Monthly Archives: May 2014

Well-Being – Real Time

The future is now. MARVELS is here.

The quantified self movement brings with it the very real opportunity to bring personal well-being into a real-time modality.

MARVELS is the acronym for what is possible:

Monitoring of:
M – MEDS (what MEDS I take, what compliance I have, etc)
A – ACTIVITY (walking, running, calories burned etc)
R – Resting Metabolic Rate (calories burned at rest)
V – VITALS (pulse, BP, etc)
E – EATS (what I eat and drink, especially calories)
L – LABS (blood testing, etc)
S – Sleep (duration, deep sleep, etc)

In any given setting – a community, a workplace, an assisted living facility, a spa, or even a well-being oriented pharmacy like CVS or Walgreens – monitoring of MARVELS (MEDS, Activity, Resting Metabolism,VITALS, EATS, LABS, Sleep) is now going to accelerate at an exponential rate.

The Privacy Imperative will be the critical success factor for all of these pushes into the future. It is foundational.

Without it, there will be no progress.

With it, personalized, real-time care will flourish. Each individual will be able to opt-in to his care-coaching community (and to opt-out whenever they choose), and get the extraordinary benefits that such a community can provide.

Want to talk to your well-being coach? FaceTime them, and they – with your permission – will help you sort out what’s going on with you.

Feel like you might need a check-in with a doctor? Send them an email – with your MARVELS history embedded in it, or get them on the phone or FaceTime, and see if they need you to come in.

The future is now.

BEWELL Centers will be EVERYWHERE. Look for:

DWELL CENTERS (part of BEWELL Centers) – for community MARVELS measuring and monitoring support. Target population is neighbors in the community.

EWELL CENTERS (part of BEWELL Centers) – for employees in workplaces MARVELS measuring and monitoring support. Target population is employees in the workplace.

SWELL CENTERS (Part of BEWELL Centers – for service-providers MARVELS measuring and monitoring support.Target population is customers of the service provider.
(Walgreens and CVS are already moving aggressively in this direction>

References:
The Privacy Imperative
LABS revolution
LABS By Disease
Quantified Self Movement

Institutional Place-Making

Summary
Institutions help give a place its unique identity. They come in many shapes and sizes and types. There are schools, museums, playhouses, photography centers, fitness centers, parks, playgrounds, daycare centers, bike shops, coffee shops. The “invisible hand” of capitalism can design, implement, and organize some of these on a sustainable basis – but very few. Most require leadership, a “coalition of the willing”, and financing that goes beyond investment with the normal paybacks and returns on capital.

Moreover institutions that can create a sense of place need planning, so that they are symbiotic and not redundant.

A master plan for institutions is every bit as important as a master plan for physical design.

Institutional Place-making
Place-making is normally a phrase which is attributed to physical place. But institutions are places too, and they need to be designed with as much care as physical places.

Institutional place-making can be approached from the standpoint of a physical place, or from the standpoint of a virtual place.

From the vantage point of a physical place
From a physical place, such as Serenbe, obviously place-making is about building a vibrant community. No matter how beautiful or sustainable or well-thought-out the physical place is, every community will be made more vibrant by the institutions that are a part of it. Again, using Serenbe as an example, the Blue Eyed Daisy is a bit hard to imagine as an institution, but is it? Architecturally, there is no doubt in the minds of Serenbe residents that it is a place.

The question arises: what is the institutional master plan for a physical place? No one questions the need for a master plan for a community. In Serenbe, Phil Tabb laid out a brilliant master physical plan, and continues to evolve it, update it, etc. In like manner, Serenbe needs an institutional place-making master plan, and is creating it and evolving it every year. The emergence of the Serenbe Playhouse as a major institution that brings joy to Serene residents and non-residents alike is just one example of institutional place-making. The Serenbe Institute, The Photography Institute and the Chattahoochee Hill Charter School are other examples.

From the vantage point of a virtual place
Any institution must choose – will it be in one physical place, or many? Will it have a virtual presence and a physical presence? If yes, which will be the stronger component? Amazon, for example, skews its institutional place-making to virtual. Starbucks, as a second example, skews its place-making to be physical.

Will the institution be designed to appeal primarily to local sensibilities or to global sensibilities? McDonalds clearly strives for a global appeal, as do most well-known global brands. Starbucks, again, is a counter-example – of a global brand that strives to present itself as very local.

The point is that institutional place-making architecture is a very real need. Good institutional place-making has an architecture all its own. It starts with a master plan, and evolves into governance issues, technology platform issues, unit-business-model issues etc. Doing it well for any physical place makes that place really special. Doing it poorly is recipe for disaster.

