At one time, people just used coin and paper cash to pay for goods and services. They managed their money by what was under their mattress or in their sock drawer. Banks came along and helped them safely store their money--turning cash into a number, rather than just a physical item. Checks changed point-of-purchase behavior, and credit card companies like American Express took things even a step further, truly making money just a number to be used and managed. They even gave instant loans (credit) and used points to reward certain behaviors with the card. AMEX has also been a leader in providing tools to help users analyze their spending and make budgets to monitor the movement of their money.
Intuit recognized the tide of people wanting to track their virtual money digitally. They innovated a common financial language so they could simplify the integration of multiple streams of data with Quicken--from your savings, checking and credit cards to investment accounts--for a complete picture of your financial wellness.
Mint.com recognized that there were still ways to make it even easier for all types of people to consistently track their complete financial picture. First, they did not require any physical software. Second, they made it as simple as entering your username and password for all of your various other online accounts, to load your data to Mint.com. Third, they automatically downloaded the data for you, for free (unlike Quicken), keeping it up to date even in times when you might be busy. Fourth, they improved the re-categorization of data, decreasing the re-coding burden on the user. Fifth, they made intelligent budget and planning recommendations based on your financial flows. And, finally, they made their own money off of referral fees for things that actually helped users--such as identifying a lower interest rate credit card.
With health, we are now on the verge of progressing beyond the era of physical cash. Each day, you and I eat, drink, move, sleep, breathe and destress (or at least, you should). You and I are exposed to environmental elements such as the sun, air and water each day. And many also medicate themselves on a regular basis-- be it doctor or self-prescribed.
Have you ever wondered why you have never left your primary care physician's office with a specific plan for what to eat, what to drink, how to move, how to sleep? CDC says that 70% of disease is preventable, so, you'd think your doctor would give you your unique and specific plan on how to do that. However, we all take these things for granted, as things we picked up in the womb, at birth or during childhood. Further, there is no ledger book for your health behaviors, to help you or your doctor make a plan. It is difficult to assess the short-term cause and effect of your lifestyle behaviors on your headaches, mood or heartburn, if you can't accurately understand the holistic picture of your lifestyle flows. It's difficult to prevent obesity, cancer or heart disease, if you're only partially aware of these complex multiple streams of inputs and outputs on your body.
We are in the early days of non-invasive digital lifestyle tracking, but the innovations are exciting. The arena of physical activity tracking-- from Nike/iPod to HopeLab, FitBit and Phillips accelerometers, it is clear that consumers are excited to explore their Movement data stream. Labs and Personal Health Records are also making it easier to track our 'outcomes' data, such as your cholesterol. Their are gaps in technology for tracking the Eating data stream, but numerous exciting products are on the horizon for that and all of the other critical lifestyle inputs and outputs. But, with all those credit cards and checking accounts and investment funds, people will need a Mint.com to track their health.
At first blush, people wonder if tracking all of this information is a good thing. At first, people asked a number of questions about Quicken and Mint.com (now both part of the Intuit family) as well. Will it be private and secure? Will it make me feel more guilty about my spending, more stressed and less carefree? Will it force me to be even more plugged-in and less focused on the world around me? Will they make me reliant on them and then charge me large fees?
People have had centuries to acclimate to the concept of tracking their wealth closely, but tracking every aspect health and lifestyle may still feel a bit more personal to people. As such, the same concerns people initially had about Mint.com are even more magnified in this arena, when moving beyond the small percentage of superusers-- such as fitness buffs or people in executive health programs.
Nonetheless, Intuit and Mint.com's experience can be instructive to the Health 2.0 communities innovating both the tracking tools and the platforms aggregating the data:
1) Privacy and security needs to be an early focus of any initiative to track and aggregate health streams. Rare stories of data leaks, 'identity theft' in the money world, will occur; if you're building a health tracking or data aggregator, just do everything you can to make sure the leaks didn't occur on your platform. Plus, HIPAA laws mandate some basic requirements you should be following from the start; ARRA, GINA and health reform legislation only strengthens those requirements.
2) The 'guilt' of tracking is a real cultural concern that requires creativity to address. The last thing we want is a society of people so glued to their contraptions and specific personalized plans that they lose their spontaneity, or capacity to use their own body to sense its own needs. It is critical for tracking, aggregator and recommendation/ planning tools to be adaptive, flexible and supplemental to our inherent senses.
