Health 2.0 2014: Infrastructure Gets Sexy, HCP Apps Steal the Show

Two of the industry’s best-known and most influential conferences occurred within weeks of each other earlier this autumn —TEDMED in Washington, DC and San Francisco, and then, a fortnight later, Health 2.0 in Santa Clara, California.

The tight scheduling made it tough for many people to attend both. But for those like me who could, the temporal proximity made it easy (and instructive) to compare these two marquee events. To compress the contrast to a single sentence: TEDMED is all about inspiration and high-minded theory, while Health 2.0 is all about pragmatism and practice.

Health 2.0 is like an entrepreneurial swap meet, where healthcare entrepreneurs deliver 200 presentations/pitches in just four days. Rather than hoisting the lofty goal of changing the world from 20,000 feet, Health 2.0 is all about on-the-ground solutions to real-world problems. Oh yeah, and getting people to buy or invest in these solutions. NOW.

With so much delivered so quickly (some presentations were less than 15 minutes), I have to admit to a certain amount of new-venture vertigo; it was hard to keep things straight and I had to check my pulse occasionally to monitor for tachycardia.

Yet despite the whirlwind of innovation and maelstrom of tweeting about innovation (which generated 11,000 pages of tweets, which I know only because we used software to track it), it was actually remarkably easy to see the major trends:

1) Too many companies chasing the same idea

2) Patient apps are Many, but HCP apps are Money

3) Infrastructure is now what’s really Sexy;

4) Pharma and Med Device companies have a real role that they are mostly not playing now, and

5) It takes a special person to compare Healthcare to Porn

Silicon Valley Express

When you send a tweet from the Santa Clara Convention Center, which was the venue for Health 2.0, the location comes up as “Palo Alto.” A bit odd, but also fitting, since it underscores the degree to which Health 2.0 is a Silicon Valley event: right smack dab in the center of the tech labyrinth, less than ten miles as the crow flies from both the Googleplex and Apple HQ. And, as if the power shift needed to be made any more obvious, this year the San Francisco 49ers moved their home field to Levi’s Stadium—literally across the street from the Convention Center.

And that’s the most distinctive thing about Health 2.0: unlike all the other healthcare conferences, this one is imbued with the VC-charged ambition and impatience of the Silicon Valley culture. Whereas in Washington I met doctors from across the globe envisioning new ways to deliver healthcare, in Santa Clara I met entrepreneurs from down the road who saw healthcare as the next big place to find a billion-dollar opportunity. Which is not to say their interest in healthcare was any less earnest or noble than the TEDMEDers; in fact, their pragmatism was actually refreshing and their initiatives potentially a lot more impactful. The energy and, frankly, the brainpower of the group was also markedly more juiced than anything I’d seen at the ‘standard’ pharma industry conferences. And I wondered, for a moment, whether the pharma organism would be able to absorb such an implant, or ultimately reject it?

On the other hand, it’s also true that if a revenue model for “the new healthcare” can’t be figured out in relatively short order, the VCs are likely to withdraw and turn again to exploring the potential of wind turbines and bitcoin. Witness the fact that both Google and Microsoft abandoned their earlier, ambitious healthcare initiatives when they learned just how hard it is to change the healthcare industrial establishment, at least in a timeframe they found tolerable.

So Many Companies, So Few Singular Ideas

This was the 8^th Health 2.0 event, and I had read other commentators declare how this year’s gathering had ‘matured.’ Maybe so, but I was struck by the fact that so many companies seemed to be chasing the same goal, in remarkably unremarkable ways.

We live in the era of Fitbit, UP24, and Nike Fuel (and just this week the introduction of Microsoft’s own fitness band, ingeniously called “Microsoft Band”). And each of these devices comes with complementary software and some form of ‘cloud’ data integration. So I was surprised to hear Walgreens, Withings, Medtronic, and several other companies offering their own versions of fitness tracking programs. Each has its own unique spin, to be fair, but there just seem to be too many companies chasing more or less the same idea.

