Branding, Cheerleading, and even some Progress

 “There’s no wrong way to spend your time at Health2.0.” – Health 2.0

Last week, hundreds gathered from around the world for the 8^th annual Health 2.0 conference in Santa Clara, California. For better or for worse, the event continues to be a one-of-a-kind affair; Matthew and Indu have a built a big tent brand that welcomes any and all variants of health tech, from social networking tools for athletes to economic development boards from Finland and Japan. With 70 some-odd sponsors, it’s no secret that educating and selling are one and the same on this stage.

Across analytics, wearables, policy, venture capital, mobile, and much more, the  breadth of topics admittedly felt slightly overwhelming. Like many, we found the chaotic, choose-your-own-adventure style schedule in need of some curating, as it seemed several of the better sessions occurred at the same time, while plenty of watered down panels dragged out the afternoons. As a systems-oriented analyst firm, we steered towards the clinical wherever possible. In general, the discussion was slightly more mature and self-aware than expected – perhaps an acknowledgement that past a certain point, hyping up a crowd simply won’t sell more products and drive real change. Below are a few of the themes that popped up over the course of three sunny days in Santa Clara.

As a sidenote for CAS subscribers, Chilmark Research will be exploring a few of these themes, particularly as they involve specific companies, products and market trends, in more depth in a forthcoming Domain Monitor.

Portal Overload
Everyone from Walgreens to UnderArmour to Cigna to numerous startups seems to have their own consumer portal. From 10,000 feet it looks nice to see major names develop more individualized engagement, but on the ground, this brand-driven approach is creating a glut of platforms that will each realistically see anemic utilization. Validic seems more focused on the enterprise than on individual consumers at this stage, so if Apple’s HealthKit isn’t an answer to this problem, perhaps future alliances of major brands can help alleviate password fatigue and prevent yet more silos of information.

Workflow or Traffic Jam?
A related issue emerging on the delivery system side is the backlog of dashboard style tools, which were part of nearly every clinically oriented demo or slidedeck we saw, from EHR to analytics vendors, not to mention the mushrooming number of care coordination plays out there. Issues around “intraoperability” – availability of data of one system in another, selecting features and configuring swap-outs, UI, and other workflow customization – are proving to be no small order in the trenches. Long story short, the provider market is moving in inches rather than looking for a Hail Mary. This may be be one of the reasons why some of the seemingly promising startups like Conversa who were making noise at HIMSS were quiet about any new customers here.

Promise of Data-Powered Self-Care
From the established companies’ product demos, like Qualcomm’s 2net, to the launch of more startups, like Livongo, a diabetes management play by Allscripts’ ex-CEO Glenn Tullman, there were a number of tools helping patients manage their care with more automation and customization. Several speakers commented cautiously on these developments, stressing that ease of use and automation is the key to sustained traction among patients. For a crowded area traditionally foggy with vaporware, this was a refreshing tone to hear. Yet the burning question we didn’t hear much about was if and how all this data is going to be consumed, managed, and used by health systems in the context of care delivery.

Payers – Drumroll or Eye-roll?
At the end of the day, the high level, 24/7/365/360 degree ‘neighborhoods of engagement’ models like the one hawked in a sponsored session by Cigna seem somewhat delusional. People still associate their insurer as the bad guy sending a bill in the mail and putting us on hold when we actually need something from them, not as a committed healthcare partner fighting on behalf of our physical, mental, and especially financial health. While payers evangelize the idea of understanding all the other parts of our lives, they shouldn’t forget our tendencies as patients – how we perceive and realistically interact with our health insurer versus our doctors, nurses, hospitals, pharmacies, and so on.

EHR Vendors: Mixed Reviews
Taking a pulse of the folks we met with here, virtually everyone is looking beyond Meaningful Use for future product development. For startups, integrating with EHRs is table stakes, so it was nice to see a few bigger names like Allscripts, PracticeFusion and eCW start incorporating third party tools into their platforms for both clinical and patient end users. athenahealth’s Jonathan Bush had his usual bold words for the crowd. Yet we’ve heard plenty about such vendors’ innovation programs (e.g. athenahealth’s MDP and at this conference, Allscripts’ pre-conference API-enabled hackathon) and virtually nil about their results – how they are being pulled into customers’ existing deployments to improve clinical outcomes, drive cost savings, or even just increase user satisfaction.

What’s Next in Analytics?
There is big money in the analytics market, and several vendors were seen circling the conference halls, talking about their unique blends of claims and clinical data feeds. We held meetings with a number of them, and when asked about their primary buyer within an HCO, more than one said they’re seeing a shift towards joint-decisionmaking by the CFO, CIO, and other leadership. While analytics products begin to play a more global role in today’s data driven environment, it’s worth wondering where the next layer of insight will come from. Vendors we spoke with here sensed more financial opportunity in SMAC than in PGHD. One of the more exciting products was Healthline’s newly announced engine to crunch unstructured patient data using NLP and assign/augment individuals’ risk score.

Underserved and Underrepresented
There was a decided lack of discussion about Medicaid populations, the homeless and severely mentally ill, financially distressed, immigrants, uninsured, and others. These are some of the costliest patients in our country, and they deserve representation despite their inability to buy a Fitbit. Moreover, it felt tactless for a global healthcare brand in their 8^th year to blithely hold a wearables fashion show while shunning off the less sexy but more important issues to a minor early morning pre-conference session. We saw a few admirable startups at said session (CareMessage and Healthify) providing tools to safety net clinics and community health facilities in places like Galveston and Baltimore. But beyond that, this was a disappointment that we hope to see ameliorated – potentially by inclusion into the Unmentionables session next year.

Regardless of the repetitive drumbeat and some of the more blatant sponsored product placement, there was a lot to see, hear, and take in at the conference. It remains a top tier networking event, drawing a diverse crowd of companies, individuals, and ideas. Across demos and keynotes, from morning coffee to late night drinks, scheduled briefings and impromptu lunch meetings, it was a busy and insightful conference, full of business, passion, technology, and stories.