Consumerization Hits Health, Part II: Where Is Our Health Data?
Apple >> Epic
A few weeks ago, I shared a graph (at right) here and on Twitter, asking “What does it mean for health tech, and the future of our health, when Apple makes more money on AirPods than the top ten EHR vendors combined?”
And got some interesting comments, most of them along these lines:
Total non sequitur. Enterprise business software (for one vertical industry in the US) isn’t comparable to a consumer hardware device sold worldwide.
– Dan Munro (@DanMunro) January 9, 2020
So how is AirPods revenue versus EHR revenue related to the future of health? Non sequitur? Meaningless? No: saying that is like saying that Apple has nothing to do with Epic because they’re “in different sectors”. But Epic’s furious resistance against proposed HHS data-sharing rules shows they understand that those sectors overlap.
AirPods data is health data
AirPods (and everything else Apple sells) and EHRs are engines for generating health data. EHR data is health data. AirPods data is health data — just as much as the rest of the data on your smartphone, and in your email and Amazon and credit card accounts.
For most of us, the determinants of our health have a lot more to do with things like what we buy at the supermarket (diet), and how far and how often and how fast and when we move every day (activity, sleep quality), and how we speak and type (fine motor control and state of mind), and probably our credit score (finances, stress) than anything contained in an EHR.
AirPods on one level are tools to listen to music, and to make phone calls. On another level, they are devices that record how much we talk, and what language we use, and how those things change over time. In the very near future (see Apple patent image at right), they will probably also be devices to record our movements, and maybe our heart rhythms and blood glucose. And they are connected to other devices that store even more health-related data — including, increasingly, that EHR data.
The fact that Apple is making more money selling AirPods is directly related to the amount of data about you that Apple has access to. And that [health] data is going to be the most important factor in health innovation as we move squarely into the age of AI — so it’s important to consider where the greatest share of it will be created.
The tail and the dog
So how much more health-related data do we now have outside the healthcare system than inside the healthcare system? It’s hard to come up with good numbers, but here are my best estimates (notes):
50EB of consumer data generated annually
0.2 exabytes of EHR data generated annually
So as a country, the US has about 250 times more consumer data than EHR data.
And for those who say most consumer data isn’t health-related (which is like saying “most of the stuff you do in your life isn’t health-related”), fine: let’s assume that 90% of it is useless or not health-related (very unlikely). And let’s also generously assume that all the data in EHRs is useful and health-related (also very unlikely).
That still leaves us with more than 96% of health data . . . outside the healthcare system.
Note: chart assumes that 90% of total consumer data is unrelated to health or otherwise useless. This is almost certainly wrong: the blue part should be WAY bigger. (with apologies to @cwhogg and probably @EdwardTufte, too).
Q: If we have at least 25 times more consumer health data than EHR data, where is health innovation mostly going to happen? In the hospital? Or at Apple, Google, and hundreds of startups?
A: It’s going to happen where the data is.
More than 96% of health data is consumer data