Robotic process automation for healthcare

Peter Nichol
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Robotic process automation for healthcare

Autonomics and multi-agent systems will be applied in healthcare to definable, repeatable, and rule-based processes. Robotic process automation will be a competitive advantage, not replacing humans but enabling them.

Autonomics ultimately aims to develop computer systems capable of self-management and was started by IBM in 2001. These self-regulating autonomic components are driving the research of multi-agent systems (MAS). MAS are computerized systems composed of multiple interacting intelligent agents within an environment. Robotic process automation (RPA) is capable of automating activities (by creating software agents) that once required human judgment. This is the evolution of automation: the automation of automation.

Transactional to analytical

In 1990, traditional onshore labor was the norm. By 2000 offshore labor was ripping through every industry including healthcare. Huge cost savings were realized shifting from the traditional onshore model to an offshore model. The next revolution of digital labor is called “no shore.” This robotic process automation is autonomic, self-learning, and self-healing system.

The Institute for Robotic Process Automation (IRPA) published an excellent report highlighting the top ten benefits of robotic process automation that cross industries.

1. Decreased operational costs – no shore models (digital software agents)

2. Improved data analytics – task executed by robots allow for analysis

3. Increased regulatory compliance – steps are tracked, traceable, and documented

4. Increased efficiency – software robots never need time off

5. Higher employee productivity – software agents address repetitive activities, freeing workers to participate in more value-added activities

6. Improved accuracy – employees are human, and all humans make mistakes

7. Increased customer satisfaction – decreased errors build deeper customer relationships, improving retention and customer happiness

8. IT support and management – it’s easier to scale software than it is people

9. Logistical upside – minimize or eliminate complications with offshore labor

10. RPA and business processors – presentation-layer automation software, mimicking the steps of rules-based non-subjective processes

Automation process cycle

When do labor efficiencies become labor elimination? To better understand how RPA can enable your organization we first need to identify the five phases of the automation process cycle:

1. Manual execution – one off, no repeatable processes

2. Scripting – linear tasks, standard and repeatable

3. Orchestration – activities that are complex, standard, and multi-scripted

4. Autonomics – dynamic processes that are non-standard, contextual, and inference based

5. Cognitive – self-aware systems, that are predictive, self-learning, and self-healing

If we want our employees engaged in activities that involve personal interactions, problem-solving, and decision-making we need first to get them out of the tedious and repetitive activities.

What if you were told there will be a new team member joining your team. You’re not sure where they are geographically located, but you managed to get some intel from your colleague. You are told they never complain, didn’t want a desk, never need coaching, and love daily performance reviews. This is the resume of the modern robot, a leader in process automation. The competition just got stiffer.

Multi-agent systems

Robotic process automation begins with an understanding of agents. Typically, multi-agent systems refer to software agents, but these systems could equally be robots or hybrid robot and human teams.

There are three primary types of agents: passive agents (simple – agents without goals), active agents (advanced – agents with simple goals, and cognitive agendas (complex – with complex calculations and activities). Agent environments where these types of agents reside can be divided into three environments: virtual environment, discrete environment, and the continuous environment. Also, each agent environment has one or more associative properties:

1. Accessibility – when possible to gather complete information about the environment

2. Determinism – if an action performed in the environment causes a definite effect

3. Dynamics – how many entities influence the environment at the moment

4. Discreteness – whether the number of possible actions in the environment is finite

5. Episodicity – whether agent actions in certain time periods influence other periods

6. Dimensionality – whether spatial characteristics are important factors of the environment and the agent considers space in its decision-making

RPA applied to healthcare

Transparency Market Research, predicts that the global IT robotic automation market to be worth USD $4.98 billion by 2020. Robotic automation is a powerful alternative to offshore outsourcing. It is curious how these processes managed to escape automation. Regardless, there are many areas where RPA can be applied to healthcare including account management, claims processing, underwriter support, customer support, billing, collections, reconciliation, and reporting and analytics consolidation.

The HfS Blueprint Report helps us identify precisely where RPA can be applied within the healthcare ecosystem.

1. Claims administration – claims adjudication and processing, payment integrity complaints, and appeals

2. Member management – account setup, eligibility, and enrollment, billing, benefit management, and customer service

3. Provider management – provider credentialing, provider data management, contracting audits, and network management

4. Health & care management – population health and wellness, utilization management, care coordination and case management, and remote monitoring

5. Administration – finance, accounting, and training

Intelligent automation is entering the business world, and CFOs are happy because RPA is delivering the promised cost savings. However, cost-only value propositions are no longer attractive to top executives. They are looking for cost-plus value propositions (transactional plus judgement-intensive plus analytics). Global labor arbitrage, the disintegration of barriers to international trade or moving to where costs of doing business are low, is no longer sufficient. In this quest for greater cost-plus value propositions, technology plays a critical role.

Start by getting to understand where repetitive task hurt your organization. First, identify the opportunity, second validate the opportunity, third design the mode, and fourth deploy a pilot. Health plans and providers are discovering software agents as a cost-effective alternative to enhancing or replacing platforms.

The conversation has expanded beyond cost reduction to quality, engagement, and innovation. This new phase of sourcing will engage and manage resources to shift workers from the mundane task to activities with deeper customer interactions.

Health innovators are using robotics process automation to drive the next stage of transformation – at affordable costs. Robotic process automation isn’t coming soon; it’s here.

Telehealth and the levers that will move the healthcare industry

Peter Nichol
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Telehealth and the levers that will move the healthcare industry

Telehealth changes how care is provided at the state and national level. Telehealth policy is a determining success factor. Thinking of rolling out a telehealth program? Providing telehealth challenges providers.

There has been a lot of progress in telehealth over the last three years. In 2013 there were only 13 states that were cleared for consultation and prescribing and three states restricted consultation in the absence of a prior in-person relationship. According to American Well, a telemedicine technology solutions company by January 2016 most states had been cleared to consult and prescribe, with various exceptions in Alaska, Louisiana, and Indiana. Inconsistent state definitions create challenges for national providers. Clinical permissibility, licensure, and reimbursement remain the flagship challenges.

Inconsistent policies

It’s often said that the only thing consistent about telehealth is that it’s inconsistent.

The Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine was reported by the State Medical Boards’ Appropriate Regulation of Telemedicine (SMART) workgroup and later was adopted as policy by the Federation of State Medical Boards (FSMB) in April 2014. This new policy guided regulation of state medical boards in the use of telemedicine technologies in the practice of medicine and educates licensees as to the appropriate standards of care in the delivery of medical services directly to patients via telemedicine technologies. This policy blazed the path for telemedicine adoption by superseding the Model Guidelines for the Appropriate Use of the Internet in Medical Practices previously adopted April 2002.l 2002.

Clinical permissibility

Clinical permissibility comes down to whether or not providers can deliver care via telehealth. Mainly this discussion swirls around telehealth policy. However, the Medical Boards have made significant strides to get the policies right. Informed consent, the evidence documenting appropriate patient informed consent for the use of telemedicine technologies must be obtained and maintained. Informed consent is a primary consideration with telehealth policy and includes:

1. Identification of the patient and physician (physical credentials),

2. Types of transmissions permitted using telemedicine technologies (prescription refills, appointment scheduling, patient education),

3. Patient agreement (that it’s the physician’s decision as to whether a telemedicine encounter is appropriate),

4. Adequate security measures (data, passwords, files, identification and authentication techniques),

5. Hold harmless clause (if due to technical failures information is lost), and

6. The requirement for express consent to forward patient-identifiable information to a third party (administration, billing, care).

These six factors ensure that informed consent is appropriate. However, even after informed consent is secured other clinical issues surface. Can the provider establish a treatment relationship sufficient to prescribe using telehealth? Must a prior relationship have been established? Is this the same standard of care as a facility visit to a provider? Does this encounter include a prescription for controlled substances or does this encounter trigger a limited formulary? Each of these questions needs to be addressed and communicated to the patient, to ensure the patient understands whether of not a prior examination is required before care is administered.

These questions also weigh on the minds of the state medical and pharmacy boards and national organizations such as the American Medical Association and Federation of State Medical Boards.

Reimbursement and licensure

State legislation defines the telemedicine reimbursement models for commercial and Medicaid reimbursements. Understanding how providers expect to be paid for telehealth is essential.

Credentialing and privileging are the same challenges providers face with facility-based care models. Providers are pressured to offer a large number of health plans across a diverse network of providers. Providers must also select privileged practitioners who can provide credentialed care. It’s tough for providers to keep up with multiple state licensure for clinicians that are decentralized.

Anticipating this licensure, the Federation of State Medical Boards issued the Interstate Medical Licensure Compact Legislation. According to the FSMB, the Interstate Medical Licensure Compact offers an expedited licensing process for physicians interested in practicing medicine in multiple states. The Compact is expected to expand access to health care, especially to those in rural and underserved areas of the country, and facilitate the use of telemedicine technologies in the delivery of health care. The Compact legislation to expand access to healthcare by expediting medical licensure has been adopted by 16 states including Kansas, Mississippi, Alabama, Arizona, Idaho, Illinois, Iowa, Minnesota, Montana, Nevada, New Hampshire, South Dakota, Utah, West Virginia, Wisconsin and Wyoming.

For states without compact legislation provider complexity is magnified. While NCQA and URAC accreditation help to ensure provider quality, they don’t do much to ensure multi-state licensure interoperability.

Evidence of progress

There are 29 states including Washington D.C. that have mandated commercial reimbursement for telehealth, as of mid-2016. Several states subscribe to parity mandates, which are a form of commercial mandates that require services be paid to the same extent and at the same level as in-person services (NV, MT, MN, CO, MS, LA, ME, DE, and CT). More cautious states, offer commercial reimbursement with limitations or restrictions, that mandate coverage for commercially provided telehealth services but contain limitations and site restrictions.

As patients demand to be the CEO of their health, the healthcare ecosystem will need to work together to tackle clinical permissibility, licensure, and reimbursement before telehealth goes mainstream.

mHealth and telehealth flight for inclusion

Peter Nichol
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mHealth and telehealth flight for inclusion

Telehealth is one of the fastest growing markets, and broad adoption is building from modular telemedicine units to teleaudiology. Not all providers are finding transitioning skills easy.

The global telemedicine market is projected to grow to $66.6 billion by 2021, at an estimated CAGR of 18.8 percent during the forecast period 2016 to 2021, according to Mordor Intelligence. While this seems significant, it’s a fraction of the market, especially considering that U.S. health care expenditures were estimated to be $3.24 trillion in 2015, and forecasted to increase to $3.78 trillion by 2018, reported by Forbes.

The adoption curve

Gartner published an excellent overview in mid-2015 that covered the hype cycle for telemedicine and virtual care. TheGartner Hype Cycle has five phases: 1. Technology trigger (tech breakthrough), 2. The peak of Inflated Expectations (media over hypes the technology), 3. A Trough of Disillusionment (pilots fail to deliver and interest declines), 4. The slope of Enlightenment (value is apparent as pilots are refunded), and 5. Plateau of Productivity (mainstream adoption becomes a reality).

The definition of telemedicine appears straight forward. Telemedicine is the use of telecommunication and information technologies to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities. What does that mean? Healthcare institutions are interpreting clinical care in different ways. Executives do have options to understand better how other practitioners are approaching telehealth. The mHealth + Telehealth World conference held in Boston July 25-26, 2016 will tackle the role of technology in health and help executives to understand the impact of the connected world on the future of healthcare.

Telehealth clinical applications

Telehealth is used in various areas to improve clinical care across the healthcare industry. The Gartner hype report presented evolving concepts to help CIOs define business strategies and prioritize their investments.

1. On the Rise – Digital Telepathology, Patient Decision Aids, Telepsychiatry, Telesurgery, EHR Support of Virtual Care, and Teleaudiology.

2. At the Peak – Modular Telemedicine Units, Healthcare-Assistive Robots, Medication Compliance, Management, Quantified Self, Wearables, Real-Time Virtual Visits, and Teletrauma.

3. Sliding into the Trough – Continua, Personal Health Management Tools, Telepharmacy, Mobile Health Monitoring, Video Visits, and Teleretinal Imaging.

4. Climbing the Slope – Home Health Monitoring, Telestroke, Teledermatology, Remote Electrocardiogram Monitoring, and Patient Portals.

5. Entering the Plateau – E-Visits and Remote ICU.

Applied perspectives for better health

The best approach for telehealth will depend on the provider practice. However, in almost all cases it starts with a champion who is a clinical practitioner who thoroughly comprehends the reimbursement cycle.