3) Business models should never disincentivize early use of health tracking or aggregator tools. That would obviously defeat the social and business purpose of such tools. Health 2.0 entrepreneurs are taking cues from Google and Mint.com, to find ways to serve the needs paying customers who ultimately foot the bill for users that enjoy the services. For Google, it was advertisers. For Mint.com, is was financial institutions that paid referral fees when people switched to a more suitable financial product. Sometimes, advertising or referrals is not enough. Eventually, consumer apps, like Pandora or Hulu, are forced with questions about whether to charge for premium services. If the product is good enough and provides a value to people they can see, there will be a set of users that will pay for more features--as long as companies don't get overly eager and charge too much.
When it comes to your finances, knowing is half the battle. The same is true for your health, and it will be an exciting decade of reflection and insight into the way we truly live our own lives.
Thursday, December 17, 2009
Wednesday, December 16, 2009
New Moves: Culture of Wellness
Only 100 years ago, cars were rare, and people walked to and fro.
Only 75 years ago, the majority of the population were farmers, in the military, construction workers, homemakers and other laborers who were physical active throughout the day.
Only 50 years ago, more people played sports than watched them; more people went out dancing than watched Dancing with the Stars. And, less than 5% of kids were obese.
Only 25 years ago, most children had physical education and recess every day, along with life skills, home economics and health class. And today, thanks to truly impressive and enjoyable innovations from automobiles to TV to video games to manufacturing robots to professional sports and reality TV, we sit at a desk, drive, and we watch TV, for far more hours than we walk, play sports, or dance. So, we enjoy ourselves, but know that something is missing, and not quite right. And, we can barely defend ourselves: 75% of 17-24 year olds are ineligible for military service, according to the Washington Post. How do we continue to enjoy TV, automated labor, intellectual work and mechanical transport, while reinserting the movement our bodies and minds need back into our life?
What if you had a treadmill in your office? Would you walk and type? What if everyone had a treadmill in your office?
What if there were after work sports at your office. Would you play?
What if there were bars you could go to where instead of just eating, drinking and talking, or getting shy about getting on a dance floor, you could play night basketball, volleyball or flag football with music playing overhead?
If your kids wanted you to play outside with them, would you? Is it too cold? Is it too hot? Is it unsafe? Is the park too far away? Does your yard have killer groundhogs that keep you inside?
If you could take a job near your house, work from home, and move closer to work would you? Or, is the extra $20,000 in salary worth the extra $10,000 you pay in gas, car wear and tear and meals on the go, and the unquantifiable cost of your lost years of life or time with your friends in family you paid for your commute?
What if swing dancing made its second comeback? Would you do it (too shy?)? Or, do you have your own New Moves you want to show off? Go for it. We're not giving up all the gadgets that have made modern life easier and, at times, a lot of fun. But, your body has evolved to move, and needs to. In the the words of Reel 2 Real, I like to move it move it, You like to move it, so, move it.
Only 75 years ago, the majority of the population were farmers, in the military, construction workers, homemakers and other laborers who were physical active throughout the day.
Only 50 years ago, more people played sports than watched them; more people went out dancing than watched Dancing with the Stars. And, less than 5% of kids were obese.
Only 25 years ago, most children had physical education and recess every day, along with life skills, home economics and health class. And today, thanks to truly impressive and enjoyable innovations from automobiles to TV to video games to manufacturing robots to professional sports and reality TV, we sit at a desk, drive, and we watch TV, for far more hours than we walk, play sports, or dance. So, we enjoy ourselves, but know that something is missing, and not quite right. And, we can barely defend ourselves: 75% of 17-24 year olds are ineligible for military service, according to the Washington Post. How do we continue to enjoy TV, automated labor, intellectual work and mechanical transport, while reinserting the movement our bodies and minds need back into our life?
What if you had a treadmill in your office? Would you walk and type? What if everyone had a treadmill in your office?
What if there were after work sports at your office. Would you play?
What if there were bars you could go to where instead of just eating, drinking and talking, or getting shy about getting on a dance floor, you could play night basketball, volleyball or flag football with music playing overhead?
If your kids wanted you to play outside with them, would you? Is it too cold? Is it too hot? Is it unsafe? Is the park too far away? Does your yard have killer groundhogs that keep you inside?
