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The Real Challenge of Digital Health Solutions: Human Idosyncracies

David Shaywitz, in his Forbes article, pulls out this great nugget of wisdom from Marc Andreessen about the challenge of applying AI to the VC business and compares it to AI replacing your doctor. I agree with David that it provides a tremendous insight into AI replacing the doctor.

Andreessen’s response (at around the 40-minute mark) speaks for itself–but also, I’d argue, for most in healthcare (emphasis added):

The computer scientist in me and engineer in me would like to believe this is possible, and I’d like to be able to figure this out–frankly, I’d like us to figure it out.

The thing I keep running up against–the cognitive dissonance in my head I keep struggling with, is what I keep seeing in practice (and talk about in theory vs. in practice)–like in theory, you should be able to get the signals–founder background, progress against goals, customer satisfaction, whatever, you should be able to measure all these things.

What we just find is that what we just deal with every day is not numbers, is nothing you can quantify; it’s idiosyncrasies of people, and under the pressure of a startup, idiosyncrasies of people get magnified out to like a thousand fold. People will become like the most extreme versions of themselves under the pressure they get under at a startup, and then that’s either to the good or to the bad or both.

People have their own issues, have interpersonal conflicts between people, so the day job is so much dealing with people that you’d have to have an AI bot that could, like, sit down and do founder therapy.

My guess is we’re still a ways off.

Who knew that developing data-driven tech solutions could be challenging in a profession that at its core is focused on human idiosyncrasies, especially under conditions of stress?

I love the description of the challenge as Human Idosyncracies. What’s interesting to me from a healthcare perspective is if we can generalize these idosyncracies in the way we treat patients.

June 8, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Using Your Mobile Trail to Improve Your Health

Mobile Health Trail

I’d always heard people talk about the value of the data collected on a mobile device and how that could be leveraged to benefit your health. However, this is the best illustration of this concept that I’ve ever seen. It’s really easy to see how much of this data could be leveraged to improve your health. There’s certainly some privacy questions, but the next generation seems to not care about it. I wonder what apps we’ll see that leverage all of this data about our habits.

June 1, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Will mHealth Apps Replaced by Chatbots?

Michael Yuan has a great post that looks at chatbots for healthcare and uses the great headline that “mHealth apps are so 2014!” Michael makes some great points about the challenges of getting patients to download mobile health apps and to get them to engage with those apps long term. There have been very few breakout hits in the mobile health app space.

For those not familiar with Chatbots, they essentially use artificial intelligence to appropriately respond to you on your favorite chat platform (Facebook Messenger, Kik, Whatsapp, Wechat (China), Google Messenger etc etc etc). Some of you may have seen my post about the way a Chinese Health Tracker integrates with WeChat. There are some really incredible benefits of engaging a patient on a messaging platform that they’re using daily already.

I think that most people just fear that messaging platforms aren’t powerful enough to really engage the patient. They often ask, can a text message change patient behavior? If you look at the WeChat integration mentioned above, you’ll see that most of these messaging platforms are becoming much more than just a set of simple text messages. However, let’s set that aside and just think about the power of a text message.

When Facebook announced their new partner program to allow people to create chatbots on their messaging platform, I asked my friend Melissa McCool from STI Innovations and MindStile if you could change people’s behavior with something as simple as a series of text messages. Her answer was a simple, “Yes.”

Of course, the devil’s in the details, but I trust that Melissa knows about how to influence patient behavior based on her experience doing it in many large healthcare organizations. The challenge isn’t technical though. Sending a text message, building a chat bot, sending a message on any of these platforms is completely academic. My 12 year old son could do it. What’s hard is what you should send, when you should send it and to whom.

While it’s great to see technology become easier and easier, that hasn’t made the challenge of behavior change that much easier. Sure, it’s great that the patient will actually read the message the majority of the time if you send it using one of these popular messaging apps. However, that doesn’t mean that the message will be effective. We still have a lot of work to send the right messages at the right time in the right way to the right people.