Once the champion is on board start with a pilot that will have depth. Two classic business cases where telehealth can be beneficial are chronic disease management and episodic care management or continuous care. Chronic illness management can shift a significant portion of facility care to telehealth. This is, however after face-to-face visits resulted in a relationship between the physician and the patient. The is nothing more important than trust in healthcare, and it’s built best in person. Episodic care management is less frequent and therefore makes a good case for telehealth replacement. MedStar Health operates more than 120 entities with over ten hospitals in the Baltimore area. Medstar Health started to offer telehealth first to employees through a pilot during 2015. This pilot expanded in 2016 to encompass those they insure. The last step is to beta telehealth in public.  

The hill yet to climb

We will get past the technical issues with mobile coverage and poor connectivity. Let’s also assume that the current fee-for-service (FFS) models are replaced with value-based payment models (shared savings, bundles, shared risk, and global capitation).

MedStar experienced three main challenges: scheduling across states (given providers are state-licensed), equipment setup, and administrative policies (coding online visits).

We all want to reach the tipping point where societal perceptions of healthcare include telehealth. This collective benefit will impact the cost of care, quality of care, and access to care. This leads us to one question: are providers ready to transition their skills?

There is a significant difference between bedside manner and webside manner. Doctors must combine their medical knowledge with technical knowledge. How will doctors be trained for this new environment? Computer-based training (CBT) is out. Train-the-trainer is also ruled out. We’re left with a training approach that requires providers to train-by-doing. To provide telehealth, you must practice providing telehealth. This means bringing telemedicine into the academic setting to prepare residents of the challenges early and educate on the huge societal benefit of remote care.

Compensation, administration (billing), and technology still have issues to work out. We’ll get there, but before the patient can be placed in charge of their health, they need to be educated. This education will require more provider time, not less. Telehealth offers an alternative to providing education to patients without a physical visit allowing providers to explain medication, images, and diagnoses more thoroughly.

Telehealth has the potential to increase patient satisfaction and trust. The success of telehealth begins with everyone starting from the same step – getting educated.

Improving health with prediction markets

Peter Nichol
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Improving health with prediction markets

Patients will soon be managing their chronic diseases as in-person support goes global and as collective wisdom produces clinical insights surpassing the knowledge of any single physician. Market predictions will be part of the future of health.

The wisdom of the crowd opens conversations around treatment options, symptoms, and options moving for improved patient care. Thinking and information processing (cognition), coordination (optimization of the utilization), and cooperation (how groups for networks of trust) applies to artificial intelligence, analytics, co-creation, and principles of the sharing economy. Social networks are creating new health information with disease association support groups (think crowd analytics). The collision of social media and healthcare create global crowds. These groups no longer need to be led by the smartest people. How clinical experience and insights are collected is changing.

Wisdom of the crowd

Are irrational mobs capable of wisdom that can be used to predict markets? In the age of social and global connected economies, can crowds make you healthier?

These principles are harnessed in the wisdom of crowds. The psychology of crowds is explained in James Surowiecki’s book, The Wisdom of Crowds. This captures his primary thesis on the wisdom of the crowd: the collective opinion of a group is superior to that of a single expert. Surowiecki, expanded on the 1841 work Memoirs of Extraordinary Popular Delusions, by Charles Mackay. Mackay is famous for saying. “Men, it has been well said, think in herds; it will be seen that they go mad in herds, while they only recover their senses slowly, and one by one.” Mackay didn’t see a lot of intelligence in crowds. Surowiecki took a differing perspective in response to Mackay’s work, saying that given the right circumstances, crowds or groups may have better information and make better decisions than even the best-informed individual. 

Crowd-enabled health

PatientsLikeMe is a great example of where connecting to people like you, learning from others, can improve your personal health. PatiensLikeMe provides a more efficient method for patients to share real-world health experiences to improve patient health and by connecting other patients like you with organizations that focus on your conditions.NursesRecommendDoctors is changing the way patients find quality doctors. The premise is that nurses know which doctors have the best reputations, the best technical skills, and the best outcomes. Why? They see it every day. Sermo is the number one social network for doctors globally. This crowd has ballooned to over 600,000 verified and credentialed physicians for big meetings of the minds. Sermos operates across 80 countries including US, UK, Mexico, Germany, Sweden, Canada, and many others. Patients, nurses, and doctors are creating crowds for wisdom.

However, as it turns out, not all crowds are wise. Surowiecki, breaks down four criteria that separate the wise crowds from the irrational ones:

1. Diversity of opinion – each person should hold private information.

2. Independence – individual opinions aren’t determined by the opinions of those around them.

3. Decentralization – individuals specialize and can offer local knowledge.

4. Aggregation – mechanism exists for turning private judgments into collective decisions.

Today, we rush to schedule doctor’s appointments, only to wait to be seen. If we apply Surowiecki’s thesis on the wisdom of the crowd to healthcare we can surmise it as follows: there is no need to chase the expert.

Forecasting markets

Social media platforms have helped to increase the collective knowledge of the crowd. These media platforms include wikis, blogs, social networks, video-sharing, online forums, and video blogs like blab.im. From WebMD to WEGO Heath, social networks are integrating into the healthcare delivery system.

Augur is the future of forecasting. Augur is a prediction market platform that rewards the users for correctly predicting the future events (a decision market to capture collective wisdom). Augur prediction markets allow users to purchase and sell shares in the outcome of an event. The current market share of an event is an estimate of the probably of an event occurring. On Augur, the price of each share adds up to $1.00 USD, so if you buy a share at even odds it will cost, $0.50 USD, and if you predict correctly, you’ll earn $1.00 USD for that share. Augur combines the magic of prediction markets with the power of decentralized networks to create a stunningly accurate forecasting tool. This all happens on the blockchain. In a centralized prediction market, one person has to report back on the outcome of the event. This encourages mistakes or even corruption. Augur, is decentralized and uses blockchain with thousands of users reporting on outcomes using reputation. With Augur, anyone anywhere in the world can create a market by asking about anything. Augur was one of the first applications built on Ethereum, a decentralized computing platform featuring digital contracts and a turing-completeprogramming language.

What if there was a healthcare market prediction platform that used the wisdom of the crowd, social media, and analytics to make everyone healthier by becoming an expert on their health?

Tomorrow’s prediction of markets

The global healthcare analytics market is expected to reach $29.53 billion by 2019 from $7.04 billion in 2014, at a CAGR of 33.2 percent over the forecast period 2014-2019, according toMarketandMarkets.com. While descriptive and retrospective analytics offer historical information, it’s the predictive and prescriptive analytics that will move the economics of global health forward. The predictive analytics market is going to impact everyone in the healthcare value chain value including payers, private insurance companies, government agencies, employers and private exchanges, providers, hospitals, physician practices and IDNs, ambulatory settings, ACOs, HIEs, MCOs, and TPAs.