References
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Evisits to doctor

Deloitte spots 600 million US/Canada doctor visits a year – how many can be replaced by evisits? And how about the visits that are about filling out forms and getting prescriptions refilled and don’t involve a doctor?

They say: expect 100 million evisits in 2015, up 4x from 2012!

Full Article about Deloitte Study Here

eVisits: The 21st Century House Call
Trends in technology and business are aligning to make 2014 a breakthrough year for online health care.

This year should see a spike in the use of “eVisits,” in which patients interact directly or indirectly with health care providers via the Internet. Deloitte predicts there will be 100 million eVisits globally in 2014, representing a 400 percent increase from 2012 levels. “This number of eVisits could potentially save over $5 billion compared with the cost of in-person doctor visits,” says Duncan Stewart, director of research for technology, media, and telecommunications (TMT) for Deloitte Canada, a member firm of Deloitte Touche Tohmatsu Limited.

“Most eVisits do not entail direct interaction with a physician, but instead involve capturing patient information through forms, questionnaires, and photos,” says Paul Lee, director and head of global TMT research for DTTL. For example, patients suffering from allergies or an earache can receive a diagnosis and, if required, a prescription, after completing an online form. “Online video consultations between patients and doctors represent just a small part of the market and offer only minor cost savings compared with an in-person visit,” he adds. eVisits are a subset of the telehealth market, which is estimated to reach $25 billion by 2015. The broader telehealth market also includes professional-to-professional consultations, remote monitoring, and alerts and notifications, among other activities.
IT leaders of physician practices, hospitals, and other health care providers will need to help their organizations benefit from the efficiencies and improvements in patient care that eVisits promise to deliver. These organizations will need to decide which investments to make in the technology infrastructure that supports eVisits, such as patient portals (the online applications that enable interactions with patients), electronic medical records, advanced analytics, and security and privacy systems. Training for physicians and other care providers will also be essential.

The Prescription for Adoption
Recent technology trends—including ubiquitous Internet access and widespread use of mobile devices—have made eVisits viable in ways that were not possible even a few years ago,” says Stewart. Advances in analytics have made it easier to automate the back office elements of eVisits, while fiber optic networks facilitate the data-intensive applications. “Greater comfort using technology among older patients, who make up the bulk of doctor visits, has also promoted eVisits’ growth,” he adds.
“The business environment in 2014 will further promote significant growth in the volume and value of eVisits,” says Lee. Health care systems aim to decrease costs by focusing on prevention and early intervention and by continuing to integrate IT. A global physician shortage and an increase in the number of people with health insurance are also likely to drive greater adoption of eVisits. “Because eVisits are more convenient, entail less time and lower cost, and enable faster treatment, demand should be strong,” says Lee. However, because the greater convenience of eVisits may lead to more interactions, some of the reduction in overall health care costs may be offset, he adds.
The use of eVisits in 2014 will likely be greatest in North America, says Stewart, where the technology infrastructure and incentives are already in place. There could be up to 75 million eVisits this year in North America, which represents 25 percent of the potential opportunity for these interactions in the region. There are more than 600 million annual visits to general practitioner offices in the U.S. and Canada, and about half are for problems that could be solved by an eVisit, says Stewart.
Some physicians may need to be persuaded about the benefits of eVisits, but there are plenty of advantages to share with them. eVisits allow physicians to spend greater time on more serious and complex cases while improving quality and efficiency of care for simpler cases. “As long as liability for virtual diagnoses is handled properly, physicians will likely welcome the ability to help more patients in less time and across greater distances, as well as the opportunity for more flexible work arrangements,” says Lee.
Outside the health care field, the telecommunications and technology industries will likely benefit from the growth of eVisits. Telecommunications providers will see growing demand for data volumes, high-speed broadband, and support for machine-to-machine connectivity. Product manufacturers and developers are likely to enjoy new growth opportunities for devices, peripherals, and apps. Technology providers will need to decide how and where their companies should participate in a healthcare ecosystem in which patients use sensors, mobile devices, and communications systems to monitor their treatment and health status.
***
The vision of providing more convenient and less expensive health care through eVisits is fast becoming a reality as the pieces of the technology puzzle fall into place. In developed markets, eVisits will augment a health care system that is already well established. The opportunity is even more profound in developing regions, as eVisits will likely offer affordable primary and diagnostic care to very large populations that do not have access to it today. “Although the initial benefit of eVisits may come from saving billions of dollars, over time the greater good may come from saving millions of lives,” says Stewart.

Related Content: “Deloitte Technology, Media & Telecommunications Predictions 2014”