“Healthcare is old & scary,” reads the front of a flyer at the Rock Health Innovation Summit, which was held August 27–28 in San Francisco. That sentiment was tempered by a bright optimism at the event. Digital health is a beacon of hope and the field is ripe for innovation. The healthcare entrepreneurs, investors, and others across the healthcare spectrum attending the event seemed to agree that, when it comes to healthcare, it is time to start from scratch.

August 29, 2012

7 Min Read
Rock Health Innovation Summit Preps Attendees for a Healthcare Revolution: Part I

“Healthcare is old & scary,” reads the front of a flyer at the Rock Health Innovation Summit, which was held August 27–28 in San Francisco. That sentiment was tempered by a bright optimism at the event. The healthcare entrepreneurs, investors, and others across the healthcare spectrum attending the event seemed to agree that, when it comes to healthcare, it is time for some real upheaval.

Healthcare is old and scaryKey in this transformation is the digital revolution, which is steadily making inroads in medicine. Rock Health, the first seed accelerator for digital health startups, is itself playing a role in this transition. Founded and headquartered in San Francisco, the incubator just graduated its first class of startups in Boston. The organization just announced that it is increasing the amount of seed funding offered to incoming startups from $20,000 to $100,000. Startups are also offered mentoring, office space, and other support.

A Keynote from Intel Pioneer Andy Grove

The Rock Health Innovation Summit kicked off with a keynote address from Intel cofounder and Silicon Valley legend Andy Grove. In his talk, Grove advocated for a medical equivalent to a manufacturer's suggested retail price for cars. Before the use of the MSRP, the markups on cars were arbitrary. Now, it is easy to determine the price of a car’s standard configuration. In healthcare, cost analysis is rarely taught in medical school. And the ability of clinicians to mine medical data from the past and anticipate future costs is poor. In order to improve healthcare, we must learn to accurately measure it, Grove stressed. He drew loud applause by concluding his talk with a slide proclaiming: "Job 1 in healthcare is to 'Free the Data!'"

Rethinking Healthcare Delivery

Following the keynote was a panel discussion titled “Healthcare Delivery Redelivered” moderated by Abbe Don who coleads the Health Systems practice at IDEO. Rounding out the panel were Thomas Lee, MD, medical director of One Medical Group, and practicing internist Jordan Shlain, MD.

Thomas Lee, MD

“The healthcare system is terrible and has been for decades because it is not designed with the consumer orientation in mind,” opined Lee. His One Medical Group seeks to address that by making concierge-style medicine affordable and covered by insurance.

Another consideration is that healthcare has been slow to adapt and take advantage of groundbreaking technological breakthroughs. “It is hard not to be influenced in technology in the Bay Area. But the question is why is it not permeating healthcare more thoroughly?” Lee asked. “Device technology has permeated healthcare very well, but information technology has not.”

Shlain’s assessment of the state of healthcare was similar. After growing tired with “treadmill-style medicine,” he became a concierge physician for a hotel. There, he saw firsthand the advantages of taking a proactive role in his patients’ healthcare.

Another consideration Shlain pointed out was that it is rare for patients to frame their health as an asset. Just having health insurance, he said, is not enough. “It is for when the wheels come off.”

Setting Software Loose on Healthcare

The next panel discussion was titled “Code for Health: How Software is Eating the (Healthcare) World” moderated by Jennifer Pahlka, founder and executive director of Code for America. The panel included Tim O’Reilly, a tech guru and founder of O'Reilly Media, and John Mattison, MD, the chief information officer of Kaiser Permanente.

Tim O'Reilly

The panelists were nearly unanimous in their statements, arguing that we are on the cusp of a huge revolution when it comes to healthcare. Digital health is poised to substantially improve the quality of healthcare and cut costs, if only we could heed the call to free health data and use massive computational power to drive better care. By using data, we clearly understand the quality improvement cycle for healthcare.

Genomics will play key roles in this transformation as their use becomes more widespread. “In a short period of time, it will be malpractice for doctors not to treat patients without their full genomic sequence,” Mattison said. The pharmaceutical industry, which is now one of the least trusted sectors in medicine, could use data gleaned from genomics to essentially guarantee that their products will work for specific patient populations. Still, privacy concerns linger and sophisticated methods for deidentification of data are required.


John Mattison, MD

Both Mattison and O’Reilly issued calls to entrepreneurs to drive the healthcare industry forward. “The biggest point about the Maker movement is that sense of permission to innovate,” O’Reilly explained. That same spirit is needed in healthcare as well, where disparate bodies such as medical device companies, pharmaceutical companies, hospitals, doctors, and so forth have aligned incentives to keep costs high to preserve profit margins. “There are opportunities in healthcare to allow the market to innovate but in order to do that we really need to start over,” he said.

Entrepreneurs should have a maniacal focus in cutting costs out of the healthcare system, Mattison added. Without doing that, “you are going nowhere,” he quipped, adding that the biggest entrepreneurial opportunities are in disintermediation—displacing high-cost providers of healthcare products and services.

Mattison also pointed out the huge gap that exists between how well motivational science has been implemented in healthcare compared to clinical science. Motivation, he explained, can go far in addressing our most pressing healthcare needs. “If you eat well, sleep well, exercise, and take care of your spiritual health, you will do far more for your longevity than medical science has to offer,” Mattision said.

Can QS go to Main Street?

Experimental man David Ewing Duncan, a bestselling author who has amassed hundreds of gigabytes on himself, chaired a session on the Quantified Self (QS) movement. Joining him were Leslie Saxon, MD, the chief, division of cardiovascular medicine at the Keck School of Medicine of the University of Southern California and Sridhar Iyengar, PhD founder and CTO of AgaMatrix, a diabetes / mHealth technology firm.

saxon_leslie.jpg

 Leslie Saxon, MD

Saxon explained how she was interested in how technology can bring patients a sense of security by allowing them to participate and feel cared for. Sensing technology can help shift healthcare from its traditional paternalistic model to a more participatory one, she said. For this to be effective requires a shift away from the fragmented approach that has been traditional in medicine. Contrast that with her Everyheartbeat website, for instance, which Saxon hopes will eventually capture heartbeat data across the world, measuring every heartbeat—“at least once.”

Iyengar backed into the QS movement from the device industry. He had experience making glucose meters and realized that patients didn’t use the data gleaned from the devices. He eventually went on to help develop the first FDA-cleared glucose monitor that connects to the iPhone. The smartphone can help patients annotate data and see how their health metrics change over time.

Iyengar’s medical device background has given him an appreciation of the validation that FDA clearance can give medical products. “Many entrepreneurs want to create products that are ‘consumer enough’ to avoid FDA. Instead, they should embrace FDA and use regulatory clearance as an advantage,” he said.

“Many entrepreneurs want to create products that are ‘consumer enough’ to avoid FDA. Instead, they should embrace FDA and use regulatory clearance as an advantage.”

As for the broader QS movement, a central question remains: Do we know what to do with all of the data gathered from it? The problem is mirrored in genomics, where data sets are massive. In the future, developing an “interpretome” may prove to be as important of a landmark as sequencing the human genome—the costs of which are decreasing so quickly that they may one day be practically free to perform. Therefore, most of the profits will likely be in interpreting genomic data rather than generating it.

It follows that, in the near future, patients (and their doctors) will know more about their health than they ever have. “We view educated patients as a way to make everybody happier,” Saxon said. “The great thing about wireless health is you can leverage healthcare over the world,” she added. “You can deploy experts wherever you want.” 

Brian Buntz is the editor-at-large at UBM Canon's medical group. Follow him on Twitter at @brian_buntz.

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