Which brings us to the $3 trillion industry known as health care (it’s really sick care or medical care, as most interactions focus on those who are unhealthy). For health care to achieve the kinds of productivity improvements occurring in most industries requires a fundamental shift away from clinician-centric businesses to software enabled, consumer centric business models that facilitate self administration.

Healthrageous exists to realize that dream. We seek to empower consumers. To give them the tools and the technology that facilitates self-managed health care. Moreover, we endorse the concept of having goals for achieving greater health, particularly when those goals are “owned” by the consumer, and not foisted upon them by a well-meaning employer.

Few children grew up to become President because it was their parents’ dream for them. Rather, the astronauts who conquered space, the mountaineers who conquered Mt. Everest, and the people who became the very best teachers of our next generation were humans passionately pursuing their own goals.

Becoming more mindful of our own body will not only lead to a more efficient health care system, it will also eradicate mindless decisions, such as going to the ER with a bad cold, or choosing not to get a flu shot because it is inconvenient, or ignoring free inoculations for your children. Learning why the medication is being prescribed, learning how losing a few pounds will help your sleep apnea, or appreciating the impact of sodium on your high blood pressure, all represent a more empowered consumer, willing to self manage.

When Americans start to demand a consumer-centric health care system that treats them as key actors in the process, willing to receive and read emails from their physicians, mindful of the vast number of useless calories in carbonated sodas, and able to set and reach goals that make them healthier in the long run, then the transformation of health care will finally be upon us. Owning our own bodies and becoming stewards of our own health is the first step down that road, which will ultimately shrink the cost of health care that is crippling our economy.

So start today, with a small step towards improved health. Get to bed on time. Take deep breaths while waiting at the bus stop. Use the stairs instead of the escalator or elevator. You’ll be glad you did.

•         Improvement in quality of care; 
•         Greater self-initiative and participation in care by the patients; and
•         Patients were better prepared for their visits with their doctors.
•         However, 42% of the physicians “sensed” undue anxiety in their patients associated with too much information (TMI), and
•         Some of the physicians started writing notes in code, such as “high BMI” rather than “obese.”
 
When the simple sharing of medical data with the patient is welcomed and applauded by participating patients, while resisted and dismissed by the participating doctors, then “Houston, we have a problem.”  There are around 800,000 practicing physicians in the US.  By 2030, there will be 75 million Baby Boomers in Medicare.  Replicating a physician-centric solution under those circumstances is foolhardy.  The math doesn’t compute.    
 
I vote for Digital Health approaches like Healthrageous being first and foremost consumer-centric.  Focus on SELF-management.  We can and will integrate doctors into our model, but we need to empower the consumer who wants to take an active role in his/her health.  Apple created an iPad that is getting huge traction with physicians.  Yet, Apple never convened a physicians’ focus group to elicit the input of different doctors. 
 
If companies build really good, intuitive solutions, physicians will find their way into the model without making it doctor-centric.  Doctors who are old school and who seek “patients” who patiently wait for them in their waiting rooms, hence disrupting our own workflows, efforts at the office, and parenting obligations, will not be compatible with the Digital Health revolution.

Lead author Sarah VanWagenen said the most common sin committed by a fitness app is lack of customization. “The majority don’t ask for age, height, weight or any kind of basic health information,” she said. “You just sign up and they give you a program and some advice based on general recommendations.”

Also cited in the study was a lack of utility for enhanced goal completion through social networking, and a tendency for 20-somethings to develop apps for 20-somethings, which is not the demographic that needs to get up and go start shedding weight.

None of these findings are surprising to us here at Healthrageous. We’ve been committed, since Day One, to creating a dynamically personalized experience for each one of our users, knowing full well that no two humans are alike.

Further, we have viewed the power of biofeedback loops. They work for some; others not at all. One of the original biofeedback loops sits between you and your windshield. It’s called a speedometer. It tells you when you are speeding and when you are within the speed limit. It is real time, personalized data. Yet, how many speeders do you witness on the roads?

