Sunday at SXSW: Healthcare costs and cancer

Jill and Joe Biden took the stage at SXSW on Sunday. 

Two things can happen to a trend at industry get-togethers like SXSW: It can be anointed or it can die. There's rarely any middle ground. Last year's poster child is often this year's cautionary tale.

And so it is with wearables. You remember wearables, right? Judging by the number of Fitbits and Apple Watches adorning the wrists of SXSW attendees, a sizable percentage of the population here certainly does. But as an industry, and especially one now questioning the utility of much of the data it was so eager to collect, healthcare seems to have moved on.

Of the 70-plus health sessions at this year's SXSW, only one (“Accuracy: Consumer Wearables & Research Converge”) specifically addressed wearables; a second (“Screening for Heart Disease with the Apple Watch”) touched on the subject peripherally. And the leaders of that one wearables-specific klatch expressed concern about the reliability of data culled from wearable devices.

See also: Saturday at SXSW: Hooray for health

Asking around, I got the sense that the diminishing interest can be attributed at least in part to fatigue. After 30 months of hearing how wearables were poised to effect a tectonic shift in the healthcare universe, some wonder why there hasn't been more in the way of quote-unquote breakthroughs. Factor in what some of them characterize as consumer indifference — one exec dismissed the current wave of wearables as “stuff you use for a few weeks, then throw in the drawer and forget about” — and, well, let's just say that the buzz has subsided to sub-audible levels.

It's notable that the most vocal and enthusiastic wearables advocate out there right now might be Under Armour, which seems as much a technology company as a fitness one nowadays. Fitbit? We'd love to get company digital-health guru Adam Pellegrini's take on this, but his PR rep has been less than responsive. Can any of y'all make an introduction? Much obliged.

Emptying out the rest of my SXSW notebook:

1. Welcome to the backlash, Watson Health. Perhaps it has something to do with IBM Watson Health's ubiquity in future-of-health think pieces, or perhaps it's just jealousy. But man, the Watson doubters weren't shy about slagging healthcare's poster child for machine learning, some going so far as to dismiss it as a mere triumph of self-marketing.

When a “Connect to End Cancer” panelist brought up the $62 million that the MD Anderson Cancer Center reportedly spent with Watson without seeing much in the way of results, the two responses that followed were borderline catty: “[Watson is] tackling the wrong problem… They're taking drugs and trying to do Netflix-style matching of drug to tumor” and “Watson is still learning to be a doctor, but one thing it's really good at is being a student. It can read everything, but that doesn't mean it knows everything.”

2. Walmart and innovation? More like, Walmart and scale. Walmart veteran Marcus Osborne slid into the new post of VP of health and wellness transformation about a year ago, not long after he played a pivotal role in building and implementing the retailer's Health Care Begins Here educational initiative. Turns out that he has plans to throw Walmart's weight around — not just in the general-health space, but also in cancer care.

That effort, as Osborne described it during the first “Connect to End Cancer” session, will be thoroughly consumer-centric. “To understand our interests, you probably need to understand our perception of the broader healthcare reality,” he said. “More times than not, the solutions we see are designed around the payer or product manufacturer and too often fail from a consumer perspective. They're not built around consumer needs.”

Osborne added that Walmart is in a better position than most to assess the current state of affairs. “In a given week in the United States, more than half of all Americans visit us at least once — and they're here for an hour per visit. We hear, ‘We are happy, but we are struggling,'” he continued. “Healthcare is one of the key challenges in that struggle.”

Regarding future healthcare plans, Osborne added, “We don't innovate — we're not an innovative company — but we allow innovators to scale… [The goal is] to unlock assets within Walmart and spin out new ventures that address various healthcare needs.”

3. Doctors, surprisingly, evangelize for transparency on costs. Let's face it: Deep dives on healthcare costs and pricing are kind of a tough sell, especially when programmed against other sexier topics. So kudos to Harvard Medical School's Dr. Neel Shah and his cohorts at the nonprofit Cost of Care, which gathers information about healthcare costs. They somehow transformed a session about helping physicians become more savvy about the price of procedures and medications into one of the day's most thoughtful and even entertaining presentations.

During “Hey Doc — How Much Will That Cost?,” Shah and lieutenants Drs. Vineet Arora and Christopher Moriates didn't just rehash the usual lines about doctors remaining relatively ignorant about the costs associated with drugs and services, they detailed what they're doing about it. (“No matter how good your doctor is, there's a question they won't be able to answer: ‘How much will that cost me?' I know, because I'm a doctor,” Moriates cracked)

“I felt like people who recognized this as an issue were the ones who were the most disenfranchised. They were the people who have already been burned,” Shah said. “It was only a decade or so ago when I was in medical school. I was specifically told that it wasn't my job to think about this stuff.”

4. President Trump, to no surprise, provokes strong responses. During the third “Connect to End Cancer” session, Columbia Business School adjunct professor and a Rock Health founder (and 2016 MM&M Top 40 Healthcare Transformers honoree) Halle Tecco asked the following question: “Mr. Trump — he has called the FDA slow and burdensome and put pressure on drug companies around pricing. What do you anticipate changing for innovators, patients, and industry? What would you tell him?”

Here are the responses that followed, presented without comment.

“I don't look to authoritarian regimes for any sort of task I'm hoping to accomplish in the world…They're nothing but an enemy to everything I'm trying to accomplish. I'd ask for nothing except for them to step down. F*** that guy.” – Jeff Hammerbacher, Hammer Lab

“From what I've seen in government, the civil servants are the ones who make it go…You have to be a little bit agnostic to what the administration is if you're going to keep your business running…There's still some amazing people there.” – Aman Bhandari, Merck

“[FDA commissioner nominee] Scott Gottlieb is a decent guy, very smart. He's more conservative than I am, but he respects the process…People don't get that the FDA commissioner can't just reach down and approve a drug. As for cancer, nothing Trump says about any aspect of the FDA is true. We approve [drugs] faster than anyone in the world…If you speed things up, patients get access sooner for drugs you know a lot less about. Every regulation has been written in blood. Every regulation got there because people were harmed.” – Greg Simon, The Biden Foundation

Hey, you ask a big question, you get big answers.

5. Diamond Joe wows the crowd. You can read longer reports about Vice President Joe Biden's rousing speech elsewhere. (Here's the Los Angeles Times' take.) But know this: If he can convert even one-tenth of his energy, charisma, and passion into results, we're gonna have a cure for cancer before too long. At SXSW, a get-together featuring actual rock stars, Biden blew everyone else off the damn stage.

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