New Metrics for Measuring Health Are Coming

ThomasGoetzA noted authority in the design and communication of healthcare data and information, Thomas Goetz is cofounder of Iodine, a health technology company with a mission to turn medical research data into clear and actionable tools for ordinary people to make better decisions about their health. Goetz, who holds a master’s degree in public health from University of California, Berkeley, is also the former executive editor of WIRED and author of two books: 2010’s The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine, and 2014’s acclaimed The Remedy, recently chosen as a Best Book of the Month by iTunes and Amazon. His 2010 TED talk on visualizing medical data has been viewed more than 400,000 times.

TEDMED: What’s the most remarkable innovation you are seeing in health tech or medicine, and what is driving it?

Goetz: It’s the growing awareness that healthcare and medicine are consumer services, not just industries. We’re becoming aware that there is a consumer, often called the patient, who should be served. The tools of healthcare technology should be designed and optimized for that consumer experience, rather than for the goals of an insurer or provider or hospital. The shift that is happening is a step beyond patient-oriented; it’s consumer-oriented healthcare.

For instance, in every process or service that exists in healthcare we’re starting to ask, “Is that service actually incorporating the feedback of the consumer? Is it serving the consumer well? Is it designed to be the most smooth and least disrupting experience possible for individuals?” These questions have not traditionally been taken into account in healthcare. That’s a promising development, and one we’re trying to drive at Iodine.

What’s driving this innovation is a couple of things. One is that, through the Affordable Care Act and other changes in insurance, the consumer is now exposed to more of the cost of their healthcare. They’re asking, “What am I getting for my money?” Some organizations see that as an opportunity. The patient hasn’t been putting money into the system and now they are in ever greater amounts. That’s kind of the stick.

The other influence is more of the carrot: People are realizing that using the tools of good design and good customer service is a good business strategy in healthcare. There has always been a mantra that healthcare is different, medicine is different. But that’s not true. Healthcare has largely been a negative experience for people. People want to have a positive experience. They want satisfying and rewarding experiences in healthcare, instead of fear, uncertainty, and death.

TEDMED: What’s the most important factor for entrepreneurial success in health tech—and is that different from your own key to success?

Goetz: Traditionally, entrepreneurs have succeeded in healthcare by finding a niche or a need and creating incremental improvements. That’s changing. There is growing awareness that healthcare technology is potentially as vulnerable to the same kind of seismic shifts and exponential growth that has occurred in other industries. Now that wave is coming to healthcare.

That’s very aligned with my own interests and background, which has been charting the impact of technologies in industry. And that is what I’m trying to do now: leverage the exponential forces of data and analytics to turn those into something that benefits healthcare as it has in so many other industries.

TEDMED: For entrepreneurs with needle-moving ideas in global health, what are the keys to finding collaborators and supporters across specialties, industries, and geographies?  

Goetz: A strategy I’d recommend is to attempt to see what has worked in other areas or to find analogies that lay out a platform for success so that you don’t have to make up everything all at once. Adapt and implement a platform that has worked rather than build a whole new process in addition to creating a new market.

That said, it’s also true that a lot of these global health opportunities leverage different technologies, such as leapfrog technologies like the mobile infrastructure. Those can be significant advantages to a global health strategy.

TEDMED: In 2020, you’re asked to give a TEDMED talk about the biggest transformation you helped bring about in your field. What is it?

Goetz: I hope that in 2020 I’ve been part of a driving shift to where people’s real life experiences are captured and considered as valuable as the traditional bodies of evidence and research. I hope that we can define a new way of creating science and a new way of helping people make better decisions based on not just the sterile environment of laboratories, but on what works for real people in the real world.

It is part of what Iodine is working on. We have always thought of the physician, rather than the patient, as the authority who can measure experience. We’re going to start acknowledging that patient-reported data is potentially more accurate and has its own inherent value. The EHR’s reign as a primary document of patient experience will end. It’s going to be recognized as a great representation of the provider experience, but not the definitive document of patient experience.

What’s great about traditional metrics and what is being measured by the EHR is that there is a list of things we measure such as blood pressure and all sorts of levels in the blood. We need to collectively determine what are the new metrics that can be captured and that are valid when coming directly from the patient. Some of those will be the same metrics and some will be brand new metrics.

There could be much better and more pervasive measurements that take into account real people’s real world experiences. That shift is already starting, and in six years my predictive powers say that could be much more widespread. I hope to be a part of it.