5 Hot Healthcare Ideas from SXSW

The SXSW conference demonstrates that technology and innovation are leading the way in healthcare while regulators struggle to keep up. Everyone is trying to answer one question: "Who provides care, and how?"

After barely recovering from HIMSS, I hustled down to Austin, Texas this past weekend to take a look at healthcare IT at South by Southwest Interactive. I hadn't been to this conference since 2012, and in those two years the health track moved from a venue across town to the Hilton right across the street from the main convention center.

Seating capacity is up, and so is attendance, with many sessions near full capacity. Here are my five biggest takeaways:

1. Wearables are hot.

A session sponsored by Rock Health an incubator for healthcare technology startups, created a line around the block that made some think that Daft Punk was making a musical appearance. The first 100 attendees received a wearable Misfit Shine physical activity monitor, and the session itself generated plenty of tweets.

In general, however, wearables aren't very wearable, or fashionable, yet.

The "geek factor" of having a conspicuous health sensor in the form of a wristband isn't cracking the fashion barrier yet. These devices need to get a lot smaller and sleeker before they break into widespread acceptance. Also, many devices don't like being wet in the shower or at the pool, and designers have to overcome that limitation (Misfit apparently has).

Fitness buffs too, are able to overlook some of these limitations, but the general public is going to wait another generation or two, at least. For now, the best consumer healthcare apps rely on data collected by mobile phones, not just wearable sensors.

And there's reason to believe that there's a place for wearables in the healthcare workplace.

2. Developers and providers need to resolve who owns apps and tools that result from joint hackathons.

This year, for the first time, the team from MIT's H@cking Medicine brought a mini version of its popular weekend-long healthcare hackathon to SXSW Interactive. I will have more to say about this in a future column, but suffice it to say that organizations such as MIT have already worked with major healthcare institutions on these hackathons and understand that providers have a stake in the game.

The brainstorming phases of these events are when pain points are identified. Participating teams, including startups and established health IT companies, try to match up their own proprietary solutions with the particular workflow needs of healthcare providers.

The hackathon format is conducive to rapid prototyping, and over the course of a weekend, different teams can join forces to rapidly create more comprehensive solutions to a problem. It was exciting to see this at work at SXSW, where collaborating and give-and-take are as natural as using social media.

3. Patients may own their data, but services are providing diagnoses along with the data, and that concerns physicians.

At another session I attended, it was obvious that physicians still feel challenged by the rapidly expanding smorgasbord of online services and apps that diagnose and recommend as well as record and report.

I even heard that some lab companies attach diagnoses to the lab results they return to clinicians – which is fine, except those same lab results also get reported to patients. I had not realized that some labs crossed into delivering diagnoses or interpretations of the results.

Physicians naturally get antsy about this, and I wonder if the labs may find themselves facing some sort of crackdown, particularly in instances where lab and clinician disagree on exactly what the results mean.

4. Doctors still haven't entirely bought into the notion of team-based care.

Leslie Saxon MD, executive director and founder of USC's Center for Body Computing, gave the SXSW Interactive healthcare keynote on Saturday morning. She touched off a Twitter controversy by saying that she didn't want to provide care to healthy patients, only sick ones, which prompted some physicians to respond that only the doctor knows how to spot the telltale signs that a healthy patient is trending toward sick. This prompted still more caregivers to say that only a team-based care approach can provide that kind of watchful care in a scalable fashion.

But Saxon was also willing to consider such controversial notions as paying patients for their medical data to further advance research. Saxon's ideas remind me that much of the innovation driving wearable devices comes out of the sports, military and even entertainment worlds, with regular old healthcare playing catchup. It should be interesting to watch those worlds collide again and again as the technology goes through its usual generations.

5. What if HIT were to follow the PayPal model?

One speaker at SXSW pointed out that when the PayPal online payment service started, it was with the full knowledge that many of the things it enabled – such as sending money electronically across state lines – were tightly regulated by the federal government.

PayPal overcame this by starting with small merchants in a single state, California, and by the time state regulators had discovered what state regulations PayPal was violating, the company had a base of small business supporters. They were willing to lobby the legislature to change the laws to accommodate PayPal, in California, and eventually across state lines as well.

In healthcare, apps and services that diagnose (see #3 above) are acquiring their own constituencies so quickly that by the time the FDA tries to crack down on them, there will be growing pressure in Congress from consumers and the new service providers to allow more lenient regulation.

That has to be one of the most disruptive possibilities of healthcare IT—the capability to break down the licensing requirements of who provides care, and how. This power is sure to fly in the face of medicine as it has been practiced ever since our current system came to be.

I am certain that the AMA and a host of other interested parties will fight it, but just like the bankers who tried to stop PayPal and are now trying to stop Bitcoin, the battle may be lost before they realize there was one.