May 26, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Is Healthcare Overhead Holding Back New #DigitalHealth Solutions?

Earlier this year I wrote an article that questioned whether the Fitbit was really a digital health solution. I essentially came to the conclusion that Fitbit’s health data wasn’t clinically relevant and so that’s why we didn’t see it really impacting healthcare as we know it.

While Fitbit’s data may not be clinically relevant, Fitbit has still gone on to be an extremely successful wearable technology solution for consumers. For some reason we enjoy tracking our steps whether it really improves our health or not. Of course, maybe they’re also riding our own misconception that tracking steps improves health. Regardless, they’ve been extremely successful and haven’t had to prove that they actually do anything to move the needle in healthcare.

I wonder if this is the model that we’ll see happen most with digital health solutions. Instead of trying to actually take part in the ruthless, brutal, and complex healthcare infrastructure, I expect we’ll see most digital health solutions work on the outside.

Think about the overhead that comes with becoming FDA cleared or the overhead that comes with proving to a hospital that your solution really does improve patients’ health. That’s a lot of work compared with just creating the illusion of health and selling it directly to consumers. Maybe the illusion will play out as reality or maybe it will not. From a company’s point of view, all you have to do is keep the illusion in play and you can be successful.

No doubt this later strategy appeals to the startup culture that’s been created in the US. There’s so little that’s “lean startup” of MVP (minimum viable product) in healthcare. Most people in healthcare are afraid of anything that’s not mature. Healthcare regulations certainly discriminate against experimentation and show bias to mature technologies.

The only case that really can be made to entrepreneurs who want to pursue the harder path of proving their technologies is that once they’ve proved it they have a great defense against competitors who haven’t gone to that effort. That’s a powerful incentive, but not one that most will appreciated when starting a digital health startup company.

My gut tells me that the complexities of healthcare are holding many innovations from happening in healthcare. That’s unfortunate.

May 18, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Walgreens Goes Big on Telemedicine Including New Behavioral Health Service

This was extremely big news for Telehealth in general, but even more so from a mental and behavioral health perspective. In case you missed the news, Walgreens and MDLIVE are partnering to offer telehealth and behavioral telehealth services (technically MDLIVE is partnering with Breakthrough for the behavioral health piece).

Walgreens involvement in telemedicine is such a big deal and is going to really push telemedicine much faster than it’s already going. Currently they can offer their telehealth medical services in 37 states (this announcement added 13 states). Here’s the type of services you can receive through these services:

  • Acne
  • Allergies
  • Cold / Flu
  • Constipation
  • Cough
  • Diarrhea
  • Ear problems
  • Fever
  • Headache
  • Insect bites
  • Nausea / Vomiting
  • Pink eye
  • Rash
  • Respiratory problems
  • Sore throats
  • Urinary problems / UTI
  • Vaginitis
  • And more

On the behavioral telehealth front, you can get non prescription services in all 50 states and behavioral health prescribing services will be available in 20 states. Here’s a look at the list of services they can offer in behavioral health:

  • Addictions
  • Bipolar disorders
  • Child and adolescent issues
  • Depression
  • Eating disorders
  • Gay/Lesbian/Bisexual/Transgender issues
  • Grief and loss
  • Life changes
  • Men’s issues
  • Panic disorders
  • Parenting issues
  • Postpartum depression
  • Relationship and marriage issues
  • Stress
  • Trauma and PTSD
  • Women’s issues
  • And more

This announcement has been met by much rejoicing in the mental health community. I think that many of them see these telehealth services as a great way to get more mental health services out to patients who wouldn’t otherwise get treatment. It sure feels like telehealth has finally arrived.

May 12, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Are There Too Many Healthcare Apps?