For example, Walgreens demonstrated its “Balance Rewards for Healthy Choices” program, which offers store points for good health habits, like exercise and smart nutrition choices, and also allows you to track your Rx preferences and immunization information. It’s potentially useful to have all this information in one place, and maybe the allure of Walgreens points is strong enough to motivate people to make the app their preferred tracker. But is Walgreens ever going to be the place you trust with all your healthcare vitals? And will they ever be able to innovate as quickly as the true tech companies in the field? I’m skeptical.

Withings, yet another company with fitness trackers (a Wi-Fi digital scale, the Pulse fitness tracker, and now the Activité fitness watch) also offers software to tie it all together. Withings makes good equipment (I use their Wi-Fi scale) but again, why will they win out over any of the dozen or so other fitness companies providing variations of basically the same thing?

Then there is Medtronic, a “traditional” medical device company that deserves enormous props for developing something unusual (if not entirely unique) in the Medical Device industry. According to Samantha Katz, who was at the time Medtronic’s Global Marketing Program Manager, their Guardian Mobile continuous blood glucose monitoring (CGM) system syncs via Bluetooth to a smartphone and allows people with diabetes to live their lives without the need to carry around a separate blood glucose monitor. A noble purpose and, if and when it’s FDA approved, let’s hope it fares better than Sanofi’s ill-fated iBGStar blood glucose meter, also designed to hook up with a smartphone.

Katz then explained that Medtronic’s Guardian also incorporates workout and other activity information, which is where I started to lose interest. A single-minded purpose to solve problems for people with diabetes—great. But to then add on fitness tracking and other ancillary tracking, to essentially start competing with the Fitbits of the world… hmmm. Why is it not enough to do one thing extremely well, without throwing in features that are bound to be pale imitations of more advanced technologies? The importance of a single-minded vision seemed generally absent among the patient apps presented at Health 2.0.

Katz mentioned that Medtronic was also “looking into” how to share the CGM data with doctors, which I will take as an opportunity to segue to a much more important theme at Health 2.0: the movement from consumer to professional apps and devices.

Follow the Money

While more investment bets were placed on consumer apps, the most investment dollars went into professional-facing apps. And beyond the money, the utility and differentiation of the professional solutions were simply a lot more exciting.

Dr. Eric Topol, the eminent cardiologist and frequent author (most recently of “The Creative Destruction of Medicine”) delivered the keynote on the first full day of the conference, and was very bullish on the potential of smartphones to significantly augment the physician’s practice.

Dr. Topol, is an early and persistent innovator in the wireless healthcare space (currently he serves on the board of Triage Wireless). But Dr. Topol’s talk was not at all self-serving but really quite visionary about the future of healthcare. (For an amusing take on it all, check out his appearance on the Colbert Report: http://thecolbertreport.cc.com/videos/udr4lu/eric-topol).

As he demonstrated to Mr. Colbert, Topol’s take is that the smartphone is becoming an irreplaceable adjunct to the physician’s black bag— only much more powerful and user-friendly: injectors, inhalers, patches and diagnostics, all delivered through mobile devices communicating in the cloud.

There followed a number of excellent examples of just such technologies: Jim Taschetta from iHealth Lab talked blood pressure monitoring; Connor Landgraf from Eko Devices explained how much more useful a smartphone was than a stethoscope, and Dr. Irv Loh of Infermedica discussed the role of mobile technology in improving diagnoses.

In the always intriguing, intersecting space between the doctor and the patient, another technology appeared to offer great promise. Brent Vaughan from Cognoa demonstrated a remote diagnostics platform that would help pediatricians diagnose whether a child might be developing along the autism spectrum; the videos can enable predictive assessment of the child’s risk and, crucially, enable earlier interventions than might otherwise occur.

I could go on and on with more examples (like Plushcare, another remote diagnosis platform that promises on-demand connections with docs from Stanford and UCSF, or PokitDok…), but the general point is that these “single-minded solutions” were one of the two most important trends I saw at Health 2.0.

Platform Heals

The single most important trend, though, wasn’t about providers or patients at all. It was about platforms.