Healthrageous knows that some things – like biofeedback loops – work for some and not others. Hence, we’ve created a community for social networkers. We’ve gamified. We have badges. We have competitions. We have data visualization and of course biofeedback loops fed by your wireless devices. No one solution will work for everyone. But customizing down to the individual has worked for us.

Too bad those researchers spent those research dollars on a study, whose answers were already known amongst the talented team of Healthrageous (I hope it wasn’t federally-funded research).

Both Mitt Romney and Barack Obama are avid exercisers, as are their wives. I suspect those exercise regimens may be de-emphasized over the next 70 days, but they most certainly represent enviable models of discipline, dietary moderation and regular physical activity to our citizenry. Paul Ryan shames them both with his P90X workouts. The spouses among the 4 party leaders seem to have embraced comparable doses of healthy living and activity.

So if leaders lead, instead of apologizing, avoiding, or diminishing the issue that absorbs over $1 trillion every year – self-inflicted chronic diseases like GERD, Type II Diabetes Mellitus, Hypertension, Sleep Apnea and Degenerative Joint Disorders – why are we not hearing anything about self management of our health?

Mayor Mick Cornett of Oklahoma City is the kind of leader to which I am referring. Five years ago, he brought his city out of the dark ages and has made it a shining example of healthy living. At that time, the city was recognized as one of the “fattest” cities in America – and Mayor Cornett weighed 220, standing at 5’9”. This is a 32.5 body mass index, considered to be “very overweight.”

He created a goal for the city to lose one million pounds. He set up a website to assist people with the goal (thiscityisgoingonadiet.com). Over 1/3 of the city’s obese population and thousands others signed up. He then levied a one-cent tax for seven years that raised $777 million. With those revenues, the city created a 70-acre downtown park, hundreds of miles of improved sidewalks and biking and hiking trails, and a senior wellness center.

By January of this year, the city had reached the 1,000,000-pound goal. The city has actively recruited employers to come and enjoy the benefits of a healthy workforce. Unemployment is 4.5 percent.

We need leaders like Mick Cornett to arrest the shocking rise in obesity that impacts every aspect of our lives, particularly that of self-inflicted chronic disease that is bankrupting our nation.

Healthrageous benefits from the human predilection to cheat. By nixing self-reported data in favor of verifiable biometric data, Healthrageous has soothed the frayed nerves of corporate HR execs wanting to ensure that they don’t pay incentives to self-reporting cheats who miraculously lose 10 pounds, even though they don’t appear to have lost any weight.

When all is said and done who is really getting cheated in this scenario?

So I win $100 even if I didn’t lose any weight. And then next year, I pack on some more pounds. And the following year, my doctor informs me that I need a knee replacement cause my poor little knee can no longer carry my formidable girth on a daily basis. Then my hips go. Then my heart.

You know the progression and have seen it in your own family, most likely. So, in the end, those who cheat in employer efforts to stimulate activity by falsifying their data are inevitably cheating themselves of a longer disease-free life. By cheating themselves they will miss out on experiences like lifting grandchildren, climbing the Great Wall of China, or simply walking the dog after dinner.

Most of us view the word motivation from our own perspective. If we are big baseball fans, we assume that a prize of two box seats to the Yankees-Red Sox game will be highly valued by us, as well as by the target audience. The days of barking coaches extracting every last ounce of effort from athletes are no longer the norm, however. Motivation only works when it is valued by the targeted person receiving the motivational message.

For example, imagine a typical company challenge involving daily exercise. An incentive of a paid day off from work may be highly valued by a lackluster worker, who then kicks daily activity into high gear in order to earn that reward. But a senior executive may conclude that the eight days of use-or-lose vacation days that expired last December because she was too busy with company deadlines are not worth competing for.

The key to motivation is to elicit it from the employee. And, for that matter, the same is true with regard to what an employee will choose to do to “become healthier, and earn rewards.”

