© kuva Michael Müller
In early October, in sunny and warm California, I am sitting in a darkened conference hall. I once again hadn’t remembered that there where people enjoy (at least from a Finn’s perspective) year-round summer, one shivers indoors. Air-condition cooled air swirls around me goose-bumping my skin as I try to follow the fast talking people popping up into the spotlight on the podium for a few minutes.
The Health 2.0 Summit at Santa Clara Convention Center is in full swing. Digital era hype is high. Sponsored pitch-runs paint a bold new future of health care and wellness that is driven by endless cool opportunities. Consumers master their health and diseases with apps that snatch data from data-clouds effortlessly, accurately and with lightning speed. People tap and swipe their handhelds to share their health data and willingly want to be a part of the globally spread health conscious community. These enthusiastic early adapters get kicks from measuring all possible bodily functions and performance parameters. They share their calorie intake, exercise achievements, daily activities and feelings diaries. Measure, share and compare. The possibilities are endless pitchers preach. Take you pick! Just one thing – or a couple – has still to be made right for the prototype to work.
During the cavalcade of pitched solutions – many still near idea stage – I hear several emotionally strong personal stories. A mother’s, friend’s, daughter’s, patient’s or the pitcher’s own struggle with a health problem had presented a so far unmet need, which now is addressed with the new healthcare business solution. As a doctor and a person who has been worried about family members’ and friends’ health and treatments I can really relate to the strong stories. At the same time I find myself wanting. In medical conferences presentations of new technological advances are always linked to research. Data is presented from clinical trials, validation studies and research that address safety, usability, reproducibility, accuracy, efficacy and other benefits of new innovations to health. It’s about medical credibility. This issue is not addressed in the pitches.
In the consumer space of health and wellness, one cannot dismiss the fact that people are sometimes sick – temporally or from a certain time point onward chronically. Illness changes how our body reacts, how we behave and are able to cope. And there is no such thing as a “typical patient”. We are in many ways individual. So in the middle of all the health hype I find myself thinking how medical and other healthcare professionals can raise these important issues without being seen as devil’s advocates.
Reflecting back on the intensive early October Health 2.0 Summit days:
A strong claim was made that consumers are the best experts of their own health. When it comes to medical issues, this statement is bold and can add an extra heavy burden to the shoulders of many people. When does one know that everything is not as it may seem to a layperson? In the end it is the health care professionals that have to fix wrong gone things and take responsibility.
Mixing hype with reality bites on societal and public health issues gave spicy depth to the event: Enthusiastic pitches on how the future of heath care looks bright for all through digitization were challenged by some thought provoking keynotes that were scattered throughout the Health 2.0 Summit. I congratulate the organizers on this – well planned!
The 19th United States Surgeon General Vivek H. Murthy addressed social inequalities: A person’s zip code is often the most important health factor: If your neighborhood is unsafe, how to exercise outdoors? If you are short on money, how to provide healthy and tasty food for your family as fast food greasy hamburgers are so much cheaper than fresh vegetables? Murthy pointed out that loneliness and social isolation are leading causes of poor health. He urged people to invest in building communities that enable making pursuit of a healthy life a team sport.
The Unmentionables session moderated by Alexandra Drane challenged us to take a look at the Ostrich index: What is blinding us and making us narrow and short-sighted because we are putting or keeping our head in the sand – not talking about psychosocial factors that affect health? Work stress is becoming an epidemic was a worrying claim. It inflicts health care professionals resulting in job dissatisfaction and increasing the risk of burnout. Worn-out doctors and nurses behave badly towards patients and each other.
Health service providers are under tight scrutiny as several apps provide customer satisfaction stars. They do not define if satisfaction is related to friendliness or success of treatment. Other apps give online, real time info on where to find the nearest available care center, tips on how to navigate to the sites, commuting time estimates, as well as information on what health care insurance you need to have to get help. In the Unmentionables session Mark Ganz CEO of Cambia Health Solutions criticized the current US system where who pays and what in healthcare is always the main issue. “Why doesn’t someone for once develop a meaningful care solution that people themselves are willing to and afford to pay?” he asked. “Do health insurance companies really know what’s best?”
Dr. BJ Miller of Zen Hospice whose thought provoking YouTube Ted talk on What really matters at the end of life has been viewed for over 2 million times reminded us that dying people are still alive. In a hospital incurably sick people often feel like a piece of meat Miller claimed. Doctors are more tuned to making sure “you don’t dare die on my shift” than helping people to live gracefully to the end of their lives. Dying is an unfixable, too often unmentionable fact of life. Miller talks about the importance of the human touch for alleviating suffering and helping people to heal. At the same time he himself is living testimony to medical technology advances as he walks smoothly on the podium with his artificial legs having lost his own in an accident.
Karin Van Zant (CareSource) tries to mend the broken welfare system. For low-income people a monthly paycheck is the best medicine for improving health. “Don’t lecture me about health, help me get a job!”
I also learned some disturbing statistics: Only 5 % of doctors working in the US feel satisfied with their work and most would now choose their profession differently if given a new chance. In a survey from 2013 nearly 80% of Finnish doctors are motivated and mostly pleased with their work. Crashing healthcare information technology systems and often user-hostile interfaces of patient monitoring systems hijacking time from patient-doctor interaction are a pain in the neck on both sides of the Atlantic. Perhaps one fact explaining the differences in job satisfaction is that doctors in the US have to constantly look out for lawyers lurking nearby and scanning for potential malpractice lawsuit cases. Whereas in Finland doctors still can concentrate on taking care of their patients without all the time worrying about being sued.
In the midst of health hype and reality bites it is clear that our basic human need to communicate face-to-face needs protection now and in the future. In the digital era the human touch, showing compassion and empathy is very much in the center of good and meaningful care. I predict that technology that provides time and space for this will be a big hit.
