richard schwartz
Nov 28, 2018 · 9 min read

The Connections Economy

In healthcare engagement today, whether you look at the world through the lens of a world-class health system, a life sciences leader, a large and integrated communications network, a well-oiled and deeply entrenched consultancy, or a scrappy group of tech innovators — one thing is abundantly clear — you probably can’t do the very best work for the patient all on your own.

We’ve entered a connections economy in business and solution development in health. Maybe I am too optimistic that we are moving more toward all holding hands and pulling our specific levers to optimize outcomes efficiently. Maybe I am not. Either way, change is coming too fast, behaviors are adapting in the wild, and providence requires us to connect with a purpose in order to optimize for future eventualities and accelerate present possibilities.

Increasingly, companies are recognizing that the best responses they get are from entities and individuals skilled in connecting — the expected — and the unexpected. The organizations that raid their intellectual pantry for new ways to mix ingredients and make something surprising and brilliant are edging out those working from recipes that satisfied the pallets of yesterday. Collaborative-minded organizations who have learned to operate with external entities toward a mutual goal are seeing dividends in the connections economy. They are also attracting the best talent by creating exceptional teams in the aggregated spaces of partnerships. Showing up with a partnered strategy is more than bringing a cool guest to the table. It is a gene-deep cultural behavior and requires getting communal in order to merge approaches and skills for the development, creation, and delivery of 1+1=3 solutions.

Don’t just look for partnerships woven into responses, require them. The sun has passed mid-day on the notion of a one-stop-shop addressing your business needs in the very best ways.

Granted, RFPs you are crafting at this time of year are off the typical planning cycle. That’s okay, off-cycle requests often carry a different sort of urgency and opportunity. The precise RFPs and RFIs you should be writing will certainly be more specific and focused on better connections between your business and your customers. But the notions below can be applied to your situation as proof points you are getting the best responses from partners cultivating skills and resources on your behalf. For recipients of requests, think of these notions as sort of a pReFP and the opportunity to craft solutions for the requests you are about to receive.

1. Quadruple Aim Focused Experiences Created at the Collision of Behavioral Science and Data Science

The era of blockbuster medicines lent itself well to expensive and effective weaponry — more reps, more media, more meetings. The margins justified the return, the bigness was intoxicating, the attribution admittedly wonky, the ignorance sometimes blissful. That era is gone. While remnants of it remain, they are echoes from the past still bouncing around in pitches and proposals. Healthcare is now demanding clear outcomes in the design, execution, evolution, and results.

We must still place well-trained people in the field to engage a broader range of influencers and customers, and our patient directed communications will not go away. In both cases, however, we’ve too much history, and access to predictive and present behaviors to not become obsessed with experience design that is measured as effective and worthy when it directly impacts Quadruple Aim (reduced cost, improved outcomes, better patient experiences, and practitioner experiences). Benchmarking against the Quadruple Aim means we are not simply selling we are clearly focused to the right side of the equal sign as arbiters of reality, relevance, and results. Outcomes, efficiencies, and experiences are the new black.

Behavioral and data science-based solutions will create checks and balances within the experiences you build — ensuring we are not building upon one of the Aim aspects at the sacrifice of the others. This is not an increased focus on operational metrics and data gathered from branded digital assets, so we can ‘target’ better. Think about it in terms of the recent quote from #ICDPPC2018 — “If personal data is to online advertising sector what oil is to the energy sector, then we’re experiencing our own version of the climate change crisis.” You see, changing human behaviors in the positive, requires deeper and richer data sets more eloquently utilized to move you from simply driving more sales to demonstrating meaningful solves.

If you think these points are not relevant for 2019, take a look at healthcare, biotech, and consumer through the lens of the World Economic Forums September 2018 Future of Jobs Report. The number of rising and net-new critical roles in data science and human-machine experience designers is a resounding bellwether. This is also a great report to read if you are shaping the roles you may be hiring for next year or have any worries about getting better and better at what matters less and less.

For us marketing stalwarts — fear not, we are part of the new order, but that order demands we build new mental musculature in human behavior and health data. realities

2. Adapting Asimov: The Four Laws of Health Data

The runway is growing shorter and shorter on the overt and subtle misappropriation of our personal data, especially in health. Consumers will increasingly demand that your utilization of their data come with some clear, direct, and valuable benefit to them. IBM Watson came out of the gates in a 2015 blog post highlighting the notion of creating radical customer centricity via data-informed engagements. The focus was that in our data-driven world — use of our data must benefit the customer by being REAL — “Reciprocal, Empathetic, Authentic and Long lasting”. Three years down the road, IBM has now strategically partnered with is built on blockchain and enables individuals to “join a global movement to claim their 31st Human Right, the right to claim your personal data as your property and have a seat at the table when your personal data is used by corporations, and other 3rd parties”. Hu-manity’s “highly secure repository of personal data consent, controlled by consumers themselves,” is a notion whose time has come and none too soon.

I liken the shifts in data use and ownership today to Isaac Asimov’s 1942 Laws of Robotics — replacing ‘robot’ with ‘data’ and tweaked slightly to address health:

· Health Data must be wholly owned by and utilized to prevent, predict, illness and harm, and manage optimal wellness in the individual creator.

