Consumer Healthcare + Tech = Adoption FAIL

by Bradley Miller on March 9, 2010

Combining medicine and technology hasn't always been smooth for people like diabetics

I’ve been thinking a lot recently about people’s [in]ability to integrate and think about a lot of different data points, particularly over time.  Specifically, I was thinking about consumer healthcare solutions that have been popping up.  I was advising a couple friends last night on an idea that they had in the consumer wireless space to help people manage a specific health condition – let’s say blood sugar for type 2 diabetics.  Seems like a noble goal, right?

I thought so too 3 years ago when I tried to create my first start-up, Element Mobile.  With our first product, CurrentCare, we were aiming to help diabetics easily, quickly and seamlessly track their blood sugar and other related statistics.  We were aiming for both type 1 and type 2 diabetics.  However, the interesting thing in the marketplace is that there’s about 1.5million type 1 diabetics (those who require insulin to live) and about 22.1million type 2 diabetics (tend to be more obese and insulin resistant) in the United States.  We were aiming for both populations with CurrentCare.

But, here’s the rub.  Type 1 diabetes patients tend to get used to a routine and learn how their body reacts to insulin and over time they lose the impetus to continuously and religiously track their blood glucose levels.  And, for the most part they do pretty well and live relatively healthy lives.  Type 2 diabetics tend to be individuals who haven’t taken as good care of themselves – if most were to lose weight and track their blood sugar levels (among many other lifestyle changes) they could probably get their disease under control and maybe even become totally healthy once again.

And, by “healthy again” I also mean that if they get back to healthy, they could avoid complications like heart attacks, toe and foot amputation, kidney failure (which requires dialysis), blindness, etc. Caring for complications of diabetes alone cost the US healthcare system about $116,000,000,000 a year – yes, $116 BILLION – and another $58 billion in associated costs.  That’s enough to scare the bejeezus out of me, but most type 2 diabetics don’t manage to control their blood sugar or attempt to lose the weight they need to avoid these ills.  Why?

One of the problems is that these complications occur many, many years after the initial onset of diabetes.  It takes 10-20 years of neglect (sometimes sooner) to run in to these issues.  It’s hard for type 2 diabetes patients to really be scared of something that’s 10, 15 or 20 years down the road, particularly if they don’t feel that bad today.  As a side note, type 2’s do report feeling worlds better if they kick the disease through diet and exercise, so there would be some immediate, near-term benefits to becoming healthy.

The same applies to people with high blood pressure, poor eating habits, or who are overweight, etc.  Most of these people feel “fine” today – they’re getting along just fine and don’t feel the need to change.  The punchline, however, is that 10-20 years down the road when the deleterious effects of a lifetime of neglect kick in, it’s almost surely too late to recover to 100% health.  This leads to the inherent problem with consumer healthcare and “health 2.0.”

If people aren’t inspired or driven to take care of their condition because they can’t see the deleterious effects that loom 15 years down the road, why would people be inspired to care for their conditions with new internet and wireless tools?  Even if these techniques and tools lower the barrier to adoption and make tracking super simple, for a vast majority of people it’s simply not worth it to care for or improve their condition.  It’s one thing to create an elegant solution and another to gain adoption among this population of people. Creating these solutions faces the problem of getting multiple types of users on board – providers, patients and payers.

All too often we only really care about our health when something is staring us in the face – like an illness or a cancer diagnosis or heart attack.  Or even something as joyous as pregnancy. And even then we go online, look up a few web pages, maybe do a bit more of investigative research and we’re satisfied.  Because of this, the opportunities to monetize these interactions and create a sustainable business is somewhat limited.

There’s an inherent human behavioral trait that’s just so hard to manage in a way that causes people to change.  However, the person or company that can solve this problem – to create a health tracking solution that gains steady user adoption and traction – will almost certainly win the start-up prize. But, until then, I think there are (unfortunately) going to be a lot of dead startups in the middle of the road. I think the answer lies more in consumer behavior rather than creating effective clinical solutions.

How are things going to ultimately change? Is it scaring people out of their wits to change? Is it substantially lowering the barriers to adoption? Is it some other intuitive device or solution? Or something completely different like incentive or disincentive programs that get people to change? What do you think?

{ 3 comments… read them below or add one }

AlaskaHughes March 9, 2010 at 11:48 pm

I think at least part of solution lies in a trusted, ongoing RELATIONSHIP – solid, true, ongoing, always accessible – with a primary care team. That’s my gut instinct and that’s one of the core concepts of the medical home or health care home model. Not until primary care is truly strengthened and back in the right ratio to specialty care will we see improved health outcomes in this challenging population – nor will we see true cost containment in health care (as well as insurance rate stability).

Diannadapt March 13, 2010 at 7:44 am

Reality can be a tough swallow- especially when it isn’t actually a reality yet. In a way, this post was pretty depressing– but also interesting and got me thinking…
What about smoking? Can we find any common ground for comparison with this health issue? It is a lifestyle choice with negative health effects appearing years later- yet in the US, we’ve managed to turn the tide of a ubiquitous unhealthy habit– can anything be learned from the smoking arena? How did we move from everyone and their children smoking around the dinner table to our current situation? Was it mostly government campaigns or private health care-related organizations? Will we move against over-processed and refined foods and push exercise and healthy food products?
In a way it feels so hopeless, if you look around at our obese children, and walk down the aisles teeming with processed foods laden with sugar, fat and complex-carbs. Can/should health activists and/or government attempt to change what is available to consumers i.e., tax ridiculously unhealthy food items in the way we tax alcohol and tobacco?? Require Peeps, Coca-Cola, and KispyKremes to include warning labels similar to those on cigarette packages? We all know they are unhealthy, just as we know smoking is unhealthy— what really turned us away from the smoking lifestyle and allowed us to seek help from the medical community??

Tracy Rose June 6, 2012 at 7:54 pm

Hi,

Healthline recently finished an infographic that shows the increasing impact type 2 diabetes has on everything from pregnancy to national health expenditures. You can find the infographic at: http://www.healthline.com/health/type-2-diabetes/statistics-infographic

We encourage you to embed this graphic on your site & share with your followers, friends, & network.

Please let me know if you have any questions.

Warm Regards,
Tracy

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