My employer may want me to shed some weight, so I will be more alert in the afternoon, and thus more productive. I, on the other hand, may be troubled about the lack of communication I’m experiencing with my teenage daughter. Until I rectify my relationship with her, I won’t be able to focus on other issues involving my health. A big part of goal achievement is selecting the right goals, as opposed to imposing the company’s prescribed regimen of bottom-line-enhancing “personal” goals. Personal goals emanate from the person, not the employer. Motivational approaches should permit the inclusion of employee-generated goals, as they will offer the greatest likelihood of success for the individual employee…and ultimately the bottom line of the employer.

Of those three scenarios, one happens hundreds of times a day in America, and the others almost NEVER happen.

Wouldn’t it be great if your primary care physician could look at your last 30 blood pressure scores, recorded over the last 2 months? Well…it is happening today, but it doesn’t happen with nearly enough frequency because the old, tired, inaccurate “one data point” process gets reimbursed; whereas, contextual, longitudinal trends on blood pressure don’t.

At Healthrageous, we witnessed the positive benefits of empowering people with hypertension through the use of wireless blood pressure cuffs. In a random controlled trial conducted in 2008 with 404 employees of the EMC Corporation in Eastern Massachusetts, those in the intervention group who used their wireless cuffs ended up receiving twice as many medication consults as the control group – leading to more precise titration of their blood pressure medications.

We are talking about a disease that is called the “silent killer” and which affects one in three adults in our country. Yet, reimbursement policy for wireless devices that yield meaningful clinical biometrics remains stuck in the 1950s. Back then, a farmer with high blood pressure paid for his doctor’s visit with a dozen eggs and a quart of milk. Surely health care reform can include accountable, self-managing consumers sharing their BP scores with their doctors. Yet, we don’t allow reimbursement for wireless blood pressure cuffs. We don’t reimburse physicians for interpreting treasure troves of accurate hypertension data collected over time. We simply shrug when patients find it too difficult and disruptive to visit their doctors in order to get medication for the silent killer. Hence, they don’t see the doctor and are “silently” being killed by our stuck-in-time reimbursement policies.

And hypertension is but one example of wireless biometrics better informing overworked doctors and giving them the necessary information to effectively prescribe for our growing, mobile population.

Simply put, being sedentary is dangerous. An American Cancer Society study found that women who sat 6 hours or more and were otherwise physically inactive were 94% more likely to die during the 14-year study period than those we were physically active and sat for less than three hours per day.

Many of us believe that we can overcome the inertia of a sedentary day through daily bouts of exercise; indeed, this is in line with government guidance to exercise 30 minutes per day at least five times per week. Unfortunately only an estimated 17% of the population complies with these recommendations. Worse still, even these people may not be getting the benefits they expect.

Researchers have found that even among physically active individuals there is a strong association between extended periods of sitting and a reduction in life expectancy. The study concluded that extended sitting correlates with an increased incidence of cardiovascular disease.

Cardiovascular disease is the leading cause of death in the United States. Currently 1 in 3 Americans have some form of cardiovascular disease that will be life limiting. The cost of cardiovascular disease in terms of medical expenditures and lost productivity is projected to exceed $1 trillion dollars by 2030.

This enormous cost will serve as a yoke around the neck of our nation and our nation’s businesses. Worse still, the human cost of 116 million Americans suffering, including lives lost and impact on families, is impossible to calculate.

The good news is that we can extend our lives with “a single step” (multiple steps are even better). We simply need to avoid extended bouts of sitting. Even very brief bouts of activity such as walking short distances or transitioning from sitting to standing can have a positive impact on body composition and triglyceride (fat) levels in our blood.

At Healthrageous, one of our goals is to empower individuals to identify and make the small everyday changes necessary to reap great rewards in health and wellbeing. We approach this goal via education, feedback loops, and gaming mechanics. First, it is crucial to understand that some movement is better than none. Whether it be a walk to the water cooler, visiting a co-worker instead of sending an email, or taking the stairs instead of the elevator; such small changes have an impact greater than the number of calories burned. They signal to the body that you are on the move and it is time to wake up and start burning some fat.

Next, we give our participants a clear picture of their activity levels throughout their day. We present a tight feedback look that visually depicts hourly activity linked – with expert advice from our automated coach. This helps Healthrageous participants to understand their behavior and recognize opportunities to make small but meaningful changes.