· Utilization of an individual’s health data by third parties for research, development, business interests, and population benefits must be done with permission, transparency, and compensation.

· Health Data may not be used to injure a human being physically, financially, or socially or — through inaction, allow a human being to come to harm.

· Health Data utilization and algorithms must obey orders given by human beings except where such orders would conflict with the First, Second or Third Law.

Every company responding to your needs should be bringing forth data-driven solutions to inform and optimize. If they are not, look elsewhere. If they are, make sure the customer their empowerment and subsequent benefit sits in the very center — and not you. The liberation and democratization of our health data will move us from the all-appeasing and false narratives of patient centricity to patient-mediated health engagement.

3. Patient-Mediated and Symphonic Engagements

Truly human-centered design must make meaningful use of behaviors and data and a great opportunity is the growth of digital health solutions to monitor patients both actively, passively, locally, and at a distance. We leave terabytes of beautiful and valuable digital exhaust and most of it ends up wasted. I am not talking about just wearables or smartphones, but all the digital DNA we slough off just living life in our connected world.

2018 brought us an explosion of genotypical assessments. 23andMe nearly tripled its valuation in 3 years to north of $2.5B today, Roche spent $4.3 billion this year buying out two specialists in cancer data, (Foundation Medicine and Flatiron Health), and Global Market Insights pegs the genotype assay market at $22B by 2024. We are also seeing 23andMe, Genomind, and others, leveraging our genetic data to predict the effectiveness of therapies. Greater clarity of our genotypical predispositions is important, but it alone is not enough. We must be clear that Genotype is largely what we are born with but Phenotype is predominantly what we die from.

Data analysis of digital behaviors generated through passive, active, owned, and ambient sensors and devices viewed through diverse disciplines can culminate in deeply meaningful interventions and patient-mediated experiences. The presence of sensors in or environments is not slowing down and 5G and Edge Computing will usher in new opportunities to capture and process health data and create in-the-moment experiences. 5G ubiquity means we will likely see telemedicine, care at a distance and yes, even AR come out of the Trough of Disillusionment in 2019.

A rising star in using digital data to map the relationships between everyday behaviors and health outcomes is Evidation. They are looking through the lenses of signal processing, epidemiology, time series analysis, biostatistics, psychometrics and, naturally, machine learning to help predict and manage health challenges. Evidation is proving that a simple question like “can our conversations over digital predict early warning signs of Alzheimer’s” is not future fiction, rather, it is a present possibility.

A 2012 paper ahead of its time, Automated Hovering in Health Care — Watching Over the 5000 Hours, highlighted the importance of understanding and leveraging what people do in the wild, more than gauging their health experiences on the reactive moments when they show up for care. This is increasingly relevant as 10,000 people turn 65 each day in the US and we face a shortage of professionals to care for them. Companies like CarePredict and Cognetivity are looking at the real needs of seniors and their families to detect illness, provide care, and provide the essential human touch that many older and elderly people lack.

In 2018, the hesitations around voice solutions started to melt away; in 2019, conversational content and connectivity need to be part of your asks. The installed base of smart-speakers is just part of the equation, the ascendancy of hearables will not be confined to smart speakers. If search is a signal, then the fact that 12% of all searches (500 million a day), are both mobile and spoken likely means that screenless is suddenly a thing. Your asks and answers can’t look at content as confined to a page or a picture going into 2019. The nuance in a voice-based query versus a text-based one will require you to be more artful in your responses. Voice may enable a richer opportunity for empathy and be part of the chain of events that link mediums — opening experiential engagement opportunities in times when we are not (or should not be) emerged in screens. Radio didn’t die, it moved, changed its name and became more responsive.

We Entered the Long Run: Healthcare Engagement in the Connections Economy

As we ask and answer requests for solutions that create personalized, patient-mediated, outcomes-based experiences, we do so knowing the gravitational pull of the familiar will be strong. People have been burned by leaping to new ideas too soon and by sneaking in the back door too late. Somewhere between fast-followers and those addicted to shiny things are the leaders and real innovators. These are people that know their best ideas age in reverse. They pivot, evolve, directly involve customers and they simplify.

In perspective, we put people on the moon before we put wheels on a suitcase. In our efforts to reduce barriers and burdens in health it isn’t always about going to the moon —sometimes it is about just going around the corner.

The late Roy Amara, a researcher, and scientist summed up the effects of technology in what has become known as Amara’s Law, “We tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run.” The notions above are not derived from the prognostications of a futurist, these are real and present opportunities to challenge yourself, your partners, and the collaborators they bring along to understand what is possible today and accelerate it to reduce the logistical, clinical, and personal friction between people and being better.

Richard Schwartz is the co-founder and Chief Connectivity Officer at Rapt Health. Rapt is a partnership-focused consultancy specializing in connecting people, companies, technologies, and ideas to create exponential, outcomes-focused health solutions.

richard schwartz

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Health is Simply the Very Best Problem to Solve

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