False Barriers to mHealth?

cartoon about good healthFrom a consumer perspective, technologies – including wireless networks, smartphones, tablets, and medical sensors – are advancing at breakneck speed, enabling the new converged field of mobile health care, or mHealth.

Technologists, on the other hand know that so much more can be done and are often frustrated by barriers that slow innovation and time-to-market, including nay-Sayers  and regulators. I’m a technologist, and I’ve been hanging out online with others in the mHealth field, maybe too long. Anyway, I’ve written about both the exciting technologies and the barriers of adopting them. See:

What prompted this post is an optimistic article by Heidi Wilson. In You’re not wrong, it’s just hard she starts out:

“Every time I turn around I see another article about how current reimbursement models are blocking widespread adoption of mHealth and I’m kind of sick of it. You see, the challenge with business models of mHealth is a false problem.”

We sometimes worry too much about making sure a third-party payer will reimburse the expense of treatment, she says, but that doesn’t keep good doctors from trying new things and doing what’s right for their patients.  In one example, she talks about early uses of photodynamic therapy (PDT) as a treatment option for macular degeneration, an age related loss of vision problem. At first, the insurance companies denied the claims, saying the treatment was “not medically indicated.” But many patients paid for the treatment out-of-pocket, and that helped to prove its effectiveness.

Her point is that people who truly innovate in health care do it because it’s the right thing for the patient, not because it fits a business model. Medical innovation involves risk-taking, and sometimes the risks of not doing something are higher than trying something new. This article on the 40-30-30 rule talks about the role of risk-taking in sports (and in life) and makes a good point. Applied to medicine, it suggests that if nobody pushed themselves outside their comfort zone we’d have only general practitioners with no neurosurgeons.

cartoon about risk-averse behavior

All jokes aside, risk-averse behavior in health care can costs lives.

Heidi goes on to say that often the experts and media get it wrong and that doing what’s right is what’s right, so to speak. She included a few quotes to make her point, but here’s a larger collection from my old consulting business.

FALSE PREDICTIONS

These quotes show that it’s risky to say that something can’t or won’t be done, especially when technology is concerned and it’s the right thing to do. I hope it inspires others to do the right thing.

