Quantified self and the future of healthcare

I met Vinod Khosla and his Chief of Staff in the Khosla Ventures office this week. We talked about Axial and discussed some of the trends driving change in healthcare.

Part of Vinod’s vision is that personal biometric devices will play an increasingly important role in health management. Based on my personal experience, I agree.



My Cholesterol Experiment

This past year, I used biometric tools from Withings, Zeo, Garmin, and FItBit to run lifestyle experiments that resulted in a dramatically improved cholesterol panel. I essentially reversed heart disease. (The subject of a future post.) 

While reviewing lab results with my doctor, it occured to me ...  he didn't have the right data. That is, his EHR system contained a woefully incomplete view of what actually caused my labs to improve. My phone was a much more valuable source of info about my health.


Provider's EHR System < Smart Devices + My Mobile 

Here is a quick data inventory:



What about the Really Sick Patients?

I have a relatively simple health profile. I see one physician, take one medication (a statin), and have one condition (high cholesterol). The inadequacy of a physician’s EHR becomes more starkly obvious when considering the Medicare population. 44% of Medicare beneficiaries have 3 or more chronic conditions. These patients see more than 6 unique physicians and fill more than 20 prescriptions per year.  It is unlikely that those six unique physicians have a comprehensive view of the patient’s medication list -- much less other important health markers. Further, if medication adherence, diet, exercise, and sleep are all essential to health, then how can a population's health be managed without insights into these areas?


Disruptive Innovation

The future of healthcare will likely involve better, faster, and cheaper biometric devices that monitor health on our behalf. The collection point for this info is unlikely to be a provider’s EHR -- without a re-imagining of EHR systems as well as the hospitals and physician practices that use them. The main collection point of health data is more likely to be a patient’s mobile device. Now combine this with intelligent algorithms that interpret the biometric data and guide users (and their physicians) towards health and away from disease and you have the makings of a new care delivery platform.


But seniors don't use smart phones, right? Wrong. Penetration is increasing across every age and income category. Keep in mind, it has only been five years since the original iPhone launch.


The provider’s EHR won’t disappear anytime soon. That said, EHR systems will struggle to stay relevant as a mechanism by which health is managed in the future.


To an incumbent, disruptive innovation may not seem threatening in its early stages. It might even seem like the benign dominion of hobbyists. Until it creeps in from the edges. And changes an industry forever.