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Wireless Technology and the De-Institutionalization of Health Care. “The Wireless Future of Health IT” New America Foundation CTIA – The Wireless Association March 23, 2009. Michael J. Barrett Managing Partner Critical Mass Consulting [email protected]

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Wireless technology and the de institutionalization of health care

Wireless Technology and the De-Institutionalization of Health Care

“The Wireless Future of Health IT”

New America Foundation

CTIA – The Wireless Association

March 23, 2009

Michael J. Barrett

Managing Partner

Critical Mass Consulting

[email protected]

www.CriticalMassConsulting.com


Self care home care and mobile care have roots and relevance
Self-care, home care and mobile care have roots and relevance

  • ≤18th C: Health care happens mostly at home and work

  • 19th C: Health care professionalizes and institutionalizes

  • 1950: 40% of MD visits are still house calls

  • 1965: Medicare includes home health, with a low profile

  • 1980s: Chronic conditions emerge as huge cost drivers

  • 1990s: “90% of diabetes care is self-care”

  • 1996: Kaiser launches online health site for members

  • 1999: Early “remote patient monitors” come to market

  • 2002: Healthcare Unbound (over)


2002 healthcare unbound
2002: relevanceHealthcare Unbound

Technology-enabled self-care, home care and mobile care have inescapably populist dimensions, rebalancing power and control towards the grassroots.

“The centralizing forces of the 1900s will yield to the decentralizing forces of the 2000s. Technology assisting, innovators will light out from 20th Century settings – hospitals, doctors’ offices and nursing homes – in order to de-institutionalize healthcare.”

“Technology in, on, and around the body that frees care from formal institutions.”

Source: Michael J. Barrett, ”Healthcare Unbound,” Forrester Research, Dec. 17, 2002


Remote patient monitoring system components
Remote patient monitoring – system components relevance

Patient Community

Source: Continua Alliance


Why should you care
Why should you care? relevance

Beneficiaries with chronic conditions as % of all beneficiaries

Uninsured

27%

Private payers

=

Medicaid only

39%

=

Public payers

Private ins.

40%

All Americans

44%

Medicare

85%

Medicare/Medicaid

87%

Source: Medical Expenditure Panel Survey (MEPS), 1998, cited in Robert Wood Johnson Foundation, “Chronic Conditions: Making the Case for Ongoing Care” (Dec. 2002)


5 year forecast americans access to smart consumer devices
5-year forecast: Americans’ access to “smart” consumer devices

(82%)

(78%)

(78%)%

(51%)

Source: Forrester Research, “The State Of Consumers And Technology: Benchmark 2008”


How far will the trend go wireless only households 2007
How far will the trend go? Wireless-only households, 2007 devices

OK – 26.2%

UT – 25.5%

NE – 23.2%

AK – 22.6%

DC – 20.0%

SD – 6.4%

DE – 5.7%

CT – 5.6%

VT – 5.1%

Source: CDC, “Wireless Substitution: State-Level Estimates from the National Health Interview Survey” 2007


What wireless brings to the party
What wireless brings to the party devices

  • Ubiquity

  • Feedback

“Learning is most likely if people get immediate, clear feedback. … Well-designed systems tell people when they are doing well and when they are making mistakes.”

-- Thaler and Sunstein,

Nudge (2008)


Still for most things today we re wired not wireless
Still, for most things today deviceswe’re wired, not wireless

Percent of North American adult users of a “cell phone/smart phone or handheld wireless device” who do the following at least once a month

Base: 44,959 North American adults with a mobile phone

Source: Forrester Research, “The State Of Consumers And Technology: Benchmark 2008”


What wireless can t do yet
What wireless can’t do (yet) devices

  • Work to mission-critical perfection (network coverage, battery life, privacy, etc.)

  • Maintain the cell phone’s “form factor” (who cares!)

  • Create the “business models” – ways to pay for services

  • Harmonize ubiquity with Medicare’s homebound requirement

  • Change human behavior when feedback mechanisms are imperfect and feedback itself is necessary but not sufficient


Thank you
Thank you! devices

Michael Barrett

Critical Mass Consulting

[email protected]

781-674-0097


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