If you could take a job near your house, work from home, and move closer to work would you? Or, is the extra $20,000 in salary worth the extra $10,000 you pay in gas, car wear and tear and meals on the go, and the unquantifiable cost of your lost years of life or time with your friends in family you paid for your commute?
What if swing dancing made its second comeback? Would you do it (too shy?)? Or, do you have your own New Moves you want to show off? Go for it. We're not giving up all the gadgets that have made modern life easier and, at times, a lot of fun. But, your body has evolved to move, and needs to. In the the words of Reel 2 Real, I like to move it move it, You like to move it, so, move it.
Life apps, not Health apps
A narrow band of people have traditionally invested time and money in their own health--before they get sick. A study done some time ago by Kaiser Permanente showed that nearly 25% of people are "Fix it" types. They believe that medicine can cure them, if and when they get sick. The bulk of people are Proactive in wanting to engage with the health system, in terms of knowing their doctor, but do only a fraction of what they could to live well. Only about 5% sought truly personalized wellness planning; typically, these were the type of people that could afford, and used, executive/ boutique care, personal training and made regular trips to Whole Foods. People developing "Health and Wellness" apps have often wondered why their tools have never taken off in the same way that search engines did... You have to eat, move, sleep, breathe, and destress every day, after all, and some have to medicate as well.
Understanding this challenge, newer Health 2.0 oriented social entrepreneurs are focusing their efforts more on daily life, rather than "health" or "wellness" or "disease." McDonald's understood a long time ago that consumers come to their stores for Taste, Convenience and Price--they used it to feed millions and build a fast food empire, while ignoring the health ramifications. Newer Life Apps and Life-oriented social enterprises will help people marry their daily preferences, social life and moods (tastes), their schedule and location (convenience), and their budget (price) with actions consistent with a healthy way of life. Finding the win-wins is primarily about recognizing the right information at the right time.
Understanding this challenge, newer Health 2.0 oriented social entrepreneurs are focusing their efforts more on daily life, rather than "health" or "wellness" or "disease." McDonald's understood a long time ago that consumers come to their stores for Taste, Convenience and Price--they used it to feed millions and build a fast food empire, while ignoring the health ramifications. Newer Life Apps and Life-oriented social enterprises will help people marry their daily preferences, social life and moods (tastes), their schedule and location (convenience), and their budget (price) with actions consistent with a healthy way of life. Finding the win-wins is primarily about recognizing the right information at the right time.
New Blood: Thankfulness Amidst Challenges to Ideal US Health Reform
It seems that most people are unhappy about the current status of the health reform. Concerns are growing that the Senate bill will stimulate a large increase in premiums for everyone, while still leaving holes by which insurance companies can drop coverage on certain patients.
In total, for all the wrangling and political capital spent, it seems that an opportunity may be missed to introduce some uniformity into our fragmented system. It's estimated that over ten million people will still remain uninsured even after the reform, and navigating the complex health care system will be little easier than it is now for most Americans. While the country decided that construction and maintenance of the most advanced highway system in the world should not be the individual responsibility of you and I (in large part because the highway system was necessary for military functions), it seems we are still deeply split on whose responsibility preventing, or treating sickness, should be. Ultimately, you'll still have to fend for yourself, if you want to keep yourself as healthy as you can be, or get the best possible care when you need it.
Stepping back for a moment, however, I want to share this anecdote. Earlier this week, I was speaking with a friend in Bucharest, Romania. Romania is not the country we all think of from the days of the Iron Curtain, but rather a rapidly developing member of the European Union where, in Bucharest, it can be as much to rent an apt as in NYC these days. A relative of his wife had an aneurysm which ruptured. Without a basic blood transfusion, he would have died. In order to save him, my friend had to round up people from his office to come to the hospital and donate blood on the spot, till the hospital could find a match.
In our country, no matter how difficult the medical billing, no matter the challenges you have with scheduling, when you need a blood transfusion, you will almost always get one. Like the highways, the collective of our country decided there should be a national system Blood Banking system, led by organizations like the American Red Cross, who work hand-in-hand with government at multiple levels.
No one is going to be entirely happy with America's Affordable Health Choices Act. In a country and states that cannot even replicate the construction and operation of high speed rails you can find in Asia or Europe, how could anyone expect that this bill could be anything more than a compromise, that is iterated over time? The pros of a compromise are that it's less likely to create severe damage compared to a more decisive experimental approach; the cons-- it has no hope of fixing ALL the problems on its own.
