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Awesome #HIT99 Profile Site

Posted on August 31, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Communities are amazing and that’s especially true of the healthcare social media community. For those who didn’t see it, we recently held the #HIT99 to recognize and thank those people who’ve been active in the healthcare social media community. You can see the official #HIT99 rankings listed here along with a number of other lists to help you find some interesting healthcare people on social media.

Steve Sisko (@shimcode) did all the massive work associated with collecting the nominations for the #HIT99 and he published the raw data for anyone to use. We both hoped that people would use that data to do cool things for the community. Luckily Don Lee (@dflee30) did just that when he created the #HIT99 List site. Here’s a description of how the #HIT99 site came to be:

A few weeks ago on the #HITSM chat a bunch of people were talking about how it would be nice to have a central blog site for the HIT99 list. I suggested a relatively easy way to do it. Rather than being the “here’s how we should do this” guy who then does nothing, I went ahead and built it. My goal is to provide an MVP that solves just the original problem – create a central place for the HIT99ers to tell us some more about what they do and more importantly, why they do it.

I love what he’s started, because it’s always fun to learn something more about the people behind the list. He’s started collecting people’s profiles (including mine) and he has details for how to update your profile if you’re on the list and haven’t sent over your info yet. Let’s all support Don and get our profiles updated.

Consumers Take Risk Trading Health Data For Health Insurance Discounts

Posted on August 28, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

When Progressive Insurance began giving car owners the option of having their driving tracked in exchange for potential auto insurance discounts, nobody seemed to raise a fuss. After all, the program was voluntary, and nobody wants to pay more than they have to for coverage.

Do the same principles apply to healthcare? We may find out. According to a study by digital health research firm Parks Associates, at least some users are willing to make the same tradeoff. HIT Consultant reports that nearly half (42%) of digital pedometer users would be willing to share their personal data in exchange for a health insurance discount.

Consumer willingness to trade data for discounts varied by device, but didn’t fall to zero. For example, 35% of smart watch owners would trade their health data for health insurance discounts, while 26% of those with sleep-quality monitors would do so.

While the HIT Consultant story doesn’t dig into the profile of users who were prepared to sell their personal health data today — which is how I’d describe a data-for-discount scheme — I’d submit that they are, in short, pretty sharp.

Why do I say this? Because as things stand, at least, health insurers would get less than they were paying for unless the discount was paltry. (As the linked blog item notes, upstart health insurer Oscar Insurance already gives away free Misfit wearables. To date, though, it’s not clear from the write-up whether Oscar can quantify what benefit it gets from the giveaway.)

As wearables and health apps mature, however, consumers may end up compromising themselves if they give up personal health data freely. After all, if health insurance begins to look like car insurance, health plans could push up premiums every time they make a health “mistake” (such as overeating at a birthday dinner or staying up all night watching old movies). Moreoever, as such data gets absorbed into EMRs, then cross-linked with claims, health plans’ ability to punish you with actuarial tables could skyrocket.

In fact, if consumers permit health plans to keep too close a watch on them, it could give the health plans the ability to effectively engage in post-contract medical underwriting. This is an unwelcome prospect which could lead to court battles given the ACA’s ban on such activities.

Also, once health plans have the personal data, it’s not clear what they would do with it. I am not a lawyer, but it seems to me that health plans would have significant legal latitude in using freely given data, and might even be seen to sell that data in the aggregate to pharmas. Or they might pass it to their parent company’s life or auto divisions, which could potentially use the data to make coverage decisions.

Ultimately, I’d argue that unless the laws are changed to protect consumers who do so, selling personal health data to get lower insurance premiums is a very risky decision. The short-term benefit is unlikely to be enough to offset very real long-term consequences. Once you’ve compromised your privacy, you seldom get it back.

Wearables Data May Prevent Health Plan Denials

Posted on August 27, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

This story begins, as many do, with a real-world experience. Our health plan just refused to pay for a sleep study for my husband, who suffers from severe sleep apnea, despite his being quite symptomatic. We’re following up with the Virginia Department of Insurance and fully expect to win the day, though we remain baffled as to how they could make such a decision. While beginning the complaint process, a thought occurred to me.

What if wearables were able to detect wakefulness and sleepiness, and my husband was being tracked 24 hours a day?  If so, assuming he was wearing one, wouldn’t it be harder for a health plan to deny him the test he needed? After all, it wouldn’t be the word of one doctor versus the word of another, it would be a raft of data plus his sleep doctor’s opinion going up against the health plan’s physician reviewer.

Now, I realize this is a big leap in several ways.

