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At CES, A Tractor And A Patient Stethoscope Point To Digital Health Future

By MICHAEL MILLENSON

A Deere tractor developed in Moline, Illinois and a stethoscope-for-patients from Singapore pointed to the future of digital health at CES 2023, the Consumer Technology Association gathering that’s become a global innovation hub.

The tractor appeared on a large video screen during the opening keynote by Deere & Company chief executive officer John May. The industrial company exec clearly relished the chance to trumpet the way Deere had turned tractors into high-tech tools to optimize farmers’ outcomes ­– an accomplishment inspiring envy among medical information mavens hoping to similarly transform patients’ outcomes.

“The John Deere presentation was one of the best technological presentations I have ever seen,” enthused ResMed chief medical officer Dr. Carlos Nunez at a later panel. Nunez pointedly noted that “you think health care would be difficult,” yet here Deere had revolutionized a centuries-old, rural, agrarian, manual profession.

Deere’s “smart machines” incorporate computer vision, soil moisture sensing, GPS with precise signal correction, machine learning and cloud computing, all of which enable farmers to plant corn, cotton and other crops “with precision beyond human capacity.” Farmers can track the tractor’s data collection with their smartphone and make real-time adjustments. In health care terms, that all adds up to personalized, evidence-based farming.

The technology gap between physicians and farmers is actually wider than May let on.

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Pressed to Demonstrate Utility, Digital Health Struggles — Just Like Traditional Medicine

After absorbing several years of increasingly extravagant promises about the remarkable potential of digital health, investors, physicians, and other stakeholders are now unabashedly demanding: “Show me the data.”

By now, most everyone appreciates the promise of digital health, and understands how, in principle, emerging, patient-focused technologies could help improve care and reduce costs.

The question is whether digital health can actually deliver.

A recent NIH workshop, convened to systematically review the data on digital health, acknowledged, “evidence is sparse for the efficacy of mHealth.”

As Scripps cardiologist Eric Topol and colleagues summarized in JAMA late last year,

“Most critically needed is real-world clinical trial evidence to provide a roadmap for implementation that confirms its benefits to consumers, clinicians, and payers alike.”

What everyone’s asking for now is evidence – robust data, not like the vast majority of wellness studies that experts like Al Lewis and others have definitively shredded.

The goal is to find solid evidence that a proposed innovation actually leads to measurably improved outcomes, or to a material reduction in cost.  Not that it could or should, but that it does.
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Will Consumers Pay for e-Health?


Lots of health startups out there are trying to zero in on ideas that will improve the lives of patients with chronic conditions. And even though patients are the target audience of this technology, companies seem to be designing their products by first asking, “What will health care providers and and health insurers pay for?” It makes sense, assuming that these two groups will foot the entire bill for electronic health (e-Health) innovations. But it doesn’t make common sense. Why not design the tech for those who are going to use it in the end?

The discussion came up at the Digital Health Summit, a two day conference at the International Consumer Electronics Show. Health 2.0′s Matthew Holt moderated a segment called “Who’s Paying the Bill for e-Health?” When Holt asked a panel if consumers would be willing to pay, Senior Advisor of of the American Association of Retired Peoples Bill Walsh indicated that most AARP members would answer “no.”

“What they’re telling us about mobile health is, ‘Gee, this is interesting but why isn’t my insurance company paying for this? This is just another medical device,’” Walsh said.

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