by John Nosta: Forbes 

On my wrists rests another chapter in the evolution of digital health.  Can you guess what it is?  I bet you can.  In fact, if you close your eyes, you might even see it. But I’m not going to name names here, I’ll leave that up to your imagination. But my point here is that I’m growing tired of another  accelerometer grabbing the thunder of digital health.  And beyond the sleek device you can hear the cacophony of voices rising in advocacy at yet another digital health summit. Recently, my friend Andrew Spong captured it perfectly with his typical acerbic wit.

We’re stuck in a rut of repetition, worn smooth by the ceaseless rotation of insipid digital pharma conferences. -Andrew Spong

And from my vantage point as both a participant in digital health, and frequent speaker at those health conferences, I can certainly see Spong’s point.

So, is 2013 really the year of digital health or the year of digital duplicity? It’s an important question and I think the answer is yes and no.  Picasso said that “good artists borrow and great artists steal.”  And he may be correct–I certainly think there’s a good deal of similar devices on the market and in development.  And that is perfectly fine. The natural pace of technological evolution is progressive and innovation builds upon innovation. But Steven Jay Gould’s concept of punctuated equilibrium may be a more appropriate perspective. The concept of prolonged periods of  stasis interrupted by significant change may very well typify digital health.  John Sculley, an out-spoken voice for science-savvy and market-driven innovation sustains his optimistic perspective.

We learned long ago in the tech world that Moore’s Law is a predictable linear gauge on computer performance improvement, but disruptive innovation is non-linear. What makes consumer era digital health solutions challenging is disruptive innovation takes domain expertise concurrently in 3 areas: technology, healthcare, and consumer branding.  Few people have expertise in all 3 domains. What makes consumer era digital health solutions challenging is disruptive innovation takes domain expertise concurrently in 3 areas: technology, healthcare, and consumer branding.  Few people have expertise in all 3 domains. -John Sculley

Yet still, innovation still looms large and the promise of game changing technology and applications still fuel the promise of digital health. For example, today a story about Aydogan Ozcan, a professor of electrical engineering and bioengineering at the UCLA who created a portable smartphone attachment that can be used to perform sophisticated field testing to actually detect viruses and bacteria without the need for bulky and expensive microscopes and lab equipment is an interesting example of digital health innovation that can have an important impact on science and medicine.  Jack Young, Director of Qualcomm QCOM +0.12% Life Fund at Qualcomm Ventures is similarly optimistic and sees the ubiquity of smart watches as part of the evolution of wrist-worn devices.

We are entering into a new wave of innovation in wrist-worn devices. Although still built around an accelerometer which has been around for many years, these new devices tethered to a smartphone bring the entire digital world to you: challenging your friends, earning your favorite rewards, sharing your progress with your caretakers, etc, which help you stay engaged. These new wearables have already found way to be used in clinical applications, for example Mayo recently completed a study which uses a Fitbit activity track to monitor recovery in cardiac surgery patients. Beyond step counting, new sensors which track your heart-rate, blood-pressure and other physiological signals will be integrated and packaged neatly into these devices. Combined with new cloud-based services including predictive analytics, we can see they become your health companion and coach around the clock.-Jack Young

So, who are the visionaries who can “punctuate” this market.  And will these point of technological grammar be periods, exclamations marks or even questions marks?  I believe that we have the genius, resources and drivers to move from mush to magic.

The POWER of pharma

Standing on the sidelines is a vast network of power, influence, cash and connections. It’s the pharmaceutical and device industry.  They have the unique ability to ignite and validate digital health.  And in doing so, they can incorporate technology and resources into the mainstream activities that include clinical trials, sales activities and medical education.


Risk and reward will always drive this dynamic.  But I wonder if the classic “exit strategy” and ROI often hurt innovation and track a path of evolution versus revolution. I wonder what the role of crowd sourcing will be in usurping the suits and bean counters?

The BRILLIANCE of academia

Less encumbered and still thriving in the world of “what if” are colleges and universities.  Public / private partnerships that can leverage this resource can hold a powerful advantage and build–from the ground up–the next generation of “smart” companies that spring from the academic setting.

The SURPRISE of the citizen scientist

In a basement, somewhere close to nowhere you will find the next Edison or Tesla.  And empowered by access to information and technology, this “punctuation” very well may  be what shakes up the status quo and illuminates a path that is unexpected, yet greatly accepted.

The YOKE of government

Regulations and validation from government agencies can play a central role in the flow of innovation.  No one knows this better than the pharmaceutical industry as it regularly seeks approval, innovation, claims and feasibility as part of the complex process of drug development. Can government partner with digital health and drive innovation while providing the level of protection that is also necessary.  It’s a fine line, but one that’s worth walking in light of the dire state of health care around the world.

So, in a few weeks I’ll be speaking at another one of conference and I’ll challenge the group with these very issues.  And after all, a person with one smart watch knows their heart rate, time, galvanic skin response, location and activity, but a person with two is never sure!

Keep Critical! Follow me on Twitter and stay healthy!

Author’s Note:  Some of you may recall the headline “Mush from the Wimp” which ran in the Boston Globe in 1980 and made reference of President Carter.  The headline was intended as an in-house joke but ended up running in over 100,000 copies of the paper the next day.  The editorial was lack-luster, but the headline was singled out as one of the greatest in newspaper history.  In the spirit of  ”digital duplicity” I’m stealing it for this post.


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