Category: Technology

Judgment day at Planet Fitness

published date
February 13th, 2020 by
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No judgment

My hotel in NYC has a decent gym, but I was looking for something more. So I visited the Planet Fitness right on the same block. I’d never been to a Planet Fitness before, but right away I noticed something odd. “Judgement free zone,” is plastered all over the place. It’s on the walls and every piece of equipment –pretty much everywhere.

Back in the day (before spell checkers) I was a good speller. I did well in the spelling bee at summer camp as a kid. (I didn’t win, because I got nervous and misspelled the word “recommend,” even though I knew better.) Still, I can usually spot a typo, and I didn’t think the American version needed that extra “e.”

Sure enough, Easy Street blogged about this very topic five years ago.

Misspellings provoke judgment from readers who catch errors. However, as with most misspellers, Planet Fitness had moved on. According to a spokesperson, “Spelling judgement with an ‘e’ started out as a mistake. Back in 1998 we considered changing it to the traditional spelling, but decided to keep it because it fit with our brand personality—we are judgment free on all matters, so what better way to demonstrate this than by keeping the original incorrect spelling.”

Who really cares? No one.

But it did get me thinking about how computerized tools and artificial intelligence can rob us of certain skills and brain function, even a they relieve drudgery and improve quality and consistency. Think about the GPS. On the one hand, it guides me to the optimal route and gives me the confidence to explore unknown areas. On the other hand, I can barely read a map these days or learn new routes on my own.

The same problems apply to healthcare providers, and I first wrote about this issue nine years ago: Are decision support tools turning doctors into idiots? If every answer is a click away or embedded into automated decision support tools, it’s hard to think for oneself.


By healthcare business consultant David E. Williams, president of Health Business Group.

Can smartphones save us from coronavirus?

published date
January 29th, 2020 by
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Happy Chinese New Year!

A friend came home from a business trip to China on Friday. His kids (teens and tweens) were ready to hug and kiss him when he returned –as they usually do-, but when they heard his cough they fled to their rooms, slammed the doors and donned surgical masks.

Did dad bring the coronavirus home with him? Except for his wife, no one in his family was taking that chance.

Which got me thinking, what’s changed since the last epidemics of  Ebola, avian flu and SARS…?

For one thing, cell phones and the Internet have become ubiquitous. Bad news travels fast, and there’s no keeping the kids in the dark.

On the other hand, maybe smartphones can help keep us safe. For example, I’m impressed by ResApp, an Australian company that helps doctors diagnose respiratory illnesses by analyzing the data in coughs. Is it asthma, COPD, pneumonia, or nothing serious? ResApp uses the smartphone to figure it out. (Here’s my interview with the company from 2016.)

The tool is designed to be used by healthcare professionals (probably to keep regulators from getting nervous about self-diagnosis) but it seems to me that patients could use the app themselves and just send the data over the web for confirmation, avoiding the possibility of infecting healthcare workers and other patients.

Kids are about to go back to school in Australia after summer vacation/fire season (remember they’re on the upside down part of the world), and everyone’s nervous that coronavirus will show up in the classroom.

I asked ResApp CEO Tony Keating CEO for his opinion. He said

The identification and isolation of patients with viruses such as this novel coronavirus is a critical public health step. Like SARS and MERS, 2019-nCoV causes pneumonia – an infection of one or both lungs, causing cough, difficulty breathing and/or fever. People with these symptoms can be identified (in places like airports), isolated, and sent for further molecular testing. However this screening is difficult, as not all patients with the virus may have a fever at the time and infrared thermometers are not 100% accurate. These symptoms are also indistinguishable from the usual winter illnesses such as influenza. New screening tests which are rapid, accurate and portable could improve screening, and potentially reduce the global spread of these viruses.

Sounds promising to me. Let’s hope these new solutions can come online soon.

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By healthcare business consultant David E. Williams, president of Health Business Group.

Life Image CTO Janak Joshi discusses real world evidence (RWE) –podcast

published date
August 12th, 2019 by
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Real world evidence?