Growth will occur across five core prediction analytics markets.

1. Clinical analytics

2. Population Health Management (precision medicine and health)

3. Quality Improvements (clinical benchmarking, operational and administrative analytics)

4. Comparative (effectiveness Analytics, clinical decision support)

5. Payment Integrity (fraud, waste and abuse)

Big data evolutions, mHealth, and customer centricity all disrupt health insurance and the business of health. Likewise, market predictions will be part of the future of health.

Is it possible to predict factors that have greater insight and influence over patients’ behaviors? Can we use prediction markets to forecast infectious disease activity? Will prediction markets help align incentives creating long-term behavioral change supporting healthcare payment reform? As the frequency of chronic diseases rise and we move toward outcomes and value-based-care can we use prediction markets to forecast the demand for hospital services? It’s going to be an exciting road ahead. Prediction markets will be part of the future of healthcare.

Surowiecki believed that groups are remarkably intelligent, and are often smarter than the smartest people in them. Let’s use the collective wisdom of the crowd to produce clinical insights and make the world healthier. Monumental change starts with believers.

Design thinking enlightened with mimicry

Peter Nichol
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Design thinking enlightened with mimicry

Innovation inspired by nature captures the power of design from nature’s observations. Today’s business architects must construct new business models for innovation. Visionary leaders begin with nature.

Solved first by nature, efficient business designs may drive the next technological innovations. Mimicry can advance innovation through design thinking. When balancing the power of design with design thinking adding in living things can teach new innovation principles.

Balancing the architect and scientist

According to the Biomimicry Institute, “Biomimicry is an approach to innovation that seeks sustainable solutions to human challenges by emulating nature’s time-tested patterns and strategies.” Why resolve problems that nature has already solved over thousands of years?

Steve Jobs, was quoted saying, “I think the biggest innovations of the 21st century will be at the intersection of biology and technology. A new era is beginning.” Maybe he wasn’t talking only about the advances of biotechnologies; he was talking about what we can learn from nature. Concepts and lessons that were in front of us, we missed because we were too busy recreating them. Janine Benyus, is a biologist focusing on innovation inspired by nature and has written two great books on the subject including Biomimicry: Innovation Inspired by Nature and The Secret Language & Remarkable Behavior of Animals. Benyus believes that designers can discover new powers of design by looking at nature. Michael Pawlyn, a TED speaker and author of Biomimicry in Architecture, summed it up well. “You could look at nature as being like a catalog of products, and all of those have benefited from a 3.8-billion-year research and development period. And given that level of investment, it makes sense to use it.”

Design thinking promotes the idea of visual thinking, to form practical and creative solution-focused thinking. It jumps ahead in the scientific method. Instead of defining all the parameters of a problem to construct a logical solution, design thinking starts with a better future in mind not with a specific problem to solve. This approach unlocks the mind and removes the mental obstructions for new growth. The conflict in design thinking challenges the [business] architect and the scientist. In 1972, Bryan Lawsonconducted investigations in the variance between the problem-focused solvers and solution-focused solves. What Nigel Cross, a British academic and Emeritus Professor of Design Studies at The Open University, the United Kingdom deducted was that scientist problem solves by analysis, using nature’s genius while designer solves problems with synthesis; design thinking uses both design analysis and synthesis.

Mimicry

Mimicry is the art of action or imitating someone or something. This is best described as WWND – What Would Nature Do?

This imitation could be represented with an animal’s deceptive behavior such as batesian mimicry (involving a palatable unprotected species, the mimic, resembling an unpalatable species e.g. a bubble bee-resembling a flower), mullerian mimicry (warning colors where both the model and the mimics are toxic e.g. a monarch butterfly resembling the viceroy butterfly), wasmannian mimicry (resembling the host structure e.g. a jumping spider representing an ant), and peckhamian mimicry (aggressive mimicry where the predator mimics it’s prey to capture it e.g. the bird-dropping spider hunting moths by producing the moth pheromones). Deceptive behavior or camouflage is often foremost on the mind when the topic of mimicry surfaces. There is, however, another form that applies to business.

The kingfisher’s design thinking principles

The Sanyo Shinkansen 500-series electric train was placed into production in 1997, and because of a maximum operating speed of 320 km/h or 200 mph, the travel time between Shin-Osaka and Hakata was shorted by 10 percent. What made this innovation successful was the design thinking principles applied used to achieve the world record speed at the time and meet strict noise standards of 70-75 dB(A) as measured 25 meters from the center of the tracks.

Eiji Nakatsu, the general manager for the Technical Development Department part of Japan Railway West and Japan Railway Kyushu, was charged with solving three train problems:

  1. Ground vibration during high speeds
  2. Aerodynamic noise generated by the body and the train’s pantographs (connecting the train to overhead wires)
  3. The sonic boom created during the trains exit from the tunnel.

The article, in the Zygote Quarterly (zq9) titled, Auspicious Forms: Designing the Sanyo Shinkansen 500-Series Bullet Train, is the most comprehensive article on this subject and well worth the read.

Problem one, pantograph vibrations, was solved by applying the principles of flight from owls. Specifically, how an owl’s natural concave face and down absorb the vibrations of movement with tiny serrations on its primary feathers.

Problem two, wind resistance creating aerodynamic noise, was solved reshaping the pantograph’s supporting shaft to look more like the body of the adélie penguin. This result was a shape like a spindle, lowering wind resistance.

Problem three, the sonic boom, was solved by understanding the bill of the Kingfisher – a revolving paraboloid shape. Trains in service before the 500-series had wedge-shaped nosecones; this shifted to a modern rotational parabolic body that changes areas by a constant ratio.

Living things teach innovation

The most efficient designs tested were from nature and taught efficient forms. New models developed from living things and the trend to apply mimicry to advance design thinking is growing globally. Germany’s BIOKON focuses on deciphering ‘inventions of nature’ and transferring them into technological innovations. France’s Centre Européen d’Excellence en Biomimétisme de Senlis (CEEBIOS) focuses on the development of biomimicry as a tool for scientific and societal transition at the international level. At the center they actively disseminate biomimicry information to innovators.

