Macadamian Blog

Cognitive Healthcare – The Evolution of Connected Health

Didier Thizy

One of the great barriers to achieving Connected Health has been providing a natural, intuitive interface that seamlessly gathers relevant health data from consumers.

Cognitive Healthcare

In 2016, Connected Health was about connecting a variety of ‘end points’ – mobile phones and apps, remote monitoring tools, personal health trackers, IoT sensors, computers and networked devices – to help providers and patients manage chronic conditions, maintain health and wellness, and improve adherence, engagement, and clinical outcomes.  In 2017, vendors will continue to develop and connect new solutions, but the trend is moving from simply connecting and exchanging data to cognitive healthcare with a smarter, richer experience. AI and machine learning will allow for personalized and more accurate ‘decision support’ for the clinician or patient. New technologies like Amazon Alexa will provide a more natural, conversational user experience through voice, video, and sensors.

As we illustrated recently with the Alexa enabled virtual caregiver that Macadamian created with LifePod, we’re moving to a more cognitive healthcare experience. From simply connecting clinicians and patients to providing rich natural conversations with personalized decision support.

Useful and Usable Are The Keys to Adoption

To date, one of the great barriers to achieving Connected Health has been providing a natural, intuitive interface that seamlessly gathers relevant health data from consumers. We learned years ago with solutions like Microsoft HealthVault and most patient portals that the vast majority of consumers were simply not prepared to manually type in their health data on a regular basis. And with most clinicians not willing or able to consume that data, not only was the interface onerous but the value you’d get out of all that effort was marginal.

More recently, there’s been a proliferation of wearable devices and smarter mobile apps that make gathering certain types of health data easier, but true adoption as part of the user’s daily lifestyle still eludes most vendors.

Only a few end points have really been sticky with users such as PatientsLikeMe and FitBit. What’s their secret?

At Macadamian, we believe the keys to users adopting a solution are simply to make it ‘useful’ and ‘usable’

  1. providing considerable value to the user on an ongoing basis (‘useful’),
  2. providing that value in a way that is natural, intuitive, and requires little to no effort on the user’s part (‘usable’).

Usability Gets A Massive Boost with Natural Language User Experiences

Amazon Alexa stole the show at CES. In health and other industries, product developers across the board are looking at ways of leveraging ‘conversational user interfaces’ driven through conversation with Alexa. As detailed in our article, whether incorporated into mobile apps for motivating health and fitness engagement, as a part of the digital prescription adherence user experience, or incorporated into interactive systems for outpatient education, we expect the conversational user interface to gain traction and become mainstream.

But there are other technologies that are providing for a more usable, natural experience than the traditional typing of text into an app. For example Owlet, a leader in the Internet of Things movement in healthcare, offers a connected baby sock, providing new parents with peace of mind and saving lives in the process. Early Sense provides a sensor under a patient’s bed and enables real-time alerts to be sent to the care team with the goal of optimizing sleep and predicting readmissions. And CareWire provides patient services naturally through text messaging.

From Connected to Cognitive Healthcare

Our friends at Involution Studios have called out a trend called Virtual Helpers, the digital health companion in your pocket. “Virtual helpers, like ‘Watson meets Siri, in your pocket’, leverage human-modelled artificial intelligence to provide both health coaching and resources to motivate patients. Such companions will assist people in adhering to their care plans, their prescription regimens, and even outpatient treatment for complex, chronic conditions.”

Indeed, the usability of the solution is critical, but the value that a user gets from personalized, valuable recommendations is just as important in ensuring Connected Health adoption.

Virtual helpers won’t just be for consumers. With major advancements in data science and machine learning, clinical decision support systems are getting a boost too, such as Elsevier’s Clinical Key and Premier Theradoc that we’ve had the privilege of helping design. Even health payers like Humana are publicizing their use of virtual helpers to provide coaching to claims agents on providing better customer interaction with patients.

Again, these AI interactions and decision support will only be adopted by the user if they are useful and usable. In a seminal research paper Interface Design Principles for Usable Decision Support, the authors document issues such as alert fatigue and out-of-context recommendations as examples of usability problems that can render even the best AI recommendations ineffective.

“Developers need to adopt design practices that include user-centered, iterative design and common standards based on human–computer interaction (HCI) research methods rooted in ethnography and cognitive science. Appropriate design strategies are essential for developing meaningful decision support systems that meet the grand challenges of high-quality healthcare.” In other words, the usability of the AI makes all the difference.

True Connected Health is connected to the Clinical Space

The IMS Institute for Health Informatics reported recently that there are more than 165,000 mobile health apps available today, more than double last year, with the majority focused on consumer lifestyle topics like diet, fitness, and stress. The consumer health market is crowded and will only get more competitive.

Meanwhile, big players like Apple have announced plans to broaden their offering from consumer health to “clinical actionable products and services”.

This is a pattern we are seeing in Connected Health. Vendors are looking to move their solutions to the clinical realm – interoperating with Electronic Medical Records data and involving clinical stakeholders like doctors, nurses, and pharmacists in the workflow. This is certainly a way of adding more value and credibility to the solution, as well as standing out from the crowd of consumer health apps.

But it comes with barriers to entry in the form of regulatory and interoperability requirements.

Ensuring your connected health solution is HIPAA compliant, and if needed, FDA compliant, especially with recent changes to FDA policy, is an important factor that should be built into your connected product strategy upfront. A qualified product partner will be able to advise on how to architect your product to push the boundaries of modern technology while advising on the strategy and risks of meeting certification constraints.

Interoperability often means working with a partner who understands the APIs of the leading ambulatory and in-hospital EMR products such as Epic, Cerner, Allscripts, and athenahealth, if not with the vendor directly, as well as establishing hospital partnerships directly for product trials.

Connected Health in 2017 – Where Do Vendors Go From Here?

Product developers who will succeed in 2017 are the ones that will demonstrate a solution that is both useful and usable. Usable means following User Experience Design best practices, especially when exploring the use of modern technology such as Amazon Alexa and IoT sensors. Useful means taking advantage of modern AI to provide personalized and valuable decision support to the user, in a way that is again intuitive and usable. It will be especially useful if it involves the use of clinicians in the workflow, allowing patients to connect with doctors, nurses, and pharmacists and work from the same shared data.

We recommend:

  1. Explore and prototype new conversational UX technologies such as Amazon Alexa
  2. Follow User Experience Design best practices, with the help of qualified UX research and design professionals
  3. Include regulatory and interoperability considerations into your product strategy upfront
  4. Don’t just connect your solution, provide a valuable personalized experience using AI data science and machine learning
  5. Start small and celebrate small victories! Prototype a demo and get stakeholder buy-in. Get feedback from users and refine your approach. Keep iterating and you will bring a strong useful and usable solution to commercial release.

For help on User Experience Design, prototyping and commercializing modern Alexa, IoT, and machine learning solutions in the consumer and clinical space, reach out to Macadamian. We’d be happy to advise or provide a team of experts to help.

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Author Overview

Didier Thizy

Didier is Macadamian's VP of Sales, running all account management as well as our growing healthcare practice. Responsible for a cross-functional unit of design and development consultants, his areas of focus include consumer and enterprise IoT software, health software, and usability of complex systems. Didier is an active member of HIMSS, MGMA and Health 2.0. When Didier is not on the road, you can find him rocking out to 80s music, and on certain rare mornings, sleeping in because his kids decided to cut him some slack. Didier has been a software professional for 16 years, holding a variety of positions in Software R&D, Product Management and Business Development.