In the mid-2000s, David Van Sickle, a researcher at the Centers for Disease Control and Prevention, had a hypothesis. He suspected asthma treatment might be overemphasizing direct patient intervention and underemphasizing broader environmental and health factors.
To test his hunch, Van Sickle enabled asthma inhalers with GPS technology and placed them in the hands of 1,000 people in Louisville, Kentucky. By tracking the time and location of asthma attacks and layering the results with open government data, Van Sickle discovered clusters of attacks in certain sections of the city — a finding that’s helping to clarify the link between asthma and environmental factors such as air quality.
According to Aneesh Chopra, cofounder of Hunch Analytics and the first-ever U.S. chief technology officer, Van Sickle — now the CEO of Propeller Health, a platform for respiratory health management — represents a new breed of health-care innovators who are using software and apps to draw insights from masses of data.
“He is just one voice of many that is coming forward,” said Chopra, during a keynote address at the 2015 Boston Children’s Hospital Global Pediatric Innovation Summit. “I believe that each and every one of us in this room has a hypothesis about how we can find segments of patients to treat better.”
How can we test those hypotheses and use the results to improve patient care and public health? Chopra proposed several key rules of thumb that would-be innovators would be wise to keep in mind.
Don’t make the same mistake Kodak did.
Kodak failed to manage its innovation pipeline.
Kodak invented the VCR but never pursued the technology; management thought it was too expensive for the consumer. Kodak also invented digital photography, but feared it would jeopardize their core business and chose not commercialize it. In the same year that Instagram revolutionized digital photography and was acquired by Facebook, Kodak filed for bankruptcy and laid off 8,000 people.
“The DNA of the organization didn’t do a good job converting ideas to products and products to wonderful solutions,” Chopra said. “Our health care challenges in many ways are these management blind spots — when we aren’t thinking about new ways of caring for patients.”
Recognize that portals are really lame.
Portals are fine for checking stocks, but not for checking health care.
When President Obama launched the precision medicine initiative, he stipulated that consumers have a right to health care data but — more importantly — the ability to access and interpret that data via software and apps that make use of application program interfaces (APIs).
“The connected apps ecosystem is the only game in town,” said Chopra. “What APIs allow us to do in IT is to decouple the system of record from the systems of consumption. There are very few people on planet earth that want to log into a portal to look at their health data. That’s on the corner of lame and lame.”
Borrow a page from the Internet economy.
The electronic health-care ecosystem should communicate with the same ease as Fitbit and MyFitnessPal.
When health care went from manila folders to IT systems, there was still an interoperability problem. But in 2009, Ken Mandl, MD, MPH, and Zak Kohane, MD, researchers in the Boston Children’s Informatics Program, called for an app store for health care.
The store has graduated from a research and development project to commercial testing, and applications that enable the systems to talk to each other are now in production.
Embrace handshakes and handoffs.
Two critical ingredients to collaboration are handshakes and handoffs — and one doesn’t work without the other.
A handshake is the opening up of the data, and the handoff authorizes the product or service to be created to add value or growth.
“You might have a lot of handshakes about how you might move forward, but an innovation can’t be created on its own,” Chopra said. “This opportunity to not only pull data from one agency but match up data from other agencies enables innovation well beyond the confines of an enterprise, organization or agency.”
Open up data like Thomas Jefferson.
Thomas Jefferson was an open-data hero. He recorded weather twice a day every day and shared it freely with thousands who wished to collaborate.
Chopra says we need that same mindset today. When the government opened up healthcare.gov data, U.S. News & World Report pulled raw data and created a health insurance finder site.
That was considered a success, Chopra said. “When healthcare.gov launched, nobody cared if you visited, we cared that the information reached you when you needed it.”
Fast forward. Uber surveys independent contractors, asking them what would improve their health care. Sixty percent say they would love tools to make smarter decisions. Uber works with another company Stride Health to pull data that looks at health care utilization at a larger scale and measures a single out-of-pocket cost, so the contractors could chose a plan right for them.
“All of these can coexist. That’s the power of APIs,” Chopra said. “APIs allow us to have more control over who is accessing what, when, how, why and where.”
Watch video highlights of the 2015 Global Pediatric Innovation Summit + Awards.