CES: Digital health progress raises all sorts of new questions

By: Neil Versel | Jan 14, 2014        

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Neil_Versel_LargeLast week, MobiHealthNews Editor Brian Dolan wrote a commentary entitled, “2014: Digital health’s big year at CES?” Note the question mark.

Brian wrote that from Boston hours before the Digital Health Summit kicked off at International CES in Las Vegas. Having just covered the event myself in person, I can say the question mark still belongs.

Yes, there were more than 300 exhibitors on the almost unbelievably massive CES show floors (plural, because it took up all three halls at the Las Vegas Convention Center as well as at least two hotel conference areas) supposedly related to digital health or fitness. Yes, the Digital Health Summit was two days of wall-to-wall panels, with not so much as a full lunch break.

But, as Dr. Joseph Kvedar, director of the Center for Connected Health at Partners HealthCare in Boston, said during a panel on Wednesday, “There’s a lot of power here, but it’s raw and new.”

And there are a lot of questions, not the least of which is why the health and fitness displays were so close to booths for all the e-cigarette companies, as Frost & Sullivan’s Daniel Ruppar noted in this tweet. I guess if drug stores can sell smokes up front and medications in the back, nicotine and health can mix elsewhere. Plus, it’s Las Vegas. Walk outside the smoke-free confines of the convention center and breathe a year’s supply of secondhand smoke that has disappeared from so many other locales around the country, or just spend a few minutes on a casino floor and feel the years coming off your life. Don’t forget to dry-clean your work clothes when you get home.

Yeah, I’m getting off track, but that would make me no different from digital health as a whole.

During one session, Amy Cueva, founder and chief experience officer of Mad*Pow, a design studio based in Portsmouth, N.H., said that “sitting is the new smoking,” in terms of the damage it can do to one’s health. Cueva had everyone stand up, stretch and introduce themselves to someone sitting near them. That was a nice little exercise to be sure, but it had nothing to do with digital health.

Other speakers did put this kind of behavior into perspective, though. “Prevention isn’t in a doctor’s office,” said Samir Damani, founder and CEO of MD Revolution. and a specialist in cardiology, genomic and digital medicine. “It’s 24/7,” helped by digital technology, he said.

“That’s what CES is about, finding ways to make prevention part of people’s lifestyle,” added Dr. Richard Migliore, executive VP and chief medical officer of UnitedHealth Group.

The cynic’s view—not that I could ever be called cynical—is that CES really is about making headlines and creating buzz with flashy new technology. Yes, I, too, was in awe of LG’s stadium-sized wall of 3-D Ultra HDTVs that greeted me as I entered one of the exhibit halls. The fleet of electric-powered BMWs patrolling the streets around the Las Vegas Convention Center also got my attention, though, unlike big video boards, emission-free vehicles can actually help improve health.

“Heathy happens between doctor visits, outside of the doctors office.” Dr. Travis Stork, host of the syndicated TV show “The Doctors,” said during a high-powered session of opinion leaders dubbed the “Digital Health Manifesto.” Stork also said healthcare is not something that a physician does to a patient, but rather with a patient.

“Most of healthcare happens outside the system,” agreed Dr. Yan Chow, director of Kaiser Permanente’s Innovation and Advanced Technology Group. Chow reminded the audience that mobile health and wearable sensors are about promoting healthy behaviors, not about the technology.

Or, as Stanley Yang, CEO of NeuroSky, maker of wearable brainwave sensors, put it, “I’m using the digital to tell me what I don’t know. That’s my sixth sense.”

That doesn’t mean that all digital technologies are appropriate or viable. Chow said he has had conversations with some 2,000 startups over the years. Maybe 10 have made it to market. However, he said new companies are better informed today than two years ago, in no small part due to the proliferation of digital health incubators.

“It’s taken a while for the venture community to understand this sector,” said Wainwright Fishburn Jr., a partner in the law firm Cooley LP, in the understatement of the conference. “The investment community has become more sophisticated.” And, slowly, so are consumers.

“I think people are becoming accustomed to putting something on and having it give them feedback,” Fishburn said about wearable sensors. “Humans don’t have built-in diagnostics,” he said, showing a slide borrowed from Dr. Eric Topol.