Real World Evidence (RWE) is becoming more important in US healthcare, but the fragmented system and lack of interoperability makes it hard to collect and analyze. In this podcast, Life Image CTO Janak Joshi discusses  the state of the field and how it’s evolving.

Overview:

  • (0:12) How would you describe the evolution of medical data?
  • (2:36) Real world evidence and real world data are becoming more prominent in healthcare –and for good reason. What are some of the challenges in assembling RWD and RWE? How can they be overcome?
  • (6:36) Is it really true that unstructured notes are becoming quantifiable and useful?
  • (9:46) There are major efforts by the US government and private sector to improve interoperability and end data blocking. You have groups like CommonWell and Carequality –now working together. What’s the current state of play and how are things changing?
  • (13:56) You talk about data brokers like Datavant and HealthVerity. How much of their success is because the US system is so broken? Do you see them having the same success elsewhere?
  • (17:31) Promoters of AI and Machine Learning –including Life Image—tout the opportunity to revolution healthcare with these new techniques. Is it for real or overhyped? And how does interoperability tie in?
  • (22:20) What are you most excited about over the next few years?

By healthcare business consultant David E. Williams, president of Health Business Group.

Interoperability in healthcare 2019: Podcast interview with Rhapsody

published date
March 19th, 2019 by

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Interoperability has a been a buzzword in healthcare for about a decade, but sometimes it doesn’t seem like we’ve gotten that far. In this podcast, Rhapsody’s EVP of Product & Strategy, Drew Ivan and I discuss interoperability: its past, present and future.

Here’s what we covered:

  • 0:20 What is interoperability anyway?
  • 2:50 Why do we hear about interoperability so much in healthcare? Is it an issues in other industries?
  • 5:11 How does interoperability in the US compare to the situation elsewhere?
  • 6:51 Does interoperability matter to patients?
  • 9:20 Has interoperability failed in the past? What new models are being tried?
  • 11:54 What’s the business model for interoperability?
  • 13:42 Are there any downsides? Does interoperability create any new problems?
  • 14:54 How will interoperability evolve in the coming year?

By healthcare business consultant David E. Williams, president of Health Business Group.

Amazon: Force the healthcare system to become patient-centric

published date
February 6th, 2018 by

The announcement that Amazon will work with JP Morgan Chase and Berkshire Hathaway to create a new healthcare organization for employees has health plans and providers running scared. Initial press coverage has focused on the impact of this group on the market value of CVS, United Healthcare and the like –but how many people really care about that?

CareCentrix CEO John Driscoll has the right idea when he suggests that Amazon should compel provider organizations to put the patient first –for real, not just rhetorically. His three specific suggestions are good ones: mandate self-service scheduling, introduce  a universal patient portal, and improve the quality of provider reviews. As simple and straightforward as those sound, they would require Amazon and its partners to overcome serious resistance. It will be fascinating to watch what happens.

Assuming Amazon can make those basic but challenging changes come to pass, I have two additional, ambitious suggestions to help patients:

  1. Ensure that patients receive clear, consistent, actionable follow-up information when they leave a doctor’s appointment or are discharged from the hospital.
  2. Use the full set of information available about a patient to anticipate their needs and help them navigate the system.

The first idea is a simple one, which should be happening anyway, and occasionally does. The challenge is to get the provider system to care enough about what happens upon discharge and provide the tools, training, information and support to enable more seamless and empowering transitions. I was shocked at how poor the discharge instructions were after my release from the emergency department a few months ago, after I was struck by a car. I received basically nothing and had to count on family and clients in the medical system to help me. I know I’m not the only one who’s had this experience.

The second idea is broader and vaguer, but starts to draw on the expertise of Amazon’s partners who are in the financial services and insurance industries and have a lot of information about their customers. The consortium could help patients chart their financial path through the healthcare system, helping them identify what insurance to select, how much to save in their HSA and FSA, and where and when to get their care. It could be a virtual concierge for patients, relying big data and machine learning to provide insights and continuous improvement.

If these suggestions were implemented they would have a high impact, even though they would not completely transform the system. It seems like about the right level for this group to shoot for. If they try to be bolder they will likely fail.

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By healthcare business consultant David E. Williams, president of Health Business Group.