Remember a mobile medical pageant full of opportunities--mhealth Summi

December 2014 7-10th, the Annual Health Summit Conference in Washington, D.C., this is the global health area of the annual meeting, participants not only from the medical services sector, as well as pharmaceutical companies, communications enterprises, Government, non-profit organizations, universities, research institutes, insurance companies, etc. It is an important annual meeting in which almost all health-related stakeholders will attend the industry. I made some notes on the gap in the meeting, to treat the domestic not to participate in the small partners, hope to bring inspiration.

Mobile + Real Time + payment + meaningful data, Health's complete ecology

Health is evolving from simple applications, simple wearable devices, to a complete ecosystem and playing an increasingly large role. According to Derek Aberle, president of Qualcomm, the ecosystem has three main features:

First, there are breakthrough technology;

Second, has the value, can ensure and strengthens the patient safety and the medical quality;

Third, and most important: it can be paid.

Can these three PC era products also be able to do? Fact。 In particular, he stressed that with the advent of the mobile Internet, our access to information, the speed of getting help has evolved from the original "Days" to the "second" calculation, the future will become "real-time", this expansion speed and coverage of the PC product is far from being able to do.

And the mobile internet makes "payments" a change. This "affordability" is achieved mainly by increasing efficiency and reducing costs, rather than reducing the quality of medical care to control costs. On the contrary, it is also in line with the principle of medical service to improve quality, strengthen patient safety and reduce risk by health.

In addition to the above three features, access to valuable data and analysis based on data to provide more accurate guidance for clinical, scientific and patient education is also a major advantage of health.

Alliance Vp--rob classmate of Pcha (Personal Connected tiyatien havasy) when talking about health interaction, divide it into three levels: device layer, system layer and data layer. Access to data through health, particularly "meaningful data", is critical to the advancement of medical services.

Interestingly, this year's Health Summit Congress also organised an entrepreneur session, and many of the health-field entrepreneurs ' themes are related to health-care data mining, so what is meaningful data? How can data analysis help doctors and patients better? I'll talk about it in section three.

Finally, health is also a communication tool that helps and facilitates communication. This exchange is very real-time and efficient, according to Verizon Global Business development vp--janet Schijns, the idea that this communication will reach 24 hours online, never offline. Anytime, anywhere, anyone can get real-time help through health, and patients are highly committed to interacting instantly with valuable information.

But this kind of communication, especially the doctor-patient exchange also must pay attention to evade the risk. In the United States, for example, no doctor is allowed to communicate with a patient who has never met, and then give a diagnostic advice, or even prescribe a drug directly. Because this is a serious violation of the medical security principle, it also violates the HIPAA Act (Tiyatien Ping Portability and Accountability Act), putting both doctors and patients at high risk.

There are doctors in the United States who are directly communicating with patients through a number of platforms, but this communication is limited to simple disease counseling, the doctor can simply analyze the patient's situation, but finally the basic will be advised to go to a hospital or clinic for medical examination, and not directly online diagnosis and prescription. In addition, doctors should also pay attention to protect the patient's privacy in the communication, never disclose the patient's privacy information.

Chinese entrepreneurs have a long way to go in order to make products

As described in the first section, health is evolving from simple wearable devices to a complete ecosystem. Remember when you came to the conference, we talked about the majority of individual app, but since last year, few people have devoted to the app.

One of the phenomena is that there are two trends in app softening and hardening. App softening is to get through with his system and become an extension of hospital information system, while app hardening refers to the combination of app and hardware to manage, store and analyze the data collected by hardware (sensor). It's really hard to get a service or business model out of an app that's not connected to the health care system. Apps don't die, they still exist, they're the dots that make up the face.

So what is "noodles"? Here I introduce two words: one is "Connected Tiyatien", Chinese translation generally bad, or turn into "interconnected health", or turn into "connectivity of health" (I wish you punctuation happiness). Another is "coordinated Care", some people call it "integrated Care", Chinese turn into "cooperative medical care". It can be said that Connected Tiyatien and coordinated care is the "face" that the American medical field is establishing through the health means.

Connected Tiyatien is not a new concept, it and telehealth (that is, telemedicine) is very close to the blood relationship, that is, using the network, through the connection of remote devices to monitor and manage patients with chronic diseases, such as monitoring blood pressure, heart rate, weight, management of smoking cessation and alcohol and other bad behavior.

But what is slightly different from telemedicine is that Connected Tiyatien also emphasizes "self-care", that is, self health management. Patients can receive health information from doctors, or other medical personnel, and then learn and follow through to manage their own health or disease to change lifestyles, reduce risk, and reduce the chance of readmission.