For one thing, today doctors are very skeptical about the value generated by patient-controlled smartphone apps and wearables. According to a recent survey by market research firm MedPanel, in fact, only 15% of doctors surveyed see wearables of health apps as tools patients can use to get better. Until more physicians get on board, it seems unlikely that device makers will take this market seriously and nudge it into full clinical respectability.

Also, data generated by apps and wearables is seldom organized in a form that can be accessed easily by clinicians, much less uploaded to EMRs or shared with health insurers. Tools like Apple HealthKit, which can move such data into EMRs, should address this issue over time, but at present a lack of wearable/app data interoperability is a major stumbling block to leveraging that data.

And then there’s the tech issues. In the world I’m envisioning, wearables and health apps would merge with remote monitoring technologies, with the data they generate becoming as important to doctors as it is to patients. But neither smartphone apps nor wearables are equipped for this task as things stand.

And finally, even if you have what passes for proof, sometimes health plans don’t care how right you are. (That, of course, is a story for another day!)

Ultimately, though, new data generates new ways of doing business. I believe that when doctors fully adapt to using wearable and app data in clinical practice, it will change the dynamics of their relationship with health plans. While sleep tracking may not be available in the near future, other types of sophisticated sensor-based monitoring are just about to emerge, and their impact could be explosive.

True, there’s no guarantee that health insurers will change their ways. But my guess is that if doctors have more data to back up their requests, health plans won’t be able to tune it out completely, even if their tactics issuing denials aren’t transformed. Moreover, as wearables and apps get FDA approval, they’ll have an even harder time ignoring the data they generate.

With any luck, a greater use of up-to-the-minute patient monitoring data will benefit every stakeholder in the healthcare system, including insurers. After all, not to be cliched about it, but knowledge is power. I choose to believe that if wearables and apps data are put into play, that power will be put to good use.

Outsourced Medical Billing #KareoChat on Twitter

Posted on August 26, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

On Thursday, August 27th at 9 AM PT (Noon ET), I’ll be hosting the #KareoChat where we’ll be discussing the good and bad of outsourced medical billing. You can follow along tomorrow on Twitter by watching the #KareoChat hashtag or by checking out my tweets on @ehrandhit.
Outsourced Medical Billing Twitter Chat
Here are the questions we’ll be discussing in tomorrow’s Twitter chat:

  1. Why are many practices choosing outsourced billing over in house?
  2. What are the disadvantages of outsourced billing?
  3. How will ACOs and value based reimbursement work with an outsourced billing company?
  4. How do you select a high quality outside billing company? What differentiates these companies?
  5. Does your outsourced billing company need to have tight integration with your EHR? Why or why not?
  6. What are the pros and cons of outsourcing your billing to your EHR vendor?

I’m particularly interested in people’s responses to question number 3. I think many in healthcare understand the good and bad of doing the billing in house or outsourcing it. Although, I’m pretty sure I’ll learn even more on the Twitter chat tomorrow. However, how things like ACOs and value based reimbursement will impact an outsourced billing company is still a really important topic of discussion. Will it drive more people towards outsourcing their billing or will it mean more practices bring their billing in house? I’ll be interested to hear people’s thoughts on tomorrow’s Twitter chat or feel free to start the discussion in the comments below.

Periscope and Healthcare – Healthcare Scene “Minute”

Posted on August 25, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Last week I posted a question on EMR and HIPAA: Do You Periscope? I’m sure that many readers had no idea what periscope even is even though there are more than 10 million Periscope accounts created to date. After writing the post, the discussion about Periscope was hopping on Twitter and so I decided that it would be fun to try something new. I call it the Healthcare Scene “Minute”.

What’s the Healthcare Scene “Minute”? Well, I basically hop on Periscope and spend ~1 minute talking about a topic related to healthcare IT. Since doing the Periscope 21 hours ago, I’ve had 24 replay viewers and I had 38 live viewers. Not a bad start. You can view the video on periscope for the next few hours here.

What I realized when I started the Periscope is that many people would love to talk about something more than just the topic I planned to talk about for a minute or 2 (or 3 in the case below). So, for now the Healthcare Scene “Minute” periscopes I do will start with 30 seconds to a minute intro where people get a chance to join live. Then, I’ll talk for a minute on a specific topic. After I finish a quick look into a specific topic, I’ll stay on and answer questions from those who attend for as long as I have time.