With the rollout of Apple’s Healthkit, healthcare platforms are actually becoming sexy. And if history is a good predictor, Apple’s platform is the most likely to be market-changing. But the initiatives from Samsung, Google and now Microsoft all merit serious attention as well.

Certainly Young Sohn, Samsung Electronics’ President and Chief Strategy Officer, thinks so. Here’s how he described the company’s platform called SAMI (Samsung Architecture Multimodal Interactions – officially the worst excuse for a memorable acronym ever crocheted together.)

“We’re going to create a platform,” said Mr. Sohn. “The reason we did that is very simple. I don’t think the issue of solving health-related topics can be done by one company. It needs to be done by many others that can contribute. So we decided to create a platform where different hardware companies can contribute, different software companies can contribute, and then in the process we believe that we can accelerate innovation.” (as quoted by Jonah Comstock, in MobiHealthNews, 9/23/14)

In healthcare, Samsung has seemed to be a step or two behind Apple. But it’s an industry heavyweight and fast follower that can’t be taken lightly.

Yet for my money, the most intriguing approach to mobile health platforms came from a smaller player, microchip pioneer Qualcomm, whose Qualcomm Life 2net Platform focuses on “universal interoperability with different medical devices and applications.”

For old nerds like myself, Qualcomm has long been one of the most important technology companies in the world, pioneering the CDMA cellular compression algorithm as well as many of the mobile chipsets that power many of the world’s smartphones. Qualcomm is like the Intel inside the mobile revolution. In healthcare, they have pursued a similarly behind-the-scenes, yet central position. Their 2net Platform essentially allows medical devices to connect and move data from the patient to whatever system they need to connect to.

Qualcomm Life is seeking to become the “enabling technology” behind the healthcare data revolution. So, as opposed to developing yet another fitness tracker thing-y mated to someone’s wrist (although Qualcomm does sell one of those too), Qualcomm thinks the true value lies in making the connections between thingies easy, productive, and secure.

In another session, someone called Apple’s Healthkit “the greatest gift to mobile health industry.” Same idea. By making it easy for the systems to talk to each other, these companies are removing an enormous amount of friction from the delivery of the healthcare future. So healthcare companies (and yes pharma companies are healthcare companies) can focus on what they’re good at, and not on trying to figure out how to make devices talk to each other securely and reliably.

Where Was Big Pharma?

Besides Medtronic, I saw very few pharma or med device companies presenting at Health 2.0. Which was surprising and disappointing. Because now that the systems companies are finally making it easier to connect everything, there is just so much potential for pharma and med device companies to add value while working in a realm where we have real strength and expertise. We understand the real needs of doctors, patients, caregivers and payers. We understand the true limitations of working in a regulated environment (there’s still enormous naiveté about that in Silicon Valley) and we have ability to measurably improve outcomes and the quality of the healthcare delivery experience at virtually every point along the patient journey.

Maybe it’s still a tad too early yet for Big Pharma, but serious executives (most definitely including marketers, who really must redefine their purpose in the digital age) need to be thinking seriously about the opportunities that are opening up so rapidly right now.

Is Healthy Porn an Option?

I don’t want to end my reminiscence about Health 2.0 without citing the most outrageous and entertaining speaker of the event. Jonathan Bush, CEO of EHR company athenahealth, walked on stage with a bag of balls, handed them to his interviewer, Health 2.0 co-host Matthew Holt, and asked him to “hold his balls.”

Then he got irreverent.

“Beer pong is the key to more disruption in healthcare.”

And “it makes no sense to be an entrepreneur in healthcare when you can be in porn.” (Which may be why Sergey Brin of Google declared that healthcare was just too difficult.)

Outrageous attention-seeking behavior? Sure. But he also said this:

“The problem with our healthcare system is that it’s not an expression of our humanity.”

And finally this: “Transformers have opportunities; others will die.”

Sometimes the truth can be outrageous.

About the Author

Bill Drummy is Founder & CEO of Heartbeat Ideas and Heartbeat West.