Ecomimicry, the practice of mimicking the natural world in the technological world, is merging with products, platforms, processes, and services to create new interactions and behaviors. As design thinking searches for new innovations, maybe the answer is hidden in nature. Will the most amazing technological advancement be traced back to mimicry?

Business can learn much from nature, and as Janine Benyus put it, “When we look at what is truly sustainable, the only real model that has worked for long periods of time is the natural world.”

Disintermediation and intermediation beyond theory

Peter Nichol
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Disintermediation and intermediation beyond theory

Bringing back the middleman for digital innovation. Disintermediation promotes disruption and intermediation fosters innovation.

Disintermediation removes the middleman from business transactions and by doing so improves the value of an existing product or service. Disintermediation is often accomplished by changing the perception of delivery. Inversely, intermediation injects a middleman between distribution channels e.g. a customer and businesses that previously sold directly to consumers. Intermediation gains traction when the platform is so large that companies can’t afford not leverage the platform to reach customers.

Coining the term

Let’s start with the history of the word, disintermediation, to guide our journey to the real meaning. Jonathan B. Welch, in his 1980’s article published in the Financial Analysts Journal, “Explaining Disintermediation at Mutual Savings Banks” describes the disintermediation of the mortgage market and the homebuilding industry during the 1960’s and 1970’s when the amounts withdrawn over a period exceed the amounts deposited. Contributing factors were interest rate differential between savings deposits and Treasury bills. However, the term disintermediation was coined in the mid-1960’s when consumers started to see government-imposed limits on interest-bearing savings.

Consumers responded by quickly investing in government securities, private stocks, and bonds that resulted in removing their prior investments from savings accounts. As a result, consumers began to explore borrowing capital from markets other than banks, circumventing banks as the middleman. Disintermediation is about removing the middleman in the distribution chain.

Unseating the middleman

A classic supply chain involves producers, wholesalers, retailers, and consumers. Disintermediation fractures the role of the middlemen between producers or avoids traditional distribution channels with intermediates such as distributors, brokers, or agents. In the case of disintermediation, one step is removed e.g. a producer goes directly to the retailer, therefore, eliminating the need for the wholesaler. Simplified, business goes directly to the consumer, although it could be the removal of any single point within the supply chain to make the process more straightforward.

The disruption generated by disintermediation can be significant and reshape entire business models as was the case with banking. The travel industry is another industry impacted by disintermediation. Travel agents were disintermediated by online travel websites such as kayak.com, expedia.com, hotwire.com, traveocity.com, andhipmumk.com. These online marketplaces unseated traditional travel agents, and the tourism industry was changed. Likewise, traditional publishing channels like Encyclopedia Britannica and Microsoft’s Encarta were disintermediated by Wikipedia.

Disintermediation can take markets by surprise. Banking wasn’t prepared, and neither was the music industry. The theme of digital disintermediation is harnessed well in the plight of the music industry with CD’s and their struggle to maintain active control over distribution. Consumers briefly loved CD’s until they hated them when during the 1990’s when consumers were forced to buy CDs with songs they didn’t need or want. Ultimately, the music industry failed and eventually, they awoke to realize that Apple controlled their inventory. Newspaper publishers, the music industry, and real-estate each has been on the leeward side of disintermediation with the likes of Craigslist, Apple iTunes, and Trulia. Disintermediators include Uber (freelance drivers and riders, removing cab companies),Airbnb (hosts and renters, removing the hotels), and Apple iTunes (viewers and creators, removing the music store). Business can be a disintermediator or intermediator, and they can even hold characteristics of both.

Disintermediation is bound to happen in healthcare. Where will disintermediation start in healthcare? The drug companies could directly reach consumers bypassing hospitals. Hospitals may opt to cut out private insurers and generate robust provider-sponsored plans offered straight to patients. Physicians may choose to circumvent hospitals and renegotiate compensation providing new care alternatives and structures through telehealth options with direct interaction with patients. Healthcare is on the cusp for disintermediation.

Intermediation

Almost more interesting than disintermediation – removing the middleman – is intermediation that adds the middleman back into the mix. Intermediation occurs when digital platforms inject themselves between the customers and a company. These platforms are so large that businesses can’t afford not to reach customers through these platforms. Intermediation creates a dependency and disintermediation removes the dependency.

The Digital Disruptive Intermediaries report published through the University of Sydney Business School captures the heart of intermediaries extremely well. Digital disruptive intermediaries are disruptors and can be categorized into eight archetypes:

1.       Digital stores (online e.g. amazon.com, expedia.com)

2.       Content hubs (consumer interaction e.g. Apple’s iTunes, Netflix)

 

3.       Sharing hubs (user-generated content e.g. Pinterest,YouTube)

4.       Promotor focus (best price to consumers e.g. Priceline.com,Groupon)

5.       Aggregators (comparisons in fragmented markets e.g.Unimall.de, Pizza.de)

6.       Discriminators (customer reviews e.g. reddit, Yelp)

7.       Crowd sourcers (customer sourced services e.g. Kickstarter,IndieGoGo)

8.       Matchers (linking supply and demand e.g. Airbnb, Uber, ore-Harmony).

Who’s an intermediary? The real definition is less glamorous; every business is an intermediator. Many intermediaries have become icons within their industries due to their disruptive impact, brand recognition amplified by the media, or word of mouth. Intermediaries include Facebook (between users and advertisers), Twitter (between companies and consumers), Apple Pay (between credit card companies and cardholders), and Apple HealthKit (between payers and members or between providers and their patients).

The digital innovators of tomorrow will forego the disruption that disintermediation creates for the innovation that intermediation fosters. Digital platforms are welcoming back the middleman.

Blockchain is not Bitcoin: Why unfamiliarity is slowing healthcare adoption

Peter Nichol
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Blockchain is not Bitcoin: Why unfamiliarity is slowing healthcare adoption

To absorb the massive virality and impact of blockchain, we must first address the hype. Hype, please square up.

Beyond the hype

The premise that blockchain is hype is false.

What is hype? The Oxford Dictionary defines hype as, “promoting or publicizing (a product or idea) intensively, often exaggerating its importance or benefits.” The simple version, the hype is an exaggerated advantage. A benefit that doesn’t align to the future reality of the product or service. As with many new technologies, there is excitement. However, the buzz and excitement around blockchain are more than hype; it’s the realization for the potential to transform industries.

