My Dream

I am imagining for a moment that the year is 2022.  As I get closer to age 50 with each passing day, I increasingly find myself within the sandwich generation — worrying about the health of my grade schooler, my teenager, and my aging parents — with very little time to worry about my own health.  But, when I reflect back on 2018, I realize that, remarkably, this healthcare juggling act has gotten EASIER.

Pictured: a woman is interacting with a smart watch. Displayed above it are holograms of health information, like heart BPM.

Back in 2018, I used to worry about my elementary schooler’s ADHD, and just how long we could go without medicating him before he fell behind in school.  Nowadays, a daily dose of educational video games trains him to focus enough on his schoolwork that we might be able to go without a pill. That’s because our doctor prescribed Akili Interactive’s ADHD treatment, a video-game based tool that was shown in clinical trials to improve attention, impulse control, and working memory in children. All that worry about unknown side effects, and the need for frequent checkups in order to renew expensive controlled substances, seems like history. Plus, we can count this towards his daily allotment of screen time.

Then there was my daughter. Always a picky eater, back in 2018 I worried about whether she was getting enough nutrition or keeping hydrated during soccer practices in the Texas heat.  But thanks to the new smart toilet we invested in, she is now able to monitor and remain accountable for her own health. Her doctor pointed us to some great interactive patient education videos about the importance of hydration, protein, and keeping glucose levels in check, and now she actively monitors her performance by checking her Toto app daily. Her porcelain friend will tell her when her iron levels are low and her sugar levels are high, and, even better, she doesn’t argue with it. Who knew that teenagers would listen to a toilet with a brain before listening to their own parents?

I also used to worry about (and get annoyed by) my husband’s snoring. Was it sleep apnea, or just his own subconscious way of getting rid of his cover-hogging spouse? Back in 2018, I bought him an Apple watch and linked it to an app from a company called Cardiogram. After a week of tracking his behavior and basic vitals, the watch, coupled with an app powered by AI, was able to diagnose that he did not have sleep apnea after all – but that perhaps he might need to see the doctor about high blood pressure. Now he takes a “smart” hypertension pill each day. This smart pill, powered by Proteus Digital Health, contains an ingestible sensor that can track when and if he took his medication. Once his sensor-enabled medication reaches his stomach, it is detected by a patch on his arm and recorded on his smart phone.  So not only can he track his blood pressure, he can also keep track of whether he’s taken his medication, not to mention how many steps he’s taken.

The Technology Trends Making My Dream A Reality

As much as this not-so-distant future of my imagination may seem very Sci Fi, the reality is that much of the technology that powers my dream is already out there, even if adoption by consumers has lagged expectations. All of these new technologies are part of a wave of digital or “connected” health startups that have emerged over the past few years, each promising the dual benefit of better health and decreased overall cost of care for those who are very sick or living with chronic conditions. Here’s a look at how some of these companies are tackling poor outcomes and high costs:

  • Behavior Change. Such is the case with Akili’s digital ADHD treatment, and prescription software from Pear Therapeutics to treat substance abuse. These “behavior change” technologies work by engaging patients, whether via gamification as is the case of Akili, or by providing tracking and engagement tools, as is the case with Pear.
  • Personalization. Such is the case with the digital hypertension pill + program, or with Livongo, a diabetes program that uses artificial intelligence and machine learning to turn patient data–whether behaviors, biometric sensors, or even claims–into customized care.
  • 24/7 Connectivity. Technology can now connect patients digitally to their health and health care directly, augmenting and in some cases replacing doctor visits. One of several examples of “connected” health is Docent Health, which provides a platform to keep patients engaged and connected to their care teams, and to provide those care teams with insights that could help improve care.

Drivers of Digital Health

Driving the growth in health tech, a.k.a. digital health, is a combination of technological innovation, payers and providers (who are financially motivated to cut costs while improving outcomes), investors, and even the FDA, which has been working to create policies and a regulatory pathway for digital health technology.

In 2017, the FDA cleared 51 digital health devices, up from 36 in 2016. Some insurers have even started to cover costs for digital health solutions that have demonstrated results.  Furthermore, 2017 was a record-setting year for digital health investment, with venture funding approaching $6B. February 2018 broke records with pharmaceutical giant Roche’s purchase of Flatiron Health, a technology platform that enables the oncology community to collect data and learn from every patient’s experience, for $1.9 billion.

Barriers to Growth

Despite the buzz around digital health, adoption of these new technologies is not yet widespread.  For now, the market has only been willing to invest in tackling the highest risk and highest cost patients and conditions. Moreover, providers are having trouble figuring out where to fit these new and untried tools into their treatment plans.  One might think that the lack of widespread use is due to consumer reluctance to share personal heath data. However, recent survey data from Unisys reports that seventy-eight percent of consumers support the notion of their health data being transmitted to providers for critical medical purposes. Cost is a more likely driver of slow patient adoption: Coverage of these new technologies is not yet widespread and is often limited on a trial basis to those patients and conditions where the risk of not optimally treating far outweighs the potential benefit of new technology.

Ultimately, the combination of investment, the need to curb rising healthcare costs, FDA efforts to smooth the path, and increasing involvement from traditional players (e.g. pharma, managed care, health systems) will overcome the barriers.

The Road Ahead

While my personal dream has yet to be realized, I am starting to see glimpses of it emerge in my professional life.  Our work with healthcare clients – including supporting development of connected devices, determining what might compel payers to cover them, or assessing usability of patient care platforms – certainly points to a future where digital health is far more prevalent

If your organization is interested in, or impacted by digital health, HawkPartners can help you assess opportunities and mitigate threats. We would love to hear from you as we continue to monitor developments, collect insights, and help our clients with their marketing strategies.