In case you missed the live Periscope linked above, here’s a look at the chopped out Healthcare Scene “Minute” video where I talk about Periscope (seemed like an appropriate topic for my first Periscope):

In the Q&A that followed, someone asked an important question, How Can Periscope Be Used in Healthcare? Turns out in my Healthcare Scene minute (which wasn’t much time even at 3 minutes) I mostly talked about Periscope and how it fit in social media and video streaming and not how it applied to Healthcare. So, here’s my in the moment response to how Periscope can be used in healthcare:

I asked on Twitter if I should be consistent in my Periscopes. I decided that I’d be consistently inconsistent. Although, I’m already planning to do the next Healthcare Scene “Minute” today where I’m going to talk about the cost of Epic (Update: Here’s a link to the Periscope stream I did today. I forgot to hit the save button and so it will be gone after 24 hours. Lesson learned!). Hopefully I’ll see you on Periscope.

Accenture: “Zombie” Digital Health Startups Won’t Die In Vain

Posted on August 24, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

I don’t know about you, but I’ve been screaming for a while about how VCs are blowing their money on questionable digital health ventures. To my mind, their investment patterns suggest that the smart money really isn’t that smart. I admit that sorting out what works in digital health/mHealth/connected health is very challenging, but it’s far from impossible if you immerse yourself in the industry. And given how much difference carefully-thought out digital health tools can make, it’s exasperating to watch failing digital health startups burn through money.

That being said, maybe all of those dollars won’t be wasted. According to no less an eminence grise than Accenture, failing digital health ventures will feed the stronger ones and make their success more likely. A new report from Accenture predicts that these “zombie” startups — half of which will die within two years, it says — will provide talent and technology to their surviving rivals. (OK, I agree, the zombie image is a bit unsettling, isn’t it?)

To bring us their horror movie metaphor, Accenture analyzed the status of 900 healthcare IT startups, concluding that 51% were likely to collapse within 20 months.  The study looked at ventures cutting across social, mobile, analytics, cloud and sensors technologies, which include wearables, telehealth and remote monitoring.

While most researchers try to predict who the winners will be in a given market, Accenture had a few words to say about the zombie also-rans. And what they found was that the zombies have taken in enough cash to have done some useful things, collecting nearly $4 billion in funding between 2008 and 2013.

The investments are part of an ongoing funding trend. In fact, digital health dollars are likely to pour in over the next two years as well, with healthcare IT startups poised to take in $2.5 billion more over the next two years, Accenture estimates. Funding should focus on four segments, including engagement (25%), treatment (25%), diagnosis (21%) and infrastructure (29%), the study found.

So what use are the dying companies that will soon litter the digital health landscape? According to Accenture, more-successful firms can reap big benefits by acquiring the failing startups. For example, healthcare players can do “acqui-hiring” deals with struggling digital health startups to pick up a deep bench of qualified tech staffers. They can pick up unique technologies (the 900 firms analyzed, collectively, had 1,700 patents). And acquiring firms can harvest the startups’ technology to improve their products and services lineups.

Not only that — and this is Anne, not Accenture talking — acquiring healthcare firms get a wonderful infusion of entrepreneurial energy, regardless of whether the acquired firm was booking big bucks or not. And I speak from long experience. I’ve known the leaders of countless tech startups, and there’s very little difference between those who make a gazillion dollars and those whose ventures die. Generally speaking, anyone who makes a tech startup work for even a year or two is incredibly insightful, creative, and extremely dedicated, and they bring a kind of excitement to any company that hires them.

So, backed by the corporate wisdom of Accenture, I’ve come to praise zombies, not to bury them. While they may give their corporate lives, their visions won’t be wasted. With any luck, the next generation of digital health companies will appreciate the zombies’ hard work and initiative, even if they’re no longer with us.

Could On Demand Medical Services Be Good for Doctors?

Posted on August 19, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve been seeing a lot of discussion lately about the peer sharing economy and how it applies to healthcare. Some people like to call it the Uber of healthcare, but that phrase has been applied so many ways that it’s hard to know what people mean by it anymore. For example, is it Uber bringing your doctor to your home/work or is it an Uber like system of requesting healthcare? There are many more iterations.

I’ll to consider doing a whole series of posts on the Peer Sharing Economy and how it applies to healthcare. There’s a lot to chew on. However, most recently I’ve been chewing on the idea of on demand medical services. In most cases this is basically the Skype or Facetime telemedicine visit on a mobile device. These models are starting to develop and it won’t be long until all of us can easily hop on our mobile device and be in touch with a doctor directly through our phone. In some cases it will be a telemedicine visit. In other cases it might be the doctor coming to visit you. I’m sure we’ll have a wide variety of modalities that are available to patients.

Every patient loves this idea. Every insurance company is trying to figure out the right financial model to make this work. Most doctors are scared at what this means for their business. Certainly there are reasons for them to be concerned, but I believe that this new on demand medical service could be very good for doctors.

