LifeCOMM: Will the Newest Personal Health Information Platform Play Nicely with Google and Microsoft?
Tuesday, November 18, 2008
| Vince Kuraitis
About the author - Vince Kuraitis JD, MBA is Principal of Better Health Technologies, LLC and author of the
e-CareManagement blog
It looks like 2009 will be the year that LifeCOMM finally makes its debut!
We've been hearing dribs and drabs about LifeCOMM for a long time. I remember Don Jones, VP Business Development for Qualcomm, first talking about plans for LifeCOMM at the Healthcare Unbound conference in 2005.
While we await final details, in this discussion I'd like to:
- Place LifeCOMM in the same category with the other personal health information (PHI) platforms -- Google Health, Microsoft HealthVault and Dossia
- Ask a central question about how LifeCOMM will play in this new ecosystem: Will LifeCOMM exchange patient data with Google Health, HealthVault and Dossia? Or will it be a closed platform, more akin to an iPhone?
These are complex issues, but I'll try to explain things in plain old English.
LifeCOMM as a Personal Health Information Platform
LifeCOMM looks like it will share key characteristics with the other PHI platforms:
- A data repository for personal health information
- Personalized applications developed by 3rd parties. These applications will draw on personal health information contained in the repository and in turn will add new PHI to the repository.
A major difference about LifeCOMM, however, is that it will focus on mobile applications:
LifeCOMM seeks to fill this gap in the continuum of care by providing mobile device delivered
health services that will assist a person in complying with his health care professional’s proscribed
care regimen. It’s like putting a nurse that can monitor and evaluate various bio-measurements in
that person’s hand. Based on that recurring evaluation, a ‘virtual nurse’ will assist him with advice,
information, and education to help him improve and maintain his health-state.
LifeCOMM promises to revolutionize the telehealth field. Current remote patient monitoring technologies and business models have emphasized home based monitoring of high cost/risk patients -- the 5% of patients that typically incur 60% of health care costs. The value proposition here is to identify and manage this group of patients to keep them away from the emergency room and out of the hospital, thus avoiding the highest cost areas of the health care system. This high cost/risk patient group tends to be older and less mobile.
LifeCOMM promises to bring telehealth applications to the masses -- the other 95% of the world that tends to be younger, healthier, and more mobile.
Read more about LifeCOMM here and here.
Multiple Issues about Standards, Interoperability and Networks
There are several types of potentially confusing standards and interoperability issues relating to LifeCOMM. Let's examine some of the most important ones:
- Device connectivity. The Continua Health Alliance is selecting connectivity standards and publishing guidelines to create telehealth device connectivity. Continua certified devices will be plug and play with each other. Since Qualcomm is a member of Continua, I expect that LifeCOMM will adopt Continua device connectivity guidelines.
- Health information technology (HIT) data exchange interoperability. This is a thornier issue. While there are many HIT standards at play, as a practical matter the relevant standards here relate to standards for summary record data exchange -- the the HL7 Continuity of Care Document (CCD) and/or the ASTM Continuity of Care Record (CCR) standards. Today, HealthVault is supporting both of these standards, while Google Health currently only supports a subset of the CCR. Google and HealthVault have agreed that their platforms will be able to exchange patient data; details are pending.
- Cellular network compatibility. In the U.S., there are two cellular networks -- GSM and CDMA. Qualcomm backs the proprietary CDMA standard, so I expect that LifeCOMM will operate only for CDMA carriers -- Verizon and/or Sprint.
My central question relates to #2: will LifeCOMM adopt open HIT standards and agree to be able to exchange patient information with the other PHI platforms?
Google Health and HealthVault have provided assurances that their platforms will be able to exchange patient information. Will LifeCOMM also play nicely?
In my experience, people often confuse device connectivity (#1) with HIT data interoperability (#2). They're not the same thing. Creating device connectivity does not assure interoperable data exchange capabilities. An analogy would be two people who speak different languages trying to have a telephone conversation; they can hear each other because of device connectivity of the network, but they still don't understand each other and can't effectively exchange information because of the language barrier (i.e., lack of data exchange standards).
Network Effects
Why would LifeCOMM want to commit to data exchange with Google Health, HealthVault and Dossia?
It's pretty simple -- the PHI platforms have a common, collective interest in growing the size of the network and in maximizing network effects.
A common example of network effects is fax machines -- one fax machine is worthless; with two machines you have point-to-point faxing between two people; with millions of fax machines you have a valuable network and can exchange faxes with just about anybody.
The PHI platforms have potential for strong network effects. The value of the network grows exponentially based on the number of users; network effect markets grow slowly at first, but will grow rapidly once a tipping point is reached.
While there's a common interest in maximizing the size of the network, the PHI platforms will compete at many other levels. For example, they will compete for users, software developers, 3rd party application partners, and many other areas.
Is there any reason why LifeCOMM wouldn't want to be interoperable with the other PHI platform companies? LifeCOMM could choose to develop proprietary IT and a proprietary business model, but I think that would add an extra burden in a market in which consumers don't yet have awareness and understanding.
Welcome LifeCOMM! We look forward to getting to know you.