Disqus - Latest Comments for cranstone

Re: Establishing Meaningful Informed Consent: Challenges in mHealth

Peter Cranstone — Tue, 16 Oct 2018 09:17:52 -0000

Here's the problem - go to any provider and they will answer with the following - we already do that.

Next follow up with this - we'd like to see exactly what data you have on me and exactly all the people who have access to that data. That's what GDPR is really for - giving the 'data subject' the ability to hold the data processor/controller accountable.

Without accountability and fines Privacy is merely and buzzword.

Re: Are interoperability and innovation possible in the age of EHRs?

Peter Cranstone — Thu, 04 Oct 2018 09:11:17 -0000

I agree with one caveat - interoperability does NOT drive behavior change of the patient... anymore than a highway drives commerce between two cities. Interoperability enables but doesn't result in either financial gain or better health. Sustainable behavior change comes from being able to engage with a patient based on their needs, values and preferences and then delivering something of value to them as conveniently as possible in support of that behavior change.

The holy grail is NOT interoperability, it is using your purpose driven analytics to deliver preventative care and presenting each individual the choice to direct their daily care path based on their needs, values and preferences, in support of better outcomes and lower costs.

Re: Putting the patient in the driver’s seat on the value-based care journey

Peter Cranstone — Wed, 03 Oct 2018 09:53:57 -0000

You quoted... With tools for a thoroughly planned and well-connected journey, the patient can finally put the pedal to the metal for improved health.

Agreed. We invented a new mobile user interface to achieve this goal. Choice® includes A Simple, Consistent, Comprehensive Data Privacy and Individualization Navigation Framework that offers Minimal business/IT risk with unlimited upside potential via new services.

This enables you to simplify care delivery... Use your purpose driven analytics to provide preventative care and close the loop in creating an individual focused, prescriptive, daily care path. The user interface autonomously adapts via simple HTML commands simplifying complex care continuum navigation, to present each individual the choice to direct their daily care path based on their needs, values and preferences, in support of better outcomes and lower costs.

https://uploads.disquscdn.c...

Re: IoT firm, UC Berkeley awarded $4.5 million research grant for dementia caregivers

Peter Cranstone — Sun, 02 Sep 2018 08:37:20 -0000

We've already invented a solution that is designed for Prof. Levenson... it's called Choice® - a software tool that enables each of us to have a personalized, evidence-based, longitudinal care map and access to a health ecosystem that brings together exactly the services we need on a daily basis.

Use your purpose driven analytics to provide preventative care and close the loop in creating an individual focused, prescriptive, daily care path. The user interface autonomously adapts via simple HTML commands simplifying complex care continuum navigation, to present each individual the choice to direct their daily care path based on their needs, values and preferences, in support of better outcomes and lower costs.

Re: The evolution of the healthcare CRM

Peter Cranstone — Wed, 22 Aug 2018 10:19:21 -0000

RE: In today’s healthcare market, customers want personalized care experiences

Right there is the key problem. Ask ANY techie in the industry and they will say 'we already do that' and yet on a daily basis almost every article talks to the fact that patients want a personalized care experience.

I think it's time to re-write the definition of personalized care... to something like this:

How to meaningfully and empathetically create a seamless user experience that engages individual patients with a prescriptive daily care path, by enabling them to choose the products and configurations they want from an ecosystem of healthcare vendors, all from their mobile device.

HCRM cannot deliver that. Why? Because it lacks the (tech time) 'presentation capability' to personalize care continuum navigation in real-time based on the constantly changing needs, values and preferences of each individual patient.

Remember - patient engagement cannot be mandated, prescribed, or expected. They will only engage when it empathetically presents and connects them to the items they need on a daily basis.

Re: Dignity Health, UCSF Health team on digital patient engagement tool

Peter Cranstone — Mon, 23 Jul 2018 09:19:03 -0000

Here's a brief overview of our solution... seems to be exactly what UCSF is looking for:

Choice®: Enabling a New Transformative Digital Care Delivery Strategy

Each of us has a personalized, evidence-based, longitudinal care map. Our vision is to allow you the ability to connect, create and monetize a seamless patient centric care ecosystem. Use your purpose driven analytics to provide preventative care and close the loop in creating an individual focused, preventative, prescriptive daily care path. Our single app user interface autonomously adapts to each user simplifying complex care continuum navigation, presenting each individual the choice to direct their daily care path based on their current condition or preferences in support of better outcomes and lower costs – while preserving their right to privacy.