It appears that Connected Tiyatien seems to be more technology-oriented, equipment-oriented, the industry also apparently noticed this, so PCHA vp--rob Havasy students also at the opening ceremony of this meeting to shout loudly: "Connected tiyatien is a connecting person, Not a connecting device! ”

Coordinated care is relatively new, it looks more like an integrated industrial pipeline, including prevention, diagnosis, treatment, first aid, rehabilitation, physical signs monitoring, follow-up ... And many other services, involving a lot of stakeholders, including hospitals, pharmaceutical enterprises, insurance companies, doctors, pharmacists, nurses, patients themselves, family members, such as patients. Coordinated care is trying to solve a system-integrated approach to medical accessibility, medical affordability, patient safety, medical quality, medical efficiency, and user satisfaction.

This "omnipotent assembly line" to try to build the "family-hospital-family" service closed loop looks very beautiful, but the parties involved in the interests of too many people, their respective demands are very different, so the implementation of the difficulty can be imagined. In this case, market-leading faction I am afraid to be located in the "big government" regulatory capacity, Pcha Vp--rob Havasy classmate also said: "Medical health and other industries have a huge difference, its value is greater, complexity is also greater, need the government to make a perfect top-level design."

Look, the living examples are already there, at the current session, Croatia's Minister of Health, Sinisa Varga, said that Croatia had achieved a "hospital-community-family-personal" service closure, including electronic appointments, electronic medical records, electronic prescriptions, online payments, insurance interventions, and patient education in closed-loop cases. , self testing, home monitoring ... have been implemented on both the PC and mobile side, envy? Oh yes, the Croatian population is more than 4 million, which is half the population of Hangzhou city. "Give me half of Hangzhou, return you a future medical treatment" is expected to become the new slogan of health industry development in Hangzhou?

Against the backdrop of soaring medical costs, an aging population, a growing chronic disease, a geographically dispersed environment and a shortage of health care workers, the U.S. government and the community are forced to look for innovative opportunities to improve quality and reduce risk, increasing efficiency and reducing costs. It's not hard to understand why the health industry is so hot in America, everyone is talking, everyone wants to do, a lot of startups, investors are also desperate to hit the money, the last wave of sand, the remaining number of winners will rely on health technology and products, even point into the surface, to provide people with a truly safe, reliable, accessible, Affordable medical and health services to form a complete health ecosystem.

By contrast, China's health industry has been fueled by the American people, but the Chinese-American system is different, the market environment is different, the medical demand is different, the Medicare payment system is different. Chinese medical Service is still in the stage of safeguarding basic medical services, and the Chinese health industry is still in the stage of concept attempt and market cultivation. In this case, both entrepreneurs and investors should remain more rational and open minded. We still have a "scatter", there is no connection and synergy, not to mention the "face", indeed there is a long way to go.

Products must be data driven, while patient-centric

For health product design, everyone has their own views, can be described as eight, recount. But the principle mentions one: data-driven. This data is not normal data, but meaningful data. What is "meaningful"? Qualcomm defines the following data as "meaningful":
Emr/ehr data (Electronic medical record/electronic health file), check data, (such as laboratory biochemical examination, medical equipment inspection, etc.), prescription data, insurance claim data.

Why is there no genetic data? Is it too early?

Anyway, the above data called "core data", combined with the patient's own monitoring data, such as through wearable equipment collected by the heart rate, blood pressure, blood oxygen, weight and other "auxiliary data", basically sketched out a patient's "data map." Then, doctors, nurses, health education commissioners, pharmacists, family members of the five groups began to serve the patients, this is the legendary "patient-centered."

Its essence is "patient data as the center", through a variety of "core data-auxiliary data" seamless flow, the establishment of patient-centered, covering the whole life cycle of health services. With regard to the "ancillary data" produced by wearable devices, Samsung's global health Vp--david Rhew A good news: Samsung opened a developer platform, including Sami and Simband, to try to open the interface and surpass Apple in its ability to integrate and analyze data HealthKit and Google Fit.

But access to data is only the first step, but also need to deep mining and analysis of data, through data-driven to find the most information patients should be informed (Data-driven information), so as to provide personalized information for the patient itself, but also to avoid the problem of homogeneity of information, It can also circumvent the as of data privacy and security in the American people.