Media weighs in

Thought leaders from Forbes and Harvard Business Review have bought into the value of blockchain technologies. For example, Jerry Cuomo, an IBM Fellow and Forbes contributor in his February 2016 Forbes article, “Blockchain: The Foundation For The Future Of Transactions,” stated that “Blockchain has the potential to become the technological foundation for all electronic transactions conducted over the Internet.” Amy Webb, in her January 2015 Harvard Business Review article titled, “The Tech Trends You Can’t Ignore In 2015” stated, “Even if Bitcoin itself never really gains traction, blockchain technology has enormous promise.”

Industry joins the party

It’s great that the media has received the mailer on the value of blockchain, but what about the industry? CISCO recently stated, “The next generation of the Internet is coming with Blockchain.” In February, Accenture launched a blockchain practice for financial services industry and entered into a partnership with announced a blockchain partnerships with Accenture, Broadridge & PwC showcasing that the “New practice will implement emerging technology that is projected to reduce financial services industry costs by more than $20 billion annually by 2021.” PwC on April 4, 2016, announced they have started a new global technology team to tap into the blockchain and have recruited 15 new leading technology and business specialists.

Deloitte has anticipated the tipping point of blockchain would not be until 2027. In a recent report titled, “Blockchain. Enigma. Paradox. Opportunity” Deloitte says that “Ultimately, the blockchain is not just about cryptocurrencies and faster peer-to-peer payments.” On October 2015, Deloitte partnered with Colu, to bring the startup into new global markets. Colu allows users to issue and track their digital assets on its platform.

The industry is unifying and joining the blockchain revolution. R3 (R3CEV LLC) leads a consortium consisting of 43 financial companies (including Microsoft as of April 4, 2016) in the research and development of blockchain usage in the financial system. However, the fabric R3 is proposing is industry agnostic. Todd McDonald, the co-founder and head of strategy for R3, likely wouldn’t refer to blockchain as hype either. The industry has taken notice of blockchain.

Historical perspectives on innovation hype

The fact that in 2015, large investors invested over 1 billion into the blockchain technology doesn’t persuade some colonialists. Remember the hype over the telegraph in the nineteenth century? The telephone has matured but hype? We all know how overstated the telephone was by the end of the nineteenth and start of the twentieth centuries. How about the buzz and overpromises of canals and railroads in the 1700’s and 1800’s? Hype probably isn’t the best word to describe the development of railroads that was one of the most important phenomena of the Industrial Revolution. The list doesn’t seem to end and continues with the likes of automobiles, radios and then the jet engine, rockets and atomic energy into the 1950’ and 1960’s with biotechnology, nanotechnology, and genomics. Do we consider the canals, railroads, telegraphs, automobiles and cell phones hype? If these hyped technologies landed us here, imagine how blockchain can change society in the future.

Hype Cycle

The Gartner Hype Cycle, introduced in 1995 offers useful insights into the promise of emerging technology. The July 2015, Gartner Hype Cycle for Emerging Technologies report, highlighted the phases of the hype cycle on emerging and collaborative tech. The five phases of the Hype Cycle include: innovation trigger (less than 2 years), peak of inflated expectations (2 to 5 years), trough of disillusionment (5 to 10 years), slope of enlightenment (more than a decade), and lastly the plateau of productivity (obsolesce is reached before the plateau). It could be argued that the Hype Cycle is not a cycle and that outcomes do not depend on the nature of the technology itself or that it’s less than scientific in nature without accounting for changes over time in the speed at which technology develops. However, it does effectively show how society feels about new technology and when historically inflated expectations and disenchantments should likely occur.

Cloud Hype Cycle

If we consider cloud to have started the innovation trigger phase in 2012, the phases of the cloud hype cycle would be the following: innovation trigger (2012 – 2013), peak of inflated expectations (2014 to 2018), trough of disillusionment (2019 to 2028), slope of enlightenment (beginning 2030), and lastly the plateau of productivity (if applicable, after 2028).

Blockchain Hype Cycle

If we consider blockchain’s innovation trigger phase started in 2014, based on when serious investors began to weigh in, the phases of the blockchain hype cycle would be the following: innovation trigger (2014-2015), peak of inflated expectations (2016 to 2020), trough of disillusionment (2021 to 2030), slope of enlightenment (beginning 2030), and lastly the plateau of productivity (if applicable, after 2030). The below charts illustrate the phases of the Hype Cycle showing visibility over time and expectations over time. If you’re looking for additional sources on the Hype Cycle Jackie Fenn and Mark Raskino, have an excellent book titled, “Mastering the Hype Cycle: how to Choose the Right Innovation at the Right Time.”

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Source:Wikipedia.org

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Source:Wikipedia.org

Beyond Finance

The paper, Bitcoin: A Peer-to-Peer Electronic Cash System, by the individual or group called Satoshi Nakamoto, was released in 2008. If this is the only framework used to evaluate blockchain, that would be a narrow view of blockchain’s potential. Minimizing the value of blockchain would be akin to stating in 1995 that the Internet would be used just for email.

Blockchain is much more than cryptocurrency, and the benefits of blockchain will extend well beyond the financial markets. For example, healthcare is ripe for disruption and applications may include:

  • Smart property for prescription drugs and regulated pharmaceuticals
  • Smart contracts between payer, provider, and doctor for decreased fraud and reimbursement
  • eBay type bidding for medical services (discrete and anonymized)
  • Health databanks (universal medical records, personal genomics)

Similar to the internet in 1995, we don’t know where blockchain will go. The one thing we do know is it’s not just hype. A quote that captures the sediment surrounding blockchain well is from Bill Gates a technologist, and philanthropist, stating, “We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten. Don’t let yourself be lulled into inaction.”

How medical robots will change healthcare

Peter Nichol
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How medical robots will change healthcare

Stardust predictions get everyone talking, separating the mythical from the magical in robotics healthcare.

Robotics health threatens to challenge how patient care and treatment is performed redefining the word “preventative.”

All too often we hear about the benefits of mobile or 3D printing, but how often do you hear about medical nanobots or nanomites? The average life expectancy is increasing. In 1960, average life expectancy was 69.8 years, thirty years later that rose to 75.2 in 1990 and today it’s around 78.8 years according to the Centers for Disease Controls and Prevention (CDC). New approaches to medicine and treatment are no longer optional, they’re essential. Robotic health offers some answers.