Lastly, at Healthrageous we believe it always helps to make things fun. We have developed (and are continuing to expand) a whole series of game dynamics targeted toward developing healthy habits. Participants can join team or individual competitions, and earn rewards for achieving personal activity goals.

At a time when the economic viability of our businesses and our nation depends on reducing the prevalence of costly chronic diseases, we are proud to be developing science-based solutions that empower people to improve their own lives. By helping people to implement crucial small changes in behavior that produce large results, Healthrageous reduces disease, controls costs, and helps keep our individuals and businesses healthy.

The way Big Data works is elegantly simple; yet execution can be extremely challenging and difficult. Random data are collected in codified bits and bytes and run through large computing systems to generate meaningful information about the end user or target.

At Palantir Technologies, a firm engaged by the Pentagon to keep America safe from terrorists, their mission is described thusly: We live in a world in which data, technologies, humans and environments are linked, at massive scale, often in unseen ways. At Palantir, we build the software that makes these unseen connections visible and intelligible. We engineer so that the world works – with less risk, higher potential and greater good.

Those who are producing the dairy and beef for the insatiable American appetite (The US consumes twice as much beef per person as the next closest country), have typed each cow in the herd in order to personalize nutrient-rich feed bags to optimize beef yield or milk production. Information on each cow is collected, sorted, analyzed and parsed through massive algorithmic-intense databases, with intelligent software performing the challenging, but rewarding analytics.

Opower is a new customer engagement platform for the utility industry. It reinvents the way utilities interact with customers—from the quality of the information provided to the way it’s presented and delivered. It helps people use energy more efficiently and ultimately save money on their energy bills. 
And it vastly improves the overall customer experience by making energy use personally relevant.

Few don’t understand how Netflix’s Big Data play is to observe – through data crunching – each subscriber’s personal tastes in media viewing in order to better appreciate how to service that customer with recommended film options.

Which brings us to Healthrageous; the machine learning delegate of the health care industry. If the previous cited examples can better understand their customer/target (Palantir’s focus on terrorists hardly qualifies as a customer intimacy example), then it stands to reason that Healthrageous can use Big Data and algorithmic computations to discern what is the special sauce that motivates each consumer to pursue a life with glycemic control, or more activity, or managed blood pressure, or fewer calories.

Every person seeking to improve their own health has begun a journey unique from others. Granted, some may want to walk their daughter down the aisle on her wedding day, but the journey to achieve that end may be highly personalized around which flight of stairs to trudge up each morning and what kind of yogurt to snack on in the late afternoon.

Just as energy users, terrorists, cows, and DVD-viewers all have their own unique reasons for doing what they do, so too do Healthrageous participants who have decided to change the way they’ve been living and to experience a new adventure that will lead to a healthier, longer, more satisfying life.

They named the site the Habit Heroes attraction.  By featuring characters like Will Power and Callie Stenics taking on super-sized villains Snacker and Lead Bottom, the exhibit conveys a positive message about healthy lifestyles in a fun and empowering way.  It demonstrates how feeling healthy and trim actually leads to greater self-esteem and more energy.

It was shut down before its official March 5 opening because some parents called it “horrifying, stigmatizing and insensitive.”  What is insensitive are the adults who are subjecting their kids to a lifetime of pain and suffering due to the impact of excessive weight – potentially both physical and mental.

We once were a nation capable of getting a health hazard like tobacco appropriately labeled and drummed out of the lifestyles of ordinary Americans because we knew – in a public health advocacy role – what was best for our population.  Now however, we are unwilling to call foul when a very similar public health epidemic is compromising the health of not only our young people but everyone.  By not courageously addressing obesity we will continue impacting our economy through ever-soaring health care budgets.

Wouldn’t it be great if the Media focused attention on the laudable exercise habits of George W. Bush, Mr. and Mrs. Obama and Mitt Romney?  Instead, the Media highlights this, The National Association to Advance Fat Acceptance said: ‘It appears that Disney now believes that using the tool of shame, favored so much by today’s healthcare corporations, is the best way to communicate with children.”