CES 2020: The driving forces behind Total Health Ownership

The Consumer Electronics Show is like no other technology conference I’ve attended. It covers 2.9 million square feet, sprawled across three well-known hotel conference facilities; bustling with exhibitor excitement and attendee energy. Highlights included a focus on digital health innovations, and a surprise visit from Apple — who haven’t visited CES for the last 28 years. They’re normally focused on those fixed release cycles and hosting the world-wide developer conference. Amazon and Facebook joined the party, too, so that the big three could come together to discuss the hot topic of data and privacy. A timely conversation given the opening keynote involving personal care and a new era of health.
This was the 53rd CES and it specifically featured digital health technologies and experiences aimed at enabling breakthroughs in healthcare transformation.
A new age of personal care—the Samsung Keynote

Samsung CEO H.S. Kim, during his keynote regarding the next decade of human-centric innovation, announced a new era of health with his vision of “personalized care, enhancing the well-being of consumers by satisfying their individual needs”. A vision largely centred around a ball-shaped robot: Ballie /baall-éy/. A clever ball that follows you around your house. I’m not entirely sure how Ballie would cope with the stairs in my house, but anyway, a nice moonshot none the less.
Personal goals for CES 2020
My personal goal was to research a handful of topics relating to digital health so that we might be able to understand and imagine what’s coming around the corner. Get a feel for the opportunities, or challenges, in delivering genuine healthcare transformation.
Total health ownership as a macro theme
Cast your mind back through the past decade, and recall some of the buzzwords and popular phrases; quantified self, IoT, the informed patient, payment by results, social prescribing, outcomes-based health, preventative medicine, or perhaps more recently whole total treatment effect? Most of these terms are used by industry — not by the consumer or patient. And CES is trade-only event: the general public are not able to attend. So, a nice surprise last week was the level of patient representation by industry. Not so much the ‘we’ve done some design research, testing, iteration’ kind of patient centricity. Instead what I saw was a wider-reaching sense of industry recognising that patients want to take control. As a result, the attitudes within digital technology companies are changing.
Total health ownership: the emerging theme that industries have recognised the growing number of patients who are demanding information, so that patients themselves can take preventative action.
Think of it as the ‘informed patient’ from the last decade. But with less of the casual googling of symptoms promptly followed by wild relief (or mild panic). More along the lines of intuitive, timely, and relevant presentation of health data in a way that enables patients to have better health conversations with their physician. There are similar early-stage ventures from the past couple of years that focus on person-held records, in the UK. The difference is this: technology is so much more prevalent now, as an enabler, and we’ve seen this past week what’s becoming available direct to consumer, rather than dependent on a specific diagnosis or prescription.
Three related themes
- Inclusion is a burgeoning force for change
For at least 2 decades now, pockets of the tech community and the design industry as a whole have been leveraging inclusivity and empathy as part of the product and service design process. It’s been part of methodologies that have helped create experiences we never knew we needed or wanted. But this year there was a different flavour of inclusion: a sense that corporations actually care beyond the product or service, technology, or experience. They care about their people and their achievements as a team — and they’re proud to talk openly about their ways of working. I’ve never been to a tech conference where so much time was spent reflecting on inclusion, empathy, and design — as an everyday business function that has an outward social impact. Interestingly there’s a recently published 7-minute read from IDEO on ‘Social Innovation’ and the significance of values-aligned companies.
2. Data collection alone is not enough
The 2010’s were all about personalisation, dynamic content and a sprinkling of privacy. Remember that wonderful month of May 2018? with all those opt-out emails courtesy of GDPR coming into effect. When it comes to health data, we’ve turned a corner: data collection no longer holds a high trade value with payors or big pharma. Data is only of value when relevant insights are served to the patient — so they can be put to good use during their conversations in a clinical setting. This was the topic of two simultaneous panel discussions (see below) on Thursday 9th.
3. Seamless reimbursement is just around the corner
Reimbursement as part of whole-service integration: digital experiences, patient-oriented services, coupled with bleeding-edge technology and a clear through-line to reimbursement. All without going near those old crusty old legacy EHR systems (except for the EHR startups doing their best to displace the old guard). Consumer choice, and in some cases the demand for data and transparency regarding privacy, is impacting the way health systems consider reimbursement design. Maybe not that much of a disruption? …except when you consider the impact this could have on state-owned health systems outside the U.S.
Before we go any further…
At this point you might be thinking that total health ownership through inclusion, empathy, effective use of data, and the advent of new reimbursement models are hardly revolutionary. That’s okay…