A pain point in health services is difficult to standardize, although the data is critical, but people are not machines, user experience and feelings are also very critical. For example, IBM is responsible for Tiyatien Industry transformation's eldest brother Harry Reynolds that the health products to meet the patient "Engage me on the My terms (I am the master)" demand, good self-willed demand Ah, But no way, the patient is the center.

The boss of Center for Connected Tiyatien Joseph Kvedar proposed adding social elements to the health product, such as the leaderboard, adding virtual money, virtual medals, or charitable donations, To stimulate the patient to use health products of stickiness and compliance.

But this statement was quickly opposed by Vp--janet Schijns, a Verizon global business development, and Janet agreed that health products do encounter higher drop-out rates in chronic disease management, but she does not think it is necessary to motivate patients in the above ways, Because the greatest incentive is to deeply understand each patient's individualized data, and with the help of data-driven to provide patients with real-time, safe, truly valuable services. I personally agree with Janet students, not self-willed, very human nature.

However, another point that Joseph has put forward is that it is possible to consider a combination of services that are highly relevant to daily life in health products, such as pushing weather forecasts while pushing health reminders. This reminds me of an exchange with the deputy Minister of Health of Kenya a few years ago, and the deputy minister said that they had been pushing for HIV prevention and safe motherhood in Kenya, and that they had added "services that are highly related to everyday life", and I was wondering if it was the weather forecast? But the weather in Africa is basically year-round in dry and rainy seasons, with no significant temperature. Later the deputy minister told me: local food prices. So there's health health management is probably like this: "To prevent aids to wear sets, cowpea eight cents 51 kg."

Interestingly, Google Glass's product design is also based on data-driven to be more promising. Some time ago about the Google Glass a lot of controversy, but in fact, Google Glass in the health field still has great application value. Google Glass in the emergency room, ambulances, doctor rounds and telemedicine and other scenarios still have extensive application prospects, the core is to get through his system, access to the patient EMR data interface calls to facilitate the doctor through video and voice input course records, real-time access to patient data, or with the patient remote communication, Provide advice.

Calm down, calm down, calm down!

Speaking of the challenges facing health, Walgreens's Vp--harry Leider classmate and center for Connected Tiyatien's eldest brother Joseph Kvedar poured cold water on it. Joseph's classmates think that the health field has been very crazy, the market expectations too high, very irrational.

Do you see the success of Apple, Samsung, Aetna Insurance in the health field? There's Wood! Medical health is very special, it will not start from zero rapid growth into a huge market, because this is health care, not tick-tock taxi, not the public comment, not taobao cat ...

Harry's classmates think that not only are entrepreneurs and investors health brain fever, patients are also health expectations too high, unrealistic.

In addition to the overheated market, how to obtain EMR data and how to use the data properly, even in the United States, there are still huge challenges. The blue button program, which claims to be able to download personal EMR data on its own, is a government-led Lan, but it does not seem to be widely accepted by doctors and patients, with few users. Everyone complains that in the United States there is not much people use the "blue button", simply can not collect the patient's personal EMR AH.

In addition, the issue of patient privacy protection is also a concern. HealthMap's head, John Brownstein, captures large numbers of data to analyze the outbreak of the global pandemic and publishes research papers in the industry's top-rated journal, the New England Journal of Medicine. One of the articles was an analysis of the outbreak of the H7N9, John said they started out as a case report from China, but not from the official channel, you know ... "but do you have any idea how I know?" John asked, then jumped out of a screenshot of Sina Weibo, which appeared a hospital in Chinese medical records, the whole uproar. John said I really don't understand why Chinese doctors have dared to post patient records to public social media.

The government's lack of app supervision is one of the challenges that we have put forward. Especially some weight loss diet, weight management, physical exercise, sleep monitoring and other apps, we do not know the contents of the knowledge is correct? Is there evidence of evidence-based medicine? But in my opinion, the U.S. is fine, the Chinese app Store in the health care classification is full of a large number of food, named Test name, kidney remedies, prostate massage, such as the app, really is not language.

Finally, there is a final challenge, in fact, the most should use health technology and products are not those who are already concerned about disease and health, but those who do not care about disease and health of the people. How to convince people who don't care about their health to use health? How do you educate these people? Instead of simply stimulating ... There is no answer to the question, and it takes a lot of effort to explore interactions with these people.

At last

Congratulations you see here, I believe you have the whole health industry at home and abroad have a basic understanding, although my record is exhaustive. But keep in mind the core content of the meeting: "Patient-centric". The core of health services is to ensure patient safety and service quality, improve quality, improve efficiency, reduce risk, reduce costs--mhealth can do, can also do well.

I believe that.