Wednesday, September 3, 2014

Silicon Valley Poised to Improve Health Care

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This post was contributed by Brian Shields

Health care has been a sector of our economy that has been largely ignored by the major tech community.  Concerns about the regulatory environment and designing applications that met HIPPAA deterred many large and small development firms from creating applications that could solve many of the major problems in health care. 

The issues with the Obamacare website in 2013 shed light on the lack of tech expertise on health care projects in the United States.  In fact, President Obama responded to this issue in December last year, assembling the titans of technology to advise him on technology in health care. Facebook’s Sheryl Sandberg, Google’s Eric Schmidt, Apple’s Tim Cook, and Yahoo’s Marissa Mayer were all in attendance at this roundtable which included other tech titans as well.

President Obama, clearly recognized that we need a technology A-Team to save our health care system.  This A-Team and their Silicon Valley neighbors are quickly responding with new technologies in 2014.

Apple’s HealthKit

Apple has put a lot of its tech muscle behind HealthKit and has spent time with the FDA and other regulatory agencies to design this platform with security in mind.  HealthKit is designed to be a secure repository of an individual’s health care information.  Building HealthKit into the IOS for iPhones allows application developers to integrate their health based apps into the HealthKit platform.  Therefore, an app developer can rely on HealthKit for the secure storage and transfer of this information to a user’s doctor, or perhaps the Patient Health record or possibly their pharmacy.

The Apple team recognized the significant obstacles that application developers face when trying to create apps for individuals in health care.  Creating an app that meets HIPPAA requirements is a bear of its own and a significant cost barrier for any developer with a good idea for a health care app. Also, creating a tool that shares information securely with a health care provider is another huge development cost, and one that also involves the risk of competing with the doctors’ other platforms.

Apple basically created a massive bridge with HealthKit.  Every day, patients are capturing individual health care information on their phones through apps such as my company’s MyWellnessApp, Lose It, Runkeeper, Instant heart rate and integrating their phones  with wearable technologies like Nike’s Fuelband, FitBit, Jawbone’s Up,  etc.  while Doctors are capturing patient information on EMRs and PHRs. The electronic info that patients are capturing is not being shared with the electronic info that doctors are capturing. HealthKit is like a bridge over an Ocean.  Application developers can now build apps that not only help improve the health care of patients, but also help them communicate with their providers.

So far, Apple has brought the big dogs to the table: WebMD, Mayo Clinic, Kaiser Permanente, Nike, and Epic are just a few of the major players that are now creating apps with Apple’s platform.  This means that an every day developer may be able to create an app that integrates with your Kaiser Patient Health record by securely saving the app data on your iPhone.  Apple’s HealthKit is bringing the health care incumbents to the table with the development community.  This is an incredible revolution ahead for us.

Beacon Technology

SF Bay based firm Estimote just launched their beacon sticker technology in the last month. These are stickers that send out signals which can then be picked up by your iPhone or Android device. This technology uses a new interface known as BLE, Bluetooth Low Energy, which sends out a signal to nearby devices such as iPhones that can be interpreted with apps.  The Apple Store and other retailers have been playing around with this technology since Apple released it in IOS7 a few months ago.  It’s a fun experience to visit the brick and mortar Apple store and see how your location in the store changes your in-store interactions on the iPhone.

These Estimote stickers make it possible for a patient to have an entirely paperless experience throughout their office visit.  A patient could be prompted to update their insurance and patient history info on their iPhone upon arrival to the office.  Also, a patient could check in digitally without needing to sign up sheets at the front desk. 

As the patient moves from one room to another, their vitals, recent history, etc. could all be confirmed with them via their cell phone as the application interacts with the proximity beacon in the office.  For example, the doctor could record his orders to the patient in the EMR and the patient confirms these orders in their iPhone.

These proximity beacons have been a game changer, but their portability on stickers is really a significant step forward.  A sticker can be placed on sneakers to record a visit to the gym, placed near your bed to record your patterns of rest, or even  placed on your water bottle to record water consumption.

Salesforce.com’s Digital Health Care Platform

In June, another Silicon Valley heavyweight, Salesforce.com, entered the health care arena with their own partnership with Phillip’s Health Care.  Through this partnership, Salesforce will develop a platform to allow patients and healthcare providers to interact and jointly monitor healthcare signals from Phillips suite of medical diagnostic devices, such as home care devices for sleep apnea and COPD.  Salesforce.com’s business model has really been about an open API or Application Programming Interface. This is basically a set of instructions that allow a software developer to develop an app that exists in the Salesforce.com ecosystem.  This term ecosystem is a very important one for health care heavyweights. Without an ecosystem for developers, it is very difficult to create change and innovation in healthcare-- There is an over reliance on incumbents.  Salesforce and Apple are making significant steps to change this.

WebGL and IOS Support

WebGL is a programming interface that allows users to view 3D animation on their modern browsers without the need of a heavy plug-in such as Flash.  Google has been a key proponent of this technology with Chrome support, and even sharing a website dedicated to these browser based 3D applications.  This technology took a significant step forward when Appleannounced support for WebGL in their new IOS 8, set to release in a few weeks.

Why is WebGL so important?  Anatomy and mechanisms of disease and action are most accurately expressed in 3D. This is a technology that has been identified by Silicon Valley startups as a game changer. I’ve been fortunate to work with some leading startup technologies such as Famo.us and MontageStudio and see their user interface technologies improve on a monthly basis.   These platform technologies allow developers to integrate 3D models from products such as Autodesk’s Maya into interactive learning applications. One such application for health care is my company’s own MedGL product. The future is bright for this technology. It’s one thing to see a 3D image of your recent knee MRI on your healthcare provider’s desktop. It will be another to interact with your own knee model on your browser or even print the joint with your local 3D printer.  

2014 is an exciting time to be a Health Care Developer.  The technology heavyweights are creating ecosystems that allow apps to connect patients with their providers through platform integration. Allowing the development community to tap into these ecosystems is a significant step forward.  Major pharma can play a role by getting a seat at the table with technology heavyweights, and partnering with startups to foster innovative application development.


You can hear more from Brian Shields at this year’s ePharma West.  Join us September 22-24 in San Francisco, CA. Download the agenda to see what’s on tap.   

SAVE 15% off the standard rate. Register here and use code XP1956SPKBSH.

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