If you follow my blog, you know that last week I went to the International Computer Electronics Show, aka CES, in Las Vegas to participate in the health care goings-on that were happening there (Digital Health Summit, Silvers Summit). Ironic, isn’t it, to think that people would gather in Las Vegas for anything health-related, but yet there we all were, the digital health cabal, talking sensors and wearables and the Internet of Things that nobody is quite sure they want or need yet.
I had not been to CES since it was a much different kind of show (my last attendance was over 25 years ago at predecessor show Comdex when I was in the software field, unrelated to healthcare). To give you a flavor of what it’s like, imagine a Tokyo subway at rush hour or Times Square on New Year’s Eve December 31, 1999, or the 1979 Cincinnati Who concert where people got crushed by the crowds, because that is what walking around CES felt like. Here is an excerpt from CES’ own press release, which I received this morning as evidence of the triumphant glory that is miles upon miles of cell phone covers and iPad cases:
CEA announced today that the 2014 CES wrapped as the largest in show history with a record two million net square feet of exhibit space housing more than 3,200 exhibitors. CES dazzled as the global gathering place for anyone involved in the business of consumer technologies with more than 150,000 industry professionals in attendance, including more than 35,000 from outside the United States.
That’s right, two million square feet of exhibit space, 150,000 tech-enabled salmon trying to swim past each other upstream, and 300,000 foot blisters, each of which was tweeting, “Help, I can’t find the exit of this exhibit hall!”
On the other hand, there were some very interesting discussions being had in the healthcare bubble at CES and my favorite comment heard at CES was from my lovely and smart friend Jane Sarasohn-Kahn, which was this, “There is more than enough technology to go around.”
The context for this quote was a discussion we were having about how technology is nice and all, but without services, healthcare technology is like a bicycle for a fish: an interesting idea but hard to operationalize or make practical. Interestingly, at least in the places I was, the overarching (if unintentional) theme I heard over and over was how unhelpful technology is likely to be without the presence of enabling human-centered services wrapped around it. Among the categories where services were clearly needed to make health technology relevant:
- Services to deploy technology in the first place, a la Geek Squad
- Services to help customers make sense of technology and help fix problems, a la Google’s Help Outs and Amazon MayDay
- Services to help customers respond to health inputs, such as nurses and others to help patients use the data that is fed to them from sensors and the like
- Services to help patients know and avoid damaging health behaviors
As Don Jones, Qualcomm Life’s VP of Global Strategy and Market Development, said, “Good technology disappears into the background.” In the foreground, I would say, we are always going to need people to help patients take best advantage of that background technology in order to live healthier lives. All too often people in healthcare talk about technology as a way to eliminate people from the process to make the delivery of healthcare “scalable.” I think this is generally the wrong way to look at it. While technology may make it possible to take care of more people, the real purpose of technology is to connect people to the healthcare services they actually need, as opposed to the ones they seek out or are given in the absence of good data and access.
One recent trend that seems to reinforce my view is the move of many medical device companies towards the services world. While traditionally firmly fixed in the business of selling boxes of widgets to hospitals to stick into patients, the world’s large and small medical device firms are starting to recognize the importance of having a longitudinal relationship with patients (and their providers) in the interests of better health, not just better one-time interventions. First of all, it is better medical care to think about the patient longitudinally. But let’s get real, it is also better business. There is more money to be made by being engaged with patients before, during and after their medical procedure than in just being there for the implant.
I think one of the big trends of 2014-2020 will be convergence, but not in the sense that people generally think of it around data. For me convergence means the blurring of lines between what has historically been the very separated fields of health IT, medical devices and healthcare services as companies build products that have pieces of all three. This is the ultimate promise of digital health, after all; but heretofore digital health has grown up in its own little cage, too focused on the “technology” side of the triumvirate and not focused enough on the medical device quality it will need to be viable or the healthcare service delivery system it needs to be successful. I believe we are in the process of seeing that change.
It is somewhat surprising to come away from the planet’s largest technology show with a message that services are, in the end, what matter. I can assure you that there were a lot of people at CES who would hear that assertion and look at me funny from behind their Google Glasses (funny line I heard is that people who wear these in public should be referred to as “glassholes”).
Outside of healthcare, it might be true that there are places where technology alone is of value, but I doubt they are many. If technology behemoths Amazon and Google are heading right back to putting people front and center in their technology offerings through MayDay (human customer service at the touch of a button on the Kindle) and Help Outs (“real help from real people in real time”), the whole world may soon recognize that while machines can replace humans in some situations, they can’t replace them in all situations. Where there is real value to be created, it appears we may still need real people. Perhaps that’s why CES has Tablet Man and not Tablet Table.