  • PHONOGRAPH – “The phonograph has no commercial value at all.” (Thomas Edison)
  • TELEGRAPH – “I watched his countenance closely, to see if he was not deranged … and I was assured by other senators after he left the room that they had no confidence in it.” (U.S. Senator Smith of Indiana, after witnessing a demonstration of Samuel Morse’s telegraph, 1842)
  • TELEPHONE – “Well-informed people know it is impossible to transmit the voice over wires and that were it possible to do so, the thing would be of no practical value.” (Boston Post, on the telephone, 1865)
  • TELEPHONE – “This telephone has too many shortcomings to be seriously considered as a means of communication. The device is inherently of no value to us.” (Western Union internal memo, 1876)
  • TELEPHONE – “The Americans think we need of the telephone, but we do not. We have plenty of messenger boys.” (Sir William Preece, chief engineer of Britain’s Post Office, 1876)
  • ELECTRICITY – “Fooling around with alternating current is just a waste of time. Nobody will use it, ever.” (Thomas Edison, 1889)
  • CARS – “The horse is here to stay, but the automobile is only a novelty–a fad.” (President of the Michigan Savings Bank, speaking to Henry Ford’s lawyer, Horace Rackham. Rackham ignored the advice, invested $5000 in Ford stock, and sold it later for $12.5 million.)
  • PLANES – “Heavier-than-air flying machines are fantasy. Simple laws of physics make them impossible.” (Lord Kelvin, president, British Royal Society, 1895)
  • INVENTION – “Everything that can be invented has been invented.” (Charles H. Duell, commissioner of the US Patent Office, recommending that his office should be abolished, 1899)
  • PLANES – “Man will not fly for 50 years.” (Wilbur Wright, to brother Orville after a disappointing flying experiment in 1901. Their first successful flight was in 1903.)
  • PLANES – “There will never be a bigger plane built.” (A Boeing engineer, after the first flight of the 247, a twin-engine plane that holds ten people)
  • RADIO – “The wireless music box has no imaginable commercial value. Who would pay for a message sent to nobody in particular?” (David Sarnoff’s associates responding to his urgings for investment in radio, 1912)
  • TANKS – “Caterpillar land ships are idiotic and useless. Those officers and men are wasting their time and are not pulling their proper weight in the war” (Fourth Lord of the British Admiralty, regarding the introduction of tanks in war, 1915)
  • TANKS – “The idea that cavalry will be replaced by these iron coaches is absurd. It is little short of treasonous.” (ADC to Field Marshal Haig, at tank demonstration, 1916)
  • MOVIES – “Who the hell wants to hear actors talk?” (H. M. Warner, Warner Brothers, 1927)
  • NUCLEAR – “There is not the slightest indication that nuclear energy will ever be obtainable. It would mean that the atom would have to be shattered at will.” (Albert Einstein, 1932)
  • NUCLEAR – “That is the biggest fool thing we have ever done. The bomb will never go off, and I speak as an expert in explosives.” (Admiral William Leahy, when President Truman asked for his opinion on the project to build an atomic bomb)
  • SPACE – “A rocket will never be able to leave the earth’s atmosphere.” (New York Times, 1936)
  • COMPUTERS – “I think there is a world market for about five computers.” (Thomas J. Watson Jr., chairman of IBM, 1943)
  • TELEVISION – “Television won’t last because people will soon get tired of staring at a plywood box every night.” (Darryl Zanuck, Movie Producer, 20th Century Fox, 1946)
  • TELEVISION – “The problem with television is that the people must sit and keep their eyes glued on a screen; The average American family hasn’t time for it.” (New York Times, 1949)
  • SPACE – “Space travel is bunk.” (Sir Harold Spencer Jones, Astronomer Royal of the UK, 1957, two weeks before Sputnik orbited the Earth)
  • COPIERS – “The world potential market for copying machines is 5000 at most.” (IBM to the founders of Xerox as it turned down their proposal, 1959)
  • SPACE – “There is practically no chance communications space satellites will be used to provide better telephone, telegraph, television, or radio service inside the United States.” (T. Craven, FCC Commissioner, 1961)
  • MUSIC – “Guitar music is on the way out.” (Decca Records, declining to record a new group called The Beatles, 1962)
  • COMPUTERS – “There is no reason for any individual to have a computer in their home.” (Kenneth Olson, founder of Digital Equipment Corporation, 1977)
  • COMPUTERS – “So we went to Atari and said, ‘Hey, we’ve got this amazing thing, even built with some of your parts, and what do you think about funding us? Or we’ll give it to you. We just want to do it. Pay our salary, we’ll come work for you.’ And they said, ‘No.’ So then we went to Hewlett-Packard, and they said, ‘Hey, we don’t need you. You haven’t gone through college yet.‘” (Steve Jobs, founder of Apple)
  • COMPUTERS – “640 K [of computer memory] ought to be enough for anybody.” (Bill Gates, founder and CEO of Microsoft, 1981)
  • COMPUTERS – “We see a corporate market of maybe 15,000 PCs a year by 1990.” (DataQuest, 1984)
  • COMPUTERS – “By 1990 75-80 percent of IBM compatible computers will be sold with OS/2.” (Bill Gates, founder and CEO of Microsoft, 1988)
  • COMPUTERS – “I predict that the last mainframe will be unplugged on March 15, 1996.” (Stewart Alsop, InfoWorld columnist, 1991)
  • INTERNET – “I predict the Internet will soon go spectacularly supernova and in 1996 catastrophically collapse.” (Robert Metcalfe, founder of 3Com and inventor of Ethernet, 1995)
  • NEW BUSINESSES – “A cookie store is a bad idea. Besides, market research and focus groups confirm that America wants soft, not chewy, cookies.” (Investor rejection letter to Debby Fields, founder of Mrs. Fields’ Cookies)
  • NEW BUSINESSES – “The concept is interesting and well-informed, but in order to earn better than a ‘C’ the idea must be feasible.” (Yale professor’s comments on a term paper submitted by Fred Smith for an overnight delivery system. Two years later, Smith founded Federal Express.)

 If you have a favorite False Prediction of your own, please  share it in a Reply below.

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