In our current system practices do amazing scheduling acrobatics to ensure that the doctor is seeing a full schedule of patients every day. They do this mostly because of all the patient no shows that occur. This makes life stressful for everyone involved. Imagine if instead of double booking appointments which leads to all sorts of issues, a doctor replaced no show appointments with an on demand visit with a patient waiting to be seen on a telemedicine platform. Basically the doctor could fill their “free time” with on demand appointments instead of double booking appointments which then causes them to get behind when both appointments do show up.

I can already hear doctors complaining about them being “mercenaries” and shouldn’t they be allowed free time to grab a coffee. I’d argue that in the current system they are mercenaries that are trying to fill their schedule as full as possible. The current double booking scheduling approach that so many take means that some days the doctor has a full schedule of appointments and some days they have more than a full schedule of appointments. If doctors chose to back fill no-shows with on demand appointments, then their schedule would be more free than it is today. Plus, if they didn’t want to back fill a no show, they could always make that choice too. That’s not an option in the double book approach they use today.

In fact, if there was an on demand platform where doctors could go and see patients anytime they wanted to see patients, it would open up a lot more flexibility for doctors much like Uber has done for drivers. Some doctors may want to work early in the morning while others want to work late at night. Some doctors might want to take off part of the day to see their kid’s school performance, but they can work later to make up for the time they took off (if they want of course).

Think about retired doctors. I’m reminded of my pharmacist friend who was still working at the age of 83. I asked him why he was still working at such an advanced age. He told me, “John, if I stop, I die.” I imagine that many retired doctors would love to still see some patients if they could do it in a less demanding environment that worked with their new retirement schedule. If there was an on demand platform where retired doctors could sign in and see patients at their whim, this would be possible. No doubt this is just one of many examples.

Currently there isn’t an on demand platform that doctors could sign into and see a patient who’s waiting to be seen. No doubt there are many legal, financial and logistical challenges associated with creating a platform of this nature. Not the least of which is that doctors are only licensed to practice in specific states. This is a problem which needs to be solved for a lot of reasons, but I think it will. In fact, I think that legal issues, reimbursement changes, and other logistical challenges will all be solved and one day we’ll have this type of on demand platform for healthcare. Patients will benefit from such a platform, but I believe it will open up a lot more options for doctors as well.

Brilliant: Hannah Galvin Looks at ICD-10’s Five Stages of Grief

Posted on August 18, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Hannah Galvin, MD has a great article on Healthcare IT News talking about ICD-10’s five stages of grief. You can go read the article to see how she describes it, but the five stages of grief are:

  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance

Pretty fascinating way to describe people’s response to ICD-10. I think we have people and organizations that are still at all 5 stages of grief associated with adopting ICD-10. Although, I think most people have bridged #3.

There are still many people that are in denial and that are angry about ICD-10. Although, that population is getting smaller and smaller. I don’t see many people still bargaining. We went through that stage for years, but I believe it’s over. The largest group of people are stuck in stage 4. I know very few people who aren’t depressed over ICD-10. The HIM profession is more excited about ICD-10 than anyone else, but otherwise it’s a general depression around the change. It’s hard to implement something where you’re not sure what value you’ll receive from it. I think that’s many people’s perspective.

Dr. Galvin’s final comment in the article linked above is also interesting: “Whether you’re ready or not, the transition is less than three months away – and in the end, I believe it will be worth all the grief.” Now we’re less than 2 months away. I’m still not sure it’s worth the switch or not, but it doesn’t really matter. It’s happening either way. I guess I’ve reached stage 5.

ZocDoc’s Company Culture – What’s Been Your Experience?

Posted on August 17, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Company culture has been in the tech news lately after this lengthy article looking at Amazon’s company culture. However, in the healthcare IT world, I was more interested in this recent article by Business Insider looking at ZocDoc’s company culture. The article paints a brutal picture of a “frat house” mentality together with sexism and drugs. Not a pretty picture and it pains me to even read stories like this. However, this part of the article really stuck out for me:

On the sales floor at ZocDoc, employees say there’s a phrase used over and over again: “churn and burn.” Former employees say this phrase indicates the competitive, often stressful nature of work in ZocDoc’s sales division.

“They are full steam ahead,” one former salesperson told Business Insider. “They have this arrogance in the company where the human capital is of zero value.”

A former employee at ZocDoc told Business Insider that employee turnover at the company is high. The company recruits and brings in batches of new employees regularly because so many end up leaving or quitting, the employee alleges.

I definitely know very little about ZocDoc’s company culture. I do know that they raised a lot of money, very quickly. That puts a lot of pressure on your company. First, you have to hire a lot of people over a very short period of time. That doesn’t leave much time to develop a quality company culture. Second, when you raise that much money, you face enormous pressure to scale the company and deliver results. That’s not an excuse for bad behavior (assuming the Business Insider report is accurate), but it could explain how their company culture got out of control.