From telemedicine (clinical health care at a distance) to bioelectronics (stimulate and monitor your nervous system), the health ecosystem is evolving quickly. The greatest medical achievement in the last 100 years is the advancement of personal genome sequencing mapped to repositories of population diseases: introducing the migration from population health to personal genome diagnosis. The N-of-1: one patient one trial. Combine this with nanobots, in a world where, nanoids, nanites, nanomachines, and nanomites all reference nanomachines and nanomotors at which time biological machines could be used to identify and destroy cancer cells. In this future world disease is not a setback but merely a distraction like a low oil light. The car isn’t sick. It just needs a repair or tune-up and quickly it’s back on the road.

Medical nanotechnology is expected to employ nanorobots that will be injected into the patient to perform work at a cellular level. Ingestibles and internables bring forward the introduction of broadband-enabled digital tools that are eaten and “smart” pills that use wireless technology to help monitor internal reactions to medications. Medical nanotechnology is just the edge of the cliff. Let’s jump off.

Dermables, digital stickers for the skin open a vast range of possibilities. Netatmo’s JUNE bracelet adds some class to UV monitoring and UVSunSense make monitoring sun exposure fun.

The day before something is a breakthrough it’s a crazy idea. – Peter Diamandis

Why don’t we hear about these advancements in robotics every day? How come the population isn’t demanding small pilots that will undoubtedly extend life? I honestly don’t know.

Stardust predictions get everyone talking – how to do we separate the mythical from the magical? We can start by understanding the stakeholders in robotic health. Hint: they are not only the mad scientists in labs looking for new breakthroughs. They are your wife, husband, daughter, son, grandmother, or grandfather – these are the stakeholders, and they all have similar goals. Their goal is simple, stay healthy.

In a draft journal article by Simshaw, Terry, Hauser, and Cummings titled, Regulating Healthcare Robots in the Hospital and the Home, the report suggests that family members and caregivers, healthcare providers, technology providers, aging or physically challenged individuals have similar goals. Their collective goal is to provide independence, preserve dignity, empower those with special needs and provide peace of mind to all of the stakeholders. These stakeholder’s goals are aligned, despite how rare this might be.

Recently the “Healthcare Robotics 2015-2020: Trends, Opportunities & Challenges” report was released by the Robotics Business Review, that provided strategic information for the global robotics industry. The findings in this report are intriguing and help segment the robotic health market. In the search for the value of medical robotics, there are three main areas of robotic health:

  1. Direct patient care robots: surgical robots (used for performing clinical procedures), exoskeletons (for bionic extensions of self like the Ekso suit), and prosthetics (replacing lost limbs). Over 500 people a day loses a limb in America with 2 million Americans living with limb loss according to the CDC.
  2. Indirect patient care robots: pharmacy robots (streamlining automation, autonomous robots for inventory control reducing labor costs), delivery robots (providing medical goods throughout a hospital autonomously), and disinfection robots (interacting with people with known infectious diseases such as healthcare-associated infections or HAIs).
  3. Home healthcare robots: robotic telepresence solutions (addressing the aging population with robotic assistance).

The Population Reference Bureau report, “Aging in the United States,” showed that Americans 65-and-older will more than double moving from 46 million today to 98 million by 2060. The growth of the total population 65-and-older population is projected to grow from 15 percent to nearly 24 percent. Who will take care of the influx of aging individuals, when timely healthcare today is already questionable?

Medical robots will change healthcare. They have to.

Blockchain gives music lessons to healthcare

Peter Nichol
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Blockchain gives music lessons to healthcare

Blockchain smart contracts provide the bridge, intersecting the music and health.

Music shapes culture, entertainment and technology. The passion for music spans industries refreshes ideas and introduces new concepts previously invisible. The music industries maturation into digital contexts and exploration of blockchain technology have uncovered lessons we can apply to healthcare.

Intersecting music and health

The world is growing, and the music industry is shrinking. Economies of scale exist, yet annually miss impacting healthcare for the better. The music and healthcare industries are managing the transition from the physical to digital. How will the music industries keep pace with the trends of instant access and play anywhere? How will the healthcare industry keep pace with the trends of instant access and view anywhere medical information? Blockchain is the answer. Smart contracts provide the bridge.

Musical revenue fragmentation

The music industry is getting a shakeup but continues to lose out in revenue. The end of 2014 marked the first year that the industry derived the same revenue from digital channels (46 percent) as from physical format sales (46 percent). According to the UN, Dept. of Economic and Social Affairs Population Division, there are 7.4 billion people in the world today growing at roughly 80 million a year. It’s disparaging to realize that the global recording music industry was a $40 billion business in 1997 and 2014 the music industry’s global digital revenues barely reached $6.85 billion, according to the International Federation of the Phonographic Industry (IFPI). The IFPI represents the recording industry worldwide, with over 1,300 record companies in over 57 countries are members.

More people are listening to music, and fewer writers and artists are getting paid for their work. Society needs a music industry that rewards people for creating great content. Not a scene where music companies wrestle over ownership rights.

Hitting the music industry with peer-to-peer

The introduction of the bitcoin peer-to-peer electronic cash system by Satoshi Nakamoto (sudo name) in 2008, immediately sparked the interest of the music industry. The wonder started with companies like Murfie, a music marketplace founded in 2011, that accepts bitcoins as payments for music downloads. Bitcoin as a payment method isn’t going to change musicians lives as a new financial standard for payment. However, the application of the blockchain technology to the music industry may change artist lives.

Blockchain has the potential to modernize every industry in the world. We just don’t know exactly how. It was common knowledge that blockchain could impact the music industry, but the full impact on the industry wasn’t articulated clearly to encapsulate the potential for positive change, until last month. In November 2015, Benji Rogers published on Medium, “How the Blockchain and VR can Change the Music Industry.” The article offers a powerful argument in support of the positive impact that blockchain technology (Etherium, Muse, Rootstock) would have on the entertainment industry. In February 2016, Roger published an update that provided substantive support both theoretical and technical on how this could be accomplished in part 2 of his post, highlighting four clear points.

  1. Smart contracts will be the enabler
  2. Blockchain will house a global Fair Trade Global Database of rights
  3. Every song will contain Fair Trade Minimum Viable Data (MVD)
  4. The new format will be called .bc or “dot Blockchain,” a non-replicable wrapper (.bc compliant systems)

Music ownership obfuscation

Will the music industry see the beauty in the blockchain scheme? Blockchain technology applied to your music means that everyone will pay for their use, driving transparency of music ownership. The artist would create a .bc file containing who owns the work and who to pay when used. The music enthusiast using a platform (YouTube, Spotify, SoundCloud, 8Tracks, Tidal, Pandora, Apple) buys and pays for music as they would today. The difference is the behind the scenes a digital ledger tracks ownership of the author and usage rights of the music enthusiast.