Like the Red Cross did for Blood Banking in tandem with government, citizens, social entrepreneurs and larger organizations will need to continue to innovate new systems to improve the Delivery of health care, and Prevention, which move beyond the walls of hospitals and clinics, back into the community and the home. Regardless of the flaws that will inevitably remain in this health insurance reform bill, it will still create some basic improvements rooted in justice and equity:
--Difficult to exclude coverage for people based on pre-existing illnesses, which are sometimes uncontrollable-- i.e. fully or partially genetically based.
--Shifting of resources to, and reimbursement of prevention and wellness, meant to keep the population at large healthy, and reduce long-term care spend.
When considering how disappointed you might feel about the health reform legislation to date, ask yourself if these are two wins you agree with, and can get behind. Ask yourself if you appreciate the fact that if you or your child bleeds out, another person has already put his/ her blood on loaner for you at a hospital nearby. Then, rather than voicing a complaint devoid of a helpful alternative suggestion, hunker down and keep working on systems and policy innovations to create a delivery system for health and wellness that will obviate the need to keep supporting the reactive care system we have in place today. One beautiful thing among all the ugly things about our legislative system, is that you can keep introducing New Blood into the legislation, to improve upon the gaps and mistakes of the past.
In total, for all the wrangling and political capital spent, it seems that an opportunity may be missed to introduce some uniformity into our fragmented system. It's estimated that over ten million people will still remain uninsured even after the reform, and navigating the complex health care system will be little easier than it is now for most Americans. While the country decided that construction and maintenance of the most advanced highway system in the world should not be the individual responsibility of you and I (in large part because the highway system was necessary for military functions), it seems we are still deeply split on whose responsibility preventing, or treating sickness, should be. Ultimately, you'll still have to fend for yourself, if you want to keep yourself as healthy as you can be, or get the best possible care when you need it.
Stepping back for a moment, however, I want to share this anecdote. Earlier this week, I was speaking with a friend in Bucharest, Romania. Romania is not the country we all think of from the days of the Iron Curtain, but rather a rapidly developing member of the European Union where, in Bucharest, it can be as much to rent an apt as in NYC these days. A relative of his wife had an aneurysm which ruptured. Without a basic blood transfusion, he would have died. In order to save him, my friend had to round up people from his office to come to the hospital and donate blood on the spot, till the hospital could find a match.
In our country, no matter how difficult the medical billing, no matter the challenges you have with scheduling, when you need a blood transfusion, you will almost always get one. Like the highways, the collective of our country decided there should be a national system Blood Banking system, led by organizations like the American Red Cross, who work hand-in-hand with government at multiple levels.
No one is going to be entirely happy with America's Affordable Health Choices Act. In a country and states that cannot even replicate the construction and operation of high speed rails you can find in Asia or Europe, how could anyone expect that this bill could be anything more than a compromise, that is iterated over time? The pros of a compromise are that it's less likely to create severe damage compared to a more decisive experimental approach; the cons-- it has no hope of fixing ALL the problems on its own.
Like the Red Cross did for Blood Banking in tandem with government, citizens, social entrepreneurs and larger organizations will need to continue to innovate new systems to improve the Delivery of health care, and Prevention, which move beyond the walls of hospitals and clinics, back into the community and the home. Regardless of the flaws that will inevitably remain in this health insurance reform bill, it will still create some basic improvements rooted in justice and equity:
--Difficult to exclude coverage for people based on pre-existing illnesses, which are sometimes uncontrollable-- i.e. fully or partially genetically based.
--Shifting of resources to, and reimbursement of prevention and wellness, meant to keep the population at large healthy, and reduce long-term care spend.
When considering how disappointed you might feel about the health reform legislation to date, ask yourself if these are two wins you agree with, and can get behind. Ask yourself if you appreciate the fact that if you or your child bleeds out, another person has already put his/ her blood on loaner for you at a hospital nearby. Then, rather than voicing a complaint devoid of a helpful alternative suggestion, hunker down and keep working on systems and policy innovations to create a delivery system for health and wellness that will obviate the need to keep supporting the reactive care system we have in place today. One beautiful thing among all the ugly things about our legislative system, is that you can keep introducing New Blood into the legislation, to improve upon the gaps and mistakes of the past.
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