Events like CES are as much about personal reflection as they are about the press headlines. It’s about pushing debate and discussing what’s new and relevant, versus what’s not. Curiosity, and a bit of solitary research is good for the soul.
CES 2020 is about getting excited for today, so you can begin to imagine tomorrow.
What follows next is more detail regarding three related themes. You can also read my 7 tips if you’re planning to visit CES for the first time. And if you’re interested, you can pre-register for 2021 now via the official CES website.
1. Inclusion is a burgeoning force for change

A chance to recognise the importance of diversity and inclusion through immersive experiences on board a tour bus called ‘Check your Blindspots’. It’s part of the CEO Action for Diversity and Inclusion founded by Tim Ryan, the chairman and CEO of PwC.
The largest CEO-driven business commitment to advance diversity and inclusion.
Once you’re in the mental mode of putting others before yourself, you hop on the tour bus and you’re asked to observe and react to a bunch of scenes that contain discrete examples of confirmation bias. I missed about half of the trigger points. Then, there’s a quick exercise on assessing the diversity of the people in your own life. Until this day I hadn’t realised the demographic biases I’m subjected to. This wasn’t complex to understand; it’s just something I rarely think about. The day-to-day assumptions and decisions we make, casual or other, are the product of gut feel and instinct, which in and of themselves are the result of the time we’ve spent at home, with friends, at work and other social circles. The cold, factual analysis presented at the end of the questionnaire made me realise that I need to make a conscious effort to consider the perspectives of others.




At the end of the tour participants are asked to make their pledge. You can do this anonymously in paper format (above right) or you can do this digitally by recording a video that goes straight to the leadership team of the Action group. The third option was to scribe your pledge on one of two huge glossy boards outside the bus, with a multitude of pen colours to choose from. It was refreshing to take a moment to pause and reflect, rather than just consume the latest and greatest intel.
This notion of reflection, empathy, and inclusion has permeated throughout the consumer electronics industry to the point where it feels like it’s becoming a cultural norm.
We need inclusivity to be part of the very fabric of companies— not just hygiene exercise — to enable people to fulfil their dreams and use technology and design to fuel innovative breakthroughs. If we’re serious about setting the right conditions for innovation, then teams need to take a moment to think about confirmation bias, and diversity including skill mix. We need to continue to immerse ourselves in experiences that help us all to think different.
2. Data collection alone is not enough

Consumer guidance on wearable technology
The Consumer Technology Association (CTA)® and the Heart Rhythm Society (HRS) have developed digital health technology guidance document for consumers, highlighting wearables that detect and monitor cardiovascular biometrics including hypertension as well as other conditions related to general health and wellbeing.
Panel chair was Christina Wurster (Heart Rhythm Society), and included Heidi Dohse (Tour de Heart), Tony Faranesh (Fitbit), Jim Li (Omron Healthcare), Nassir Marrouche (Toulane University School of Medicine).
People are no longer amazed by the ability to collect data, what’s changing is the availability of immediate personalised insights that drive action as a result
What types of data do consumers value? and why are we becoming more ‘okay’ with companies collecting health data? how does this encourage informed 2-way dialogue with physicians? Would patients want to avoid contact with the doctor if given the choice?
How do we manage ongoing device consent? when upgrades are deemed as minimal — just as announced today — Fitbit ‘quietly’ enabled blood oxygen tracking on some of its wearables, to help detect breathing issues. This was a soft launch under the existing T&Cs (and only picked up by the press when some users started to report changes in the device behaviour on social forums).
How about personalised nutrition based on your DNA thanks to a wearable? DnaNudge demonstrated last week that it’s a “quick and simple one-time-use cheek swab” which is then inserted into a DnaCartridge and placed into a ‘NudgeBox’.

DNA is extracted and specific SNP’s (a ‘snip’ is a single ‘letter’ out of the 3 billion in your DNA code), relating to nutrition-related health conditions are analysed. Fingers crossed the security protocols are as tight as the value proposition.
It’s not a diet, you still decide what to eat. DnaNudge uses your own DNA to nudge you towards healthier choices each time you shop. These every day small swaps can lead to big positive changes to your health over the long term.
For some people we might think this is a step too far in data sharing, one estimate suggests that in 2019 roughly 26 million people have taken home ancestry kits, and that’s set to reach 100 million by the end of this year.
Technology for better outcomes
Whilst technology has the potential to change health systems, demonstrating higher value healthcare needs to be centred around user encouragement — specifically around what patients want to see within their data, and the action needed as a result.
People are willing to give data permissions more extensively when they can see the value it delivers
Panel chair: Alan Lotvin (CVS Health), joined by Amy Foley (J&J), Nicola Kamath (Ginger), Vivian Lee (Verily), Jennifer Schneider (Lovingo).
Addressing chronic conditions, co-morbidities, and the nuances of thousands of cultural variances needs (no surprise) an iterative product development process. Truly relevant experiences can only be shaped over time. And we need data to create insights, human synthesis to create themes, and the creation of new features for further testing. Then, more data and analytics showing usage and uptake. Kind of what google have been doing with web search for the last 20 years, only now we’re talking about evolving healthcare strategies based on (mostly consented) patient behaviours.
76% of people have interacted with our health coaches outside of office hours, so we tailor experiences and serve insights based on these behaviours
In developed countries collecting data is just part and parcel of checking that tick box regarding the T&Cs that you never took the time to read. The tech industry is embracing transparency — thanks in small part to numerous headline mishaps — because the patient demand for total health ownership has hit tipping point.
Vivian Lee (Verily) noted the single biggest threat to the sustainable care models is healthy ageing and patients living with frailty. Food for thought. We’re all heading that way, so it’s time we take care of ourselves and get the data we need to remain stronger… for longer.
Incidentally, in other news, Verily continues along its aggressive partnership strategy, this time with Colour, the genetic testing company.


