by Diccon Hyatt
The words “Digital Health” may not seem exciting to most people. But most people aren’t Adam Dole, who gave up on his childhood dream of becoming an astronaut not because it was unattainable, but because it wasn’t as exciting to him as becoming an entrepreneur in the field of digital healthcare.
Today Dole is a Presidential Innovation Fellow, working with the Obama administration on a project called Blue Button, which is intended to give people better access to their health records. Dole believes the time is right for a revolution in health information technology.
Dole had long dreamed of going into outer space. His first job out of college was with the one employer that could send him there: NASA. As a research assistant, Dole was part of the agency’s “human factors” team that was helping plan a mission to Mars. The team was concerned with how a group of astronauts would work together under the stressful conditions of an extended space flight.
The human factors team had long discussions with the astronauts, and when real astronauts were unavailable, they had people play video games that were designed to produce stressful situations. The experiments were the basis for a series of scientific reports published in academic journals. But Dole had a desire to change the world, not to create a series of meticulously crafted studies that few people would read.
“My first job was an amazing experience,” he says. “But after a couple years of doing that work, I realized the academic setting of research was not something I wanted to continue doing. I had more interest in taking those skills that I had learned in terms of interviewing people and trying to observe people in their environment — what their motivations are, what keeps them up at night — and apply that to real-world problems.”
Dole said goodbye to outer space and turned his skills to more earthly problems, ending up in his current year-long post at the White House as a kind of liaison between government and business. Dole will share what he has learned along the way at Tigerlabs’ annual Digital Health Innovation in Context conference Thursday, April 24, at 252 Nassau Street. Tickets from $250. For more information, visit www.digitalhealth2014.comlaunchtrack.com. About 28 speakers will talk at the conference, representing companies from all across the healthcare industry.
Dole believes the digital health field is due for a flourishing of new business and new ideas. Although the goal of giving patients better access to health records has been around for years, he says, it is only now becoming feasible to help gather them in one place. Government policies — especially the Affordable Care Act — give healthcare providers real incentives to create electronic health records. More importantly, patients now have big incentives to become “consumers” of healthcare rather than passive recipients of it. With many people shopping for health insurance for the first time, and with high-deductible health plans becoming the norm, patients now have an incentive to seek out high quality, low-cost healthcare services.
Dole says that with demand coming from both ends, there is now an opening for businesses to get into the digital health game.
Big Data has tried to reach into the healthcare arena before, without success. Google launched its “Google Health” service in 2008 and was discontinued in 2012. The service was supposed to give patients a place to keep their own health records, but Dole says it was doomed by how hard it was to upload them to the service.
Whereas other Google services were able to pull information from the vast sea of web traffic, Google Health depended on people uploading records themselves from multiple providers. “Patients basically had to run around and spend a lot of effort either on the phone, or in person, trying to wrangle their records,” Dole says. “When they did get their records, oftentimes it would come to them in non-secure E-mail, or faxed to them, or sent in on paper. Very rarely would they be transmitted electronically through secure and machine-readable formats.”
With more and more providers switching to electronic records, there is more data to work with, Dole says. And Dole has been able to learn a lot by carefully studying how patients have managed their own records, with few services available to do it for them. Listening to the potential customers is Dole’s number one piece of advice for people looking to make an impact in the digital health arena.
Identify the right problems. “A lot of technology companies are taking a solution and looking for a need,” he says. “We need to start identifying what the needs are at a patient and provider level.” How you go about doing that is his next piece of advice:
Get out of the office. “Talk to people,” Dole says. “Talk to users.” Then, he says, talk to people who are related to who you think your users are. It may be that your users are not who you thought they were. For example, he says, when designing a healthcare app, your potential customers would be healthcare patients and providers, but it would also be worth considering all the other stakeholders — the insurance companies, the caregivers, and the consumer brands. “Trying to figure out a value proposition for each of those target markets is something you have to constantly do.”
Empathize. Once you have identified your target market, understanding their problems is of paramount importance. For the Blue Button initiative, Dole talked to people who had to collect their own health records and share them with their providers. Some of them made elaborate spreadsheets to keep track of their treatment over many years. Some went to extremes, and Dole says you can learn a lot from people like that.
The most adept “power user” of e-health records Dole knows of is a man who goes by “e-Patient Dave.” Actually a Massachusetts resident named Dave deBronkart, e-Patient Dave used the Internet in multiple ways to cope with his 2007 kidney cancer diagnosis. deBronkart used the web to communicate with other cancer patients, learn about the disease from websites, access his records via his hospital’s computer system, and start an online journal where he discussed his treatment and recovery.
“He’s an inspirational individual,” Dole says of e-Patient Dave. “He basically saved his own life by becoming engaged.” Dole says his project has learned a lot from studying the way deBronkart and other patients have managed their health records.
Wrangling with the healthcare system is nothing new for Dole. His father, a cardiologist, and his mother, a nurse, gave Dole a system-wide view of healthcare from a young age. His parents sent him from his childhood home in California to high school at the Lawrenceville School in order to improve his chances of getting a college lacrosse scholarship, which he did, earning a degree in communications from Syracuse in 2004. After his stint at NASA, Dole went back to California to earn an MBA in design strategy from the California College of the Arts. His career in healthcare startups includes being entrepreneur-in-residence at the Mayo Clinic, where he incubated a digital health startup called Better.
Dole says that while recently, the best and brightest of Silicon Valley’s business leaders have focused on social apps — witness the $19 billion success story of What’s App, a messaging service bought out by Facebook in March — a lot of focus may soon turn to the healthcare field.
“The digital health space is a really interesting one and something that I’m really excited to be a part of now,” Dole says. “Things are happening at a scale that is going to be really exciting.”
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