Dr. Ezekiel Emanuel, vice provost for global initiatives and chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania, is a self-described “technoskeptic.” In a keynote address to the 12th annual Connected Health Symposium Friday in Boston, offered up a single word to describe his skepticism about digital health: Theranos.
“That kind of sums it up, I think,” Emanuel said, referring to the embattled diagnostics company that was the darling of the healthcare innovation world until a scathing exposé two weeks ago. “I think it’s a great case of technohype coming down to earth.”
Emanuel didn’t stop there. He turned his ire to the buzz around fitness wearables. “I just don’t think I need to know I did 10,000 steps every day, give or take 250, except on days I go running,” the former head of bioethics at the National Institutes of Health said.
“I think you can forget about wearables for the masses,” the outspoken Emanuel said. “Investing in them is not going to pay off.”
That’s because wearable gadgets are targeting the wrong segment of the market, according to Emanuel. “Users tend to be young, rich, healthy and connected. You’re not going to get anything out of them from a healthcare perspective,” he said.
In a system where at least 60 percent of healthcare spending comes from 10 percent the population who are older, have multiple chronic conditions and often are at the lower end of the socioeconomic scale, fitness gadgets won’t change much. “They need stupid, invisible devices that stay behind the scenes,” Emanuel said of this population.
The return on investment in digital health will come from avoiding hospitalization and other expensive care, Emanuel suggested.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
“We can have good technologies,” he said. Emanuel spoke in favor of “connected” companies that “peel away medicines,” since so many patients are overmedicated.
“I think there’s a big space in the mental health sphere,” he added, mentioning video in the home as an example.
Emanuel then listed seven steps that stand between technology and the end result of better care at lower cost:
- Engage patients in some way;
- Get data from people;
- Find a reliable, secure means of transmitting data;
- Use data inside the healthcare system;
- Apply the information to create sustainable behavior change;
- Behavior change leads to health improvement; and
- Save money so people will adopt the technology in the first place.
“Each of those steps has a huge challenge,” Emanuel said.
Photo: Twitter user Twine Health