Company culture aside, their description of their sales organization mimics what I’ve heard from a number of doctors about ZocDoc. I’ve only ever met one doctor who liked ZocDoc. That doctor felt that he got patients he wouldn’t have otherwise gotten and so it was worth it. Every other doctor I’ve talked to said that ZocDoc charged way too much for new patient referrals and so they didn’t use them.

Outside of doctors’ views on ZocDoc’s pricing model, some doctors told me how aggressive the ZocDoc sales people were with them. They’d tell me about being contacted all the time by their sales people. I remember one practice manager telling me that they would never do business with ZocDoc since they hated their sales approach. The practice manager didn’t talk about the ZocDoc product or service at all. The sales person had ruined ZocDoc with that practice.

After hearing so many practices talk about ZocDoc over the years, it resonated with me when the former salesperson described the “arrogance in the company.” That’s the impression I’d been given by the many practices I’d talk to myself. I’m sure the $97.9 million they’d raised in funding (and reports said they’re raising another $152 million) helped perpetuate that culture.

What’s been your experience working with ZocDoc? I’d love to hear from more doctors and practice managers.

WearDuino Shows That Open Source Devices Are a Key Plank in Personal Health

Posted on August 13, 2015 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://radar.oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

New devices are democratizing health. We see it not only in the array or wearable fitness gear that an estimated 21 percent of Americans own (and that some actually wear), but also in innovative uses for mobile phones (such as testing vision in regions that lack doctors or checking athletes for concussions) and now in low-cost devices that are often open source hardware and software. Recent examples of the latter include the eyeSelfie, which lets a non-professional take an image of his retina, and the WearDuino, a general-purpose personal device that is the focus of this article.

WearDuino is the brainchild of Mark Leavitt, a medical internist who turned to technology (as have so many doctors pursuing visions of radical reform in health care). I ran into Leavitt at the 2015 Open Source convention, where he also described his work briefly in a video interview.

Leavitt’s goal is to produce a useful platform that satisfies two key criteria for innovation: low-cost and open. Although some of the functions of the WearDuino resembles devices on the market, you can take apart the WearDuino, muck with it, and enhance it in ways those closed platforms don’t allow.

Traits and Uses of WearDuino
Technically, the device has simple components found everywhere, but is primed for expansion. A small Bluetooth radio module provides the processing, and as the device’s name indicates, it supports the Arduino programming language. To keep power consumption low there’s no WiFi, and the device can run on a cheap coin cell battery for several months under normal use.

Out of the box, the WearDuino could be an excellent fitness device. Whereas most commercial fitness wearables collect their data through an accelerometer, the WearDuino has an accelerometer (which can measure motion), a gyroscope (which is useful for more complex measurements as people twist and turn), and a magnetometer (which acts as a compass). This kind of three-part device is often called a “9-degree of freedom sensor,” because each of those three measurements is taken in three dimensions.

When you want more from the device, such as measuring heartbeat, muscle activity, joint flexing, or eye motion, a board can be added to one of the Arduino’s 7 digital I/O pins. Leavitt said that one user experimented with a device that lets a parent know when to change a baby’s diaper, through an added moisture detector.

Benefits of an Open Architecture
Proprietary device manufacturers often cite safety reasons for keeping their devices closed. But Leavitt believes that openness is quite safe through most phases of data use in health. Throughout the stages of collecting data, visualizing the relationships, and drawing insights, Leavitt believes people should be trusted with any technologies they want. (I am not sure these activities are so benign–if one comes up with an incorrect insight it could lead you to dangerous behavior.) It is only when you get to giving drugs or other medical treatments that the normal restrictions to professional clinicians makes sense.

Whatever safety may adhere to keeping devices closed, there can be no justification on the side of the user for keeping the data closed. And yet proprietary device manufacturers play games with the user’s data (and not just games for health). Leavitt, for instance, who wears a fitness monitor, says he can programmatically download a daily summary of his footsteps, but not the exact amounts taken at different parts of the day.

The game is that device manufacturers cannot recoup the costs of making and selling the devices through the price of the device alone. Therefore, they keep hold of users’ data and monetize it through marketing, special services, and other uses.

Leavitt doesn’t have a business plan yet. Instead, in classic open source practice, he is building community. Where he lives in Portland, Oregon a number of programmers and medical personnel have shown interest. The key to the WearDuino project is not the features of the device, but whether it succeeds in encouraging an ecosystem of useful personal monitors around it.