Roger suggests, defining the rules governing play at the time of encoding, by the artist and the music rights holders, as part of the song’s Fair Trade Minimum Viable Data. The author, composers, contributors, owners, and usage rights are defined as part of smart contracts enabled by blockchain technologies. The music enthusiast also benefits paying only for what they play, instant payment, and multi-platform accessible. The .bc was envisioned to replace DVD, Blu-Ray and support a new virtual reality (VR) format that has no standardized format or wrapper. This format would contain Minimal Viable Data using the W3C Web standard JSON-LD, illustrated in the dot blockchain concept illustration.

The music industry has struggled with digital rights management (DRM) for years. Blockchain provides a ledger as a means of payment, automatic royalty payment splitter, and simplified licensing using legal enforcement non-ambiguous smart contracts. This concept is more than DRM. Its is DRM+.

Intersecting music and health

Blockchain technology can improve transparency of ownership for music as well as health records. Music industry’s song ownership challenge parallels the healthcare industry’s problem with medical health record ownership. The U.S. life and health insurance industry reached $877.9 billion in 2014 according to statista.com. How much more transparency in your personal medical records have you seen in 2014 compared to 2015. I’ll share my experience between 2014 and 2015; I saw zero positive impact towards better visibly into my medical records. Personal health records continue to be as fragmented between providers and physicians as song ownership and royalty payments of the music industry. Platform scale, interoperability, and privacy are surmountable challenges. How do we transfer trust, when patients have no faith in the system? Payments don’t reflect treatment provided. We can’t blame patients for their lack of confidence when even experts have trouble explaining the circus we call today’s “healthcare system.”

Blockchain has the potential to give patients, like you and I hope, and restore trust in healthcare. Transparency and ownership of our medical health records are the beginning. New healthcare platforms will emerge returning medical record ownership back into the hands of the patient.

Blockchain applications for healthcare

Peter Nichol
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Blockchain applications for healthcare

Blockchain opportunities are changing healthcare globally – innovative leaders see the change. There are many blockchain applications for healthcare. The exponential growth of blockchain applications can benefit population health, medical records, and patient-generated data. Healthcare startups have already discovered how to leverage blockchain technology for healthcare.

The first industry to visibility take advantage of blockchain was financial services. Financial services had the courage to believe in the potential of blockchain technologies and grew a three tier model:

  1. Applications and solutions (brokerages, exchanges, soft wallets, hard wallets, investments, merchants, compliance, trading platforms, capital markets, microtransactions, money services, banks, ATMs, payroll and insurance, payments, trade finance)
  2. Middleware and services (services, software development, general APIs, special APIs, platforms, smart contracts)
  3. Infrastructure and base protocols (public, special, payment, miners)
    Healthcare is late to the show but also hasn’t missed the show. Blockchain opportunities are changing healthcare globally – blockchain is fitting into a new world.

Population health management

Health information exchanges (HIE) and all-payer claim databases (APCD) have become obsolete with blockchain. It doesn’t make sense to trust organizations to verify member’s trustworthiness when it’s not required with blockchain. Eliminating this prehistoric middleman increases data security and removes the cost, time, and resources required to prove that a party is doing what they say they’ll do. New models that share medical records are emerging.

In 2007, the government of Estonia joined forces with Guardtime, a leader in cybersecurity using blockchain’s Keyless Signature Infrastructure (KSI), to provide authentication on a massive scale. Their combined challenges were to verify the integrity of data-at-rest on a global scale. Estonia is among the few if not the only digital societies which have 100% of their medical health records online. Spending time and resources verifying members’ trustworthiness (e.g., HIE, all-payer claims database, local EMRs) no longer makes savvy business sense. Blockchain will leap frog population health by providing trust where none exists for continuous access to patient records by directly linking information to clinical and financial outcomes. Population health just got smarter.

Healthcare mobile communications and notifications

Tierion can collect data from web and mobile apps, record information in the blockchain and slingshot data to other systems by using REST API or HTML form submissions. Already have an existing mobile application? Leveraging REST APIs can extend functionality and provide a “safe” way to amplify your corporate innovation footprint. In October 2015, Philips Healthcare’s announced a joint blockchain project with Tierion. Tierion supports over 400 applications such as Google Sheets, Gmail, and Slack and also assisted the Department of Economic and Community Development of Connecticut surveying 200 top technology companies. Tierion can also handle medical, financial, and legal records through their blockchain integration and infrastructure platform.

PGHD meets wearables

Patient-generated health data (PGHD) has tremendous potential, but to-date hasn’t delivered the promised value. Mainly, because this data never makes it to the patient.

Under Armour HealthBox, Bragi Dash, Hexoskin smart shirt, OMSignal OMbra all generate industry excitement while playing safely on the fringe of patient transformation. Wearable tech is exciting, hip, and a great conversation starter. Value alignment is found at the intersection of wearable tech and integration of medical records. FHIR APIs, needed to connect the patients to EMRs, won’t be mainstream in 2016. The major EHRs vendors aren’t going to publish a complete service definition for FHIR profiles to share with software companies. Access to data is preventing adoption, not technology or even patient behavior. No data – no insight.

In 2011 at the World Economic Forum, personal data was declared a new asset class. Healthbank, based in Switzerland, is a global digital health innovator taking a radically transparent approach to health system transactions. Their approach is a new way of sharing data and uses personal data that is secured. A next logical step for healthbank would be to incorporate blockchain technology. The healthbank mantra is “my data, my choice, my healthbank.” Blockchain applications place personal and patient information into the hands of the individual. Doctor visits, sleep patterns, heart rate, glucose, and other IoT devices can all be polled and then stored using the healthbank blockchain. This innovative blockchain company is attending conferences and telling their story in Finland, Barcelona, and Brazil – the world is watching. Also, Noser Health (Germany) and Netcetera (Switzerland) have recently joined healthbank as partners to mature its global health data transaction platform.

Patient-owned

Once patient-generated data is owned by the patient from wearables to physician and clinical visits; a dramatic shift will occur.Trust is difficult to find in today’s global economy. The “cloud” is considered safe, well up until the point that your personal information is going to reside there. Blockchain technology can authenticate access to medical information, quickly and securely.

Innovative leaders can see the change. It’s happening now; the patient experience is evolving.

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