that great body computing data can’t squeeze into EMRs and workflow right now. One wonders why the condescension to the very people you’re trying to get on board, to ostensibly make their lives and patient care better, easier, more affordable, etc.
In short, here we go again with not only ‘the fluffy future’ but also the ‘we know better than you’ Silicon Valley trope (applied to both doctors and consumers). It may also be the academic setting, where funding comes from others and the view is limited to leading-edge companies. But with growing adoption and acceptance, Mr. Market moves on (ask Zeo and Samsung). It also confirms the old marketing adage, ‘people do things for their reasons, not yours.’ It’s not enough to have a better mousetrap and whiz-bang tech–it’s developing a business model that integrates into present systems and finds its way into people’s lives/wallets. It will help the tech that’s working here and now, which is desperately trying to gain funding, customers, providers and provider buy-in–and transition. It will guide future developers, who need to get their heads out of the theoretical, the QSers and into a business model of getting a job done for the customer, as well as being attractive, easy to use and low in cost–in other words, true disruptive innovation. Only then will the customers–physicians, other clinicians and provider groups, especially long-term care housing, and the end users–really start getting on board.
Leading the charge in wireless health (CNN ‘What’s Next’ blog) Plus a big tip o’ the hat to David Doherty of 3G Doctor/mHealth Insight and his LinkedIn mHealth group.
David Albert, MD
Donna, thanks for the nice comments about my wardrobe, but on a more serious note, Leslie IS pushing the envelope! At a time when US healthcare is being crushed by its cost and MOST of the existing players (including physicians) are resisting the inevitable changes needed, she is pushing from a patient’s perspective. Many of her colleagues are skeptical- I know- I’m trying to sell to them. Leslie is not alone as others like Eric Topol are pushing healthcare to get out of its comfort zone. We have yet to determine where helpful monitoring becomes intrusion, but we will only determine that by pushing. I applaud Leslie for doing that and for doing that from the perspective of a caring physician (she is a great doctor) and loving mom & wife.