Today Anne Zieger wrote a blog post arguing that there are too many healthcare apps. It’s a really interesting take on the plethora of healthcare apps out there and the need for there to be apps that handle more than one specific condition or measurement. Anne argues that patients don’t want to open a whole bunch of different apps to manage their health. Plus, she points out that the highest cost patients are often chronic patients whose health needs to be managed across multiple diseases and multiple data points.

While I find Anne’s analysis interesting, I’m prone to think that we actually need more healthcare apps. I say that because I don’t think the current crop of healthcare apps are really moving the needle. So, we need more healthcare apps that actually attack the right problems. Piggybacking Anne’s comments, I’m not sure the current crop of apps are going to scale to the complexity of a patient, so we likely need new healthcare apps that work with that complexity in mind.

The reality I’ve seen with most healthcare apps is that they lack ambition. Can you name a healthcare app that illustrates the ambition to improve the health of a patient and lowers the cost of healthcare as we know it? Those are big claims to make and so you don’t see anyone claiming it. Claims aside, are there any companies that are really doing it?

My experience shows that there are a few apps that in a very limited scope are able to improve the health of the patient. Although, very very few of them have done the studies necessary to be able to claim that. They have plenty of anecdotal stories about how their app improved someone’s life. However, they don’t yet have the data to prove what they believe their app is able to accomplish.

It’s going to take a lot more ambition from healthcare app developers to really attach the problems that vex healthcare. Keeping someone healthy is an extremely complex issue and won’t likely be solved by a 99 cent app.

If that’s too big of a vision for you as an entrepreneur, how about you start with a simpler concept. Show me an app that changes people’s behavior. Let’s start with something that simple and scale from there. Most health apps aren’t even brave enough to take on that challenge. I’m not blaming them. It’s hard, but that’s what will make it so valuable.

May 4, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

No Doubt Digital Health Has Gone Mainstream

The big digital health news yesterday was that Nokia was acquiring Withings. There’s no better sign of the massive market opportunity that is the digital health space. It also seems to show a huge pivot in the business model of Nokia. Long a phone manufacturer, they’re now using their massive war chest and understanding of the mobile industry to enter into the digital health space in a big way with this acquisition.

From the Withings perspective, I’ll be interested to see what Nokia can do as far as distribution of the Withings product lines. Withings has had a strong presence in the digital health space for a while, but there’s definitely a land grab happening between all the various players in the industry. We’ll see if having Nokia around can accelerate their acquisition of market share.

I’ll be interested to see where Nokia takes this as well. Is this the first of many digital health acquisitions? Withings has a great digital health product line, but we’re seeing an explosion of health sensors that could compliment their product line. Nokia has much deeper pockets than Withings, but are they willing to acquire companies to build up their war chest of health sensors? It will be fun to watch it play out.

I wonder if Nokia’s ties to Microsoft will be a help or a hindrance to Withings. Certainly they’re going to have to hook into the iOS and Android platforms. They already are, but will this acquisition make those integrations harder? Will they miss out on opportunities with these 2 major phone types because of the new connection to Nokia?

I’m always interested which large companies are starting to enter the digital health space. We’ve seen a ton of work from large brands like Adidas, Nike and Under Armour for example. iFit has been working really hard on the space and they come out of NordickTrack. Fossil acquired Misfit. I’m sure there are bunch more I missed, but such an extraordinary diversity of companies working in the space.

Who else do you think will enter the space? Any companies you think that will become the leaders?

April 27, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

360 Degree View of Cancer Surgery Broadcast Live in Virtual Reality

This week I’ve had virtual reality and video on my mind as I’ve attended the NAB (National Association of Broadcasters) conference in Las Vegas. One of the main topics at the show has been the evolution of 360 degree video recording and virtual reality. The merging of those two technologies is fascinating to watch and is still in its infancy.

As I’ve been thinking through these technologies for healthcare, it was ironic that I’d find the news that a cancer surgery was broadcast live online using 360 degree virtual reality video for the first time. Here’s a short video describing the technology and their efforts to use this to educate medical students:

Lest people think this is some super expensive technology that will never make it to healthcare, one of the companies announced a 360 degree video camera at the conference that only cost $600. That’s an incredible price and will continue to go down.