Re: Aneesh Chopra on the future of FHIR: It’s starting to come together

Peter Cranstone — Wed, 02 Aug 2017 15:09:24 -0000

Regarding this quote... So, for example, there has been nothing quite like HTTP with the Internet, where everyone knows that when you type a certain combination of letters, a specific action will happen

That's no longer true. As one of the inventors and patent holders (US. Pat: 7873710) of Internet privacy we invented a way where you can type (send data) and a specific action will occur.

And as its standards based and uses an open framework it will support FHIR

Re: Comparing 11 top telehealth platforms: Company execs tout quality, safety and EHR integrations

Peter Cranstone — Wed, 02 Aug 2017 15:03:35 -0000

Bill,

Great article - however I respectfully submit that it would have more value if you showed the financial status of each entity. A quick check of Teledoc for instance reveals a 1.7B market cap - unfortunately their margins are -36.49%

Hmmm.

Re: Geisinger CEO Dr. David Feinberg: 'I'd like to eliminate the waiting room and everything it represents'

Peter Cranstone — Sun, 01 Jan 2017 21:33:16 -0000

We call the idea The Walking Clinic™ - it's designed to do exactly what Dr. Feinberg is asking for without the need for additional head count which would only increase costs and decrease operating margin. The concept is simple - A single point of access that presents and connects the patient with the most appropriate care channel for their current needs AND measures real-time adherence to lower the costs of acute and chronic care delivery for maximum impact. And it enables you to collaborate with network partners within your digital care delivery value network.

Re: UCLA’s strategy for patient-facing apps inside and outside the hospital

Peter Cranstone — Thu, 12 Nov 2015 20:01:32 -0000

Here are some additional considerations...

Point of need. Lets say that you manage to solve the interoperability issues and build a web portal with a single source of truth. Your next problem is delivering that on mobile. Why? Because I want my healthcare at the point of ultimate convenience - or where I am right now. It must be simple to use and easy to navigate. If it fails that test I won't engage.

Money - the current mobile strategy in healthcare is one of a constellation of apps. The patient is expected to install, configure, navigate and use all of these apps and change their behavior. Right now all they are doing is connecting as there is no active collaboration between them and their healthcare provider (the Doctor).

How can we measure this? Well follow the money - take any large care provider/payer and review their financials. 80% of their costs lie in the treatment of chronic conditions. Unless the app(s) gets the patient to change their behavior then costs remain unchanged or climb.

Couple this with a 'fee for outcome' business model and people are buying bronze and silver plans and letting the HC provider/payer deal with the rest. The result - patient numbers are up, revenues are up, but costs are climbing faster and therefore collapsing margins.

A single of truth only counts if it can be measured and the only measurement that really counts is money. There's a new truth in healthcare - if the patient doesn't change their behavior then the app hasn't engaged.

Re: Apple and Google’s different, but complementary, approaches to medical research

Peter Cranstone — Wed, 11 Mar 2015 10:53:40 -0000

RE: “What will it take for mobile-enabled trials to really take off?”.

Pretty simple really - a connected healthcare standard that is device agnostic and allows for active collaboration in real time with a personalized response. So far no one has figured out A) how to build a connected standard that is device agnostic and B) make integration simple with existing infrastructures. People keep forgetting that someone has to pay for all this change and unless I can engage with the patient in real time then it has no value.

Re: How to Improve Patient Engagement in the Provider Community

Peter Cranstone — Wed, 11 Mar 2015 10:19:14 -0000

Follow the money and the dependencies - outline the cost of upgrading all the backend systems (EHR's etc) to support all of this. With margins already under severe pressure there's no budget to simply upgrade everything to support something that has as of yet no definable value. Secondly patient engagement is about active collaboration - neither ResearchKit, HealthKit or GoogleFit allow for that personalized response. So in essence all these new technologies are doing are creating more data silo's. What's required is a connected healthcare standard that is platform agnostic and provides for simple integration without the need for costly upgrades. The value is there but not with the current approach to digital healthcare.

Re: California Poised to Get Do Not Track Disclosure Law

Peter Cranstone — Wed, 04 Sep 2013 13:09:52 -0000

Katy,

A correction. There are currently NO browsers that have DNT turned on by default. Microsoft have no made DNT part of the set up screen so that the consumer has a choice in whether or not to enable.

