Wireless Technology and the DeInstitutionalization of Health Care

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Wireless Technology and the De-Institutionalizati
on 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 mbarrett_at_CriticalMassConsulting.com www
.CriticalMassConsulting.com
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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)

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2002 Healthcare 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
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Remote patient monitoring system components
Patient Community
Source Continua Alliance
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Why should you care?
Beneficiaries with chronic conditions as of all
beneficiaries
27

Private payers
39
Public payers

40
44
85
Medicare/Medicaid
87
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5-year forecast Americans access to smart
consumer devices
(82)
(78)
(78)
(51)
Source Forrester Research, The State Of
Consumers And Technology Benchmark 2008
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How far will the trend go? Wireless-only
households, 2007

• 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
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What wireless brings to the party

• 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)
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Still, for most things today were 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
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What wireless cant do (yet)

• Work to mission-critical perfection (network
  coverage, battery life, privacy, etc.)
• Maintain the cell phones form factor (who
  cares!)
• Create the business models ways to pay for
  services
• Harmonize ubiquity with Medicares homebound
  requirement
• Change human behavior when feedback mechanisms
  are imperfect and feedback itself is necessary
  but not sufficient

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Thank you!
Michael Barrett Critical Mass Consulting mbarrett_at_
CriticalMassConsulting.com 781-674-0097