I’m excited to see this technology finding a place in healthcare. Plus, we’re just at the start.

April 20, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Regulation Lesson Learned from Theranos

For those who haven’t been following the Theranos drama, it’s a total mess. At first Theranos and its founder, Elizabeth Holmes, were being touted as the next major thing to happen to healthcare. They used that fame to raise $700 million (per Techcrunch) on the back of lab tests from samples as small as a few drops of blood. However, through a series of missteps, Theranos got itself in real trouble with CMS.

Today, it seems like things have gone from bad to worse as regulators plan to revoke Theranos’ lab license and to remove Elizabeth Holmes and Sunny Balwani, company president, from their positions as leaders of Theranos. You can read more in this Techcrunch story and see the letter from CMS. I’ll leave the analysis of Theranos’ future to others who are covering every detail. However, it’s worth noting that others are working on similar lab testing that uses small amounts of blood, so I’m hopeful we’ll still see that technology come to market.

Instead of focusing on Theranos’ future, I think we’re better served learning an important lesson from the Theranos experience. Government regulation matters in healthcare and you better have all your i’s dotted and t’s crossed.

There are a lot of startup companies that enter the healthcare startup world thinking that they can be rebels and succeed in healthcare. In some respects they can and I’d be the last to discourage rebels from entering healthcare. We need more rebels that fight against some of the lame status quo experiences we have today in healthcare. However, rebellion can only go so far in a massively regulated environment like healthcare. Whatever rebellion you want to lead has to fit within the constructs of regulation or it will come back to bite you.

The good thing is that the Senate is trying to make it more clear what healthcare technology will be regulated and which won’t with bills like the MEDTECH Act. However, there’s still a ways to go and there’s still some leeway for the FDA to get involved if you overstep your startup into regulated territory.

This exact problem is why many startup founders see so much opportunity in healthcare, but then shy away. I remember reading a venture capitalist that said “All the normal business mechanics that you’re use to seeing don’t apply to healthcare.” I don’t agree completely with that quote, but there’s definitely some truth to it.

I’m not saying that startups shouldn’t enter healthcare. They should, but they should think very seriously about the regulation required to participate in many parts of the healthcare system. Some will see the regulation as a downside, but remember that regulation can also be a great barrier to entry for your competitors. You have to take the good with the bad. We all know that healthcare regulation isn’t going anywhere. In fact, it’s likely to get worse over time.

April 13, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Are We More Honest with Our Phones Than with Our Doctors?


This is such a great question, but like most great questions requires more than a Yes or No answer and usually leads to a depends response. If you’re asking for my short answer though, I’d say that usually yes.

Certainly there are some exceptions. There are certain people that won’t share anything on the internet and that includes their phone. So, of course they’re not going to be more honest with their phone than they are their doctor. However, social media proves that the majority of people don’t mind sharing. In fact, when you look at what people are willing to share publicly, you have to wonder what they’re sharing online privately.

From a health perspective, this can be a huge benefit as you try to track someone’s health. In the article linked above they talk about how a smart phone app was a much better way to get data from teenagers participating in their research. They described the paper surveys as homework and the mobile app as fun. No doubt that resonates with anyone that has spent time with teens.

However, that really only addresses the accessibility and ease of providing the data. There’s a disconnect from reality that happens on the phone which allows us to be more comfortable sharing some things that we wouldn’t likely share face to face with the doctor. In healthcare, we’re usually battling against this issue as we talk about Telemedicine and how it’s not the same as an in person office visit. They’re right. Telemedicine isn’t the same as an in office visit. In some ways it feels less threatening and people are more willing to share. While this “disconnect” can be a down side, it can also be used as an upside.

Like most things in life, there are pros and cons. The key as we approach digital health solutions is to understand the benefits and challenges and make the most of what’s possible.

April 6, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.