One-step closer to combining population health with Polygenic scores and mass-consumer digital behaviours. Maybe next year, up on stage, we might see mainstream ‘sequencing as a therapy’.
3. The future of reimbursement

A watch that’s actually pretty smart…?
Omron, an established robotics and health devices manufacturer, were demonstrating an autonomous robot capable of beating semi-pro ping-pong players. At the back of this exhibition I stumbled upon another Omron creation: the HeartGuide. It’s a smart watch that measures blood pressure. This is the first ever watch capable of such measurement.

A fully functional blood pressure monitor on your wrist. The first closed-loop service capable of reactive nudges and offering patient advice.
It’s also the first service to directly reimburse the patient: instant rewards based on daily health habits.
Think about that for a second. A class II medical device, the first ever wrist-worn blood pressure monitor, helping the everyday consumer understand fluctuations in their blood pressure, and paying cash monies for good behaviour.

Measuring blood pressure is the only clinically approved method for monitoring people living with hypertension: over 100 million people in the U.S. (roughly 1 in 3) and the available WHO data shows a higher ratio across Europe and Africa. Not to mention Asia and rest of world.

The preventative care opportunity for this is massive. And what about reducing the need to (physically) visit a physician? Imagine having daily conversations on the impact of the choices you’re making, and actually understanding how to act on your own personal health data. These scenarios are now here: if you can afford the retail price of $499. Basic features include a smart step count that delineates between aerobic and anaerobic steps, and detailed sleep quality reports.
There’s a premium version of the digital service, too. For £$4.9/mo you get a connected tablet dispenser that notes each time you take a medicine. Plus, a real human in the loop coach who can nudge patients to simple multiple-choice questions about lifestyle and diet, to enrich the clinical data set with lifestyle variables.
Combining patient activity, with daily adherence reports, systolic and diastolic measures, sleep quality, and what you ate the evening before, you can begin to imagine very real and organic patient activation.
This is a genuine step towards preventative medicine in the hands of the everyday consumer. Pretty soon I can see fit and healthy people starting to wear wrist-monitors, as it offers more accurate health insight compared to the current activity apps and smartwatches. In the panel discussion (above), doctors are pushing the blood pressure measure accountability upstream by encouraging patients who are sufficiently privileged to own such a device, to monitor themselves.
Last year Omron committed to a soft launch at CES 2019 after exhibiting the alpha release (watch only). They have since rolled out the digital service over these past 12 months. And this year they took the Health and Wellness award for Omron Complete.
A clever release strategy: alpha release (hardware only) in year 1, collect and use data to design digital experiences, launch said digital experiences a year later.
The combination of hardware, algos, coaching and rewards, and direct-to-patient reimbursement has finally hit the mass consumer market. Pharma and Life Sciences corporations better get in line...
Omron were founded in 1933 and specialise in robotic automation and medical devices. They have a mar-cap of ~$12.6bn at the time of writing.
Outlook
This year we had the much-hyped keynote (6-min video covering all the “new age of personal care” reveals), the eagerly anticipated demos of MicroLED and quantum television, and suggestions that robots should be delivering canapés at the next summer office party.
My advice: take it all with a pinch of salt. Get excited about what’s relevant to you. A lot of it is about the vibe and the enthusiasm; the energy people give when they’re pitching something they’re passionate about. It’s unmistakable.
There’s the networking to be done and the deals to be made after a few courtesy drinks in the casino. But most of all these events are about being excited for the year ahead — in ways that are difficult to achieve via browsing the web, reading a book or attending a meet-up during the dull winter months of London.
Thanks to CES we can start the year full of ideas and inspiration!
For now, though, it’s back to business. We turn our attention to all those unmet needs out there, and figure how technology can be leveraged as an enabler for genuine healthcare transformation.