Re: Single page web apps: the worst of both worlds

Peter Cranstone — Tue, 18 Jun 2013 19:30:57 -0000

Doesn't exist.

Re: Single page web apps: the worst of both worlds

Peter Cranstone — Tue, 18 Jun 2013 19:27:45 -0000

Fine - but then stop asking for a browser that supports JavaScript accessing native apis. Because for that to happen you'll have to build another browser. Which returns me to the first point - you don't want to solve that problem badly enough.

Re: Single page web apps: the worst of both worlds

Peter Cranstone — Tue, 18 Jun 2013 19:24:16 -0000

It's a fully standards compliant Android browser. In fact it has more capability that Android's own browser. We've tested it side by side with Android and i believe the delta on the HTML5 test was like 5 points or something.

Re: Single page web apps: the worst of both worlds

Peter Cranstone — Tue, 18 Jun 2013 13:41:05 -0000

If it solves the problem then why not use it? It's already been tested on 26 carriers, 72 different OS versions and from people around the globe. No issues. Guess you don't want to solve the problem that badly.

Re: As Populist as it May Feel, 98% of VCs Aren’t Dumb

Peter Cranstone — Sun, 26 May 2013 23:10:41 -0000

IRR's are the only thing that count. If you have positive IRR's then you're not dumb. If not, you're learning.

Re: Do Not Track

Peter Cranstone — Wed, 24 Apr 2013 11:16:21 -0000

Choice is actually a very simple thing to engineer - there's even a browser called 'Choice'. It allows the user to control the collection, flow and use of their private data. It meets and exceeds by a wide margin all of the current ideas and specs put forward in the DNT standard.

BTW - DNT is already a standard, just not a W3C approved standard. Why? It's supported in over 1/2 a billion devices already. What's missing is the documentation to make it an approved standard.

The arguments at the TPWG notwithstanding - it's time to get to Last Call. Failing that then it's obvious to all that negotiation is simply not working (it's been over 2 years) and it's time for an alternative approach.

Tick Tock - July is a real deadline that you have to make.

Re: The little things I learned from the valley – April 2013 edition

Peter Cranstone — Wed, 17 Apr 2013 18:39:32 -0000

Welcome to the show that never ends. You don't need to be in the valley to solve a big idea, in fact sometimes it's more of a distraction. The valley will find you if you hit one out of the park.

Re: Late State Convertible Debt

Peter Cranstone — Thu, 11 Apr 2013 17:05:36 -0000

Agreed. FS has taken (including this amount) over $100m in funding. That's a lot to prove a revenue model. Heck I'm looking for funding and have half a billion users of our IP and then won't look at me until i have over a million in trailing. FS is a long way ahead of me - but with a $100 million of debt (i class liquidation preference as debt)

Re: Late State Convertible Debt

Peter Cranstone — Thu, 11 Apr 2013 12:34:57 -0000

Well when FS goes public we'll get to see.

In the interim if you use your metrics above with FaceBook and Twitter you see two different businesses. FB is not a google with profitable revenue, so it's just an ok business which isn't growing. Twitter is still an unknown - and yet the claim is $1b in revenue. I say great - but show me the earnings - that's tells me if this is an ok business or a great business.

FS has taken a lot of capital, the revenue model should have already been established. It's not yet which means that the earnings/profitability isn't established either. Which illustrates why they did a convertible debt round. The investors don't know what is going to happen and rather than pick a valuation they went with Plan B which is to defer the valuation until there is more 'meaningful data'.

The risk is that FS can't find that event horizon that generates meaningful revenue with profit. In which case it's back to the well. And Fred wrote a great post on what that means (when things don't work out.

FS is hovering in that arena - so it's now or never.

Re: Late State Convertible Debt

Peter Cranstone — Thu, 11 Apr 2013 12:22:09 -0000

Revenues without cash flow and earnings means debt. Apple has 'measurable, sustainable, profitable revenue from volume'. Anything less than that metric means you're not a real business, but you're trying like hell.

Re: Late State Convertible Debt

Peter Cranstone — Thu, 11 Apr 2013 11:09:09 -0000

Earnings = real business (and that's what makes this business so darn difficult)

Re: Late State Convertible Debt

Peter Cranstone — Thu, 11 Apr 2013 09:37:54 -0000

Lets hope that the revenue event is at the same place on the event horizon as the inflection point.