Fishburn predicted that implantable diagnostic devices will be in wide use within 20 years. That, of course, is an eternity in technological terms, and probably too late to help many people who have serious health problems today.

Maybe by then, the industry will have figured out what to do with all the data coming from wearable and implantable devices. “Quantified self is a pretty fuzzy thing right now,” noted Leslie Ziegler, a San Francisco design consultant (and former Rock Health founding team member) who quantified her own health for a full year. In a session she moderated, Ziegler warned of a new problem from overquantification: “track-a-holism.”

Indeed, for every answer we find from digital health, there are more questions.

  • http://www.wirelesslifesciences.org/ Rob McCray

    Neil – this is very thoughtful commentary. Let’s call it “skeptical” rather
    than
”cynical” and appropriately so in my opinion. CES is all about
hype
    and any movement needs to be hyped. Publicity does not guarantee
    success but without broader awareness consumer-driven health solutions
    will not achieve their potential.

    On the other hand, without curation for quality and outcomes this movement will fail to achieve its promise. I will posit that the goal is to reengage consumers with their own health and equip them with the tools to do so. This
    requires a cultural shift, in addition to technology. The logical goal of
    connected consumer health is to reduce the avoidable demand for health
    care products and services that is created by individual behavior and
    lifestyle. This is complementary to the goal of connected health care,
    which is to improve the quality and efficiency of health care products and
    services. 


    At the risk of sounding “skeptical,” I doubt that the health care industry will
    lead the cultural shift, which, if successful, will reduce the demand for
    health care products and services by up to 50%. Thought leaders and
    defectors from the sector are critical to its internal transformation
    (efficiency, quality, 
accountability) and will play a big role if the cultural
    shift gains momentum. 
We have benefitted from this type of change in other
    sectors of the
economy including energy, entertainment and even automobiles. There is no guarantee that we will gain the same degree
    of transformational benefits of digital technologies and knowledge
    in health/health care, though that is my mission.

    Returning to the need for curation, there is a thought trend that deregulation of significant areas of digital health technologies is an appropriate policy. While I believe we should substantially modify our regulatory approaches to utilize the benefits of connected technologies and speed the approval AND removal of products from the market, substantial deregulation will consign digital health to the health care backwater with the “nutritional
    supplements” industry. $28 Billion in annual sales sounds big
    in comparison to digital health, but when the true goal is be the
    elimination of waste within the $2.5 Trillion health care sector, the
    supplements market is trivial. One reason: the weight of clinical research
    is that supplements are not generally beneficial to human health. If
    digital health goes this deregulated way, the industry will have failed. 

So,
    let’s bang the drum for connected and digital health but separate quality
    from hype by focusing on offerings that are supported by evidence and
    embrace a world in which outcomes are transparent and are used to
    continuously improve the products and services. In this manner society
    will benefit in health care as it does in some other sectors including CE
    and cars – products become better AND cheaper over time.

    Ten years ago we set out to bring the technology and health care sectors together. It is heartening to see that convergence well underway. We now face the more difficult task of driving the adoption of tech-enabled solutions for personal health and the health care system. I am good for another decade and hope you are as well.

  • Robin Raskin

    As the founder of Living in Digital Times, the parent company of Digital Health, I appreciate your lively commentary. I’ve actually thought many times of doing a pavilion called “Vice Tech” for e-cigs, alcohol and substance metering, etc. (yes, it’s a joke). One of the things i like about the Digital Health discussion at CES vs some of the others I’ve been to is the cross pollination of different disciplines. I always liken CES to the China Silk Road of yore. You can march up down the road with your own tribesmen all year, but when you get to the bazaar (Ok, maybe bizarre) that’s when advances in medicine, arts and more happen. Digital Health Summit has been orchestrated to bring new voices and ideas to the discussion. And I agree with Rob that when consumers feel vested and in control, and an economic infrastructure develops, change will happen. CES is a great catalyst for that.

  • David Davidovic

    Neil, excellent commentary. I was there and came away with similar impressions. Progress in a myriad of me-too devices with marginal value. But not much addressing health delivery, accessibility, cost and quality.