Royal Philips International seems to be placing its bets on some innovative healthcare IT markets. Here are some that I’ve noticed in the past couple of years:

• VISICU (a remote ICU monitoring technology company acquired in 2007)
• Digital Pathology (commercial offering in 2009)
• Motiva (Remote patient management and education delivered through television)
• TeleStation (In-home hub for two-way communication between provider and patients with chronic diseases, integrated with wireless measurement devices)

The list above is not comprehensive by any means, it’s just what I could recall right away. Without making this a post about Philips’ strategy, here is the latest addition to my personal list of innovative Philips Healthcare IT offerings- DirectLife activity monitor. It tracks your physical activity (through a triple axis accelerometer) to calculate calories burned. Results show up on a personal webpage (detailed) and on the device (simple indicator lights).

It’s like FitBit, but with some design differences – DirectLife is waterproof and needs USB-based sync (FitBit is wireless through a hub). Most importantly, DirectLife comes with a coach- a real person to provide inspiration and assistance to meet your target weight or activity level. The device (hardware) is $99, but coaching is a monthly subscription of $12.95 (first four months free).

The entry of Philips in this lifestyle-tracking arena makes the proposition more legit for mass adoption- now the HR departments of large enterprises  can think of offering it as a health benefit, maybe health insurance companies will pay attention too. FitBit is a great device in itself, but what’s needed is a “wellness service”, much like what DirectLife is starting to sound like. My prediction is that we’ll see proliferation of such services in the next few years- maybe even a lower premium option in your medical insurance if you choose an integrated activity tracking service.

NLM may not be known for Health 2.0 efforts, but this one surely qualifies for one. Pillbox.nlm.nih.gov is a fantastic tool that lets users identify medications by the way they look. A beautiful Adobe Flex powered interface enables selection of various physical characteristics like shape, color, size etc. and comes up with matches.

The website is not currently recommended for clinical use- mainly because the images have not yet been verified by pill manufacturers. Still, it’s a smart tool that can benefit multiple care settings. Many seniors coming through the emergency room and clinics don’t remember the name of their pills, but can recall its visual characteristics. A tool like this can be a great addition to EMRs and even PHRs.

RememberItNow is an online medication reminder service. Once you enter the pill information (what, when) it can send email/text reminder messages at the right time. Also included are some features around access control , scheduling, charting, journal etc.

The site was inspired by a true story, and I agree that we can do better by utilizing web technology for medication adherence. But I’m not sure if there is a need for a devoted web service just around medication reminders. They are currently in beta so all services are free, but looks like they will offer paid accounts once they are out of beta.

Reminder functionality is best served as a part of a bigger PHR platform (like Google Health) and in most cases, there are generic substitutes available. For example, why not use 30Boxes or Reqall or even your Google Calendar instead of paying monthly subscription? All of these are capable of sending reminders at a preset time. Medication reminders is an important issue, but emails/text is not going to be the complete answer imho. Especially given the fact that most of the people having trouble remembering are in an age group where emails/text are not the choice of communication anyway. That is why devices like ePill exist.

ZocDoc is a free service that allows patients to book Doctor appointments online in New York City. It started in September 2007 as a service to help people find and make dentist appointments in NYC, and has now includes other specialties too (like primary care, dermatologist, ENT, ortho, OB/GYN, allergist, podiatrist, etc.)

Patients get to use the site for free-  looking up physicians that accept their insurance and setting up appointments with them. Apparently, physicians need to pay to join ZocDoc and their enter availability info. Given their recent start, focus on one metropolitan area, the monthly unique visitor count is significant (20K+ according to dataopedia).

Interesting idea overall, kind of OpenTable.com for clinical care. The fact that you can set up a guaranteed appointment with a care provider today is a great feature (hard to execute in all cases though). What blows me away is the backing they have- Khosla, Bezos and Benihoff! That has got to be the most incredible investment partner team I’ve seen so far in any small healthcare IT startup.

While the conventionalists argue otherwise, there is some truth to the fact that plenty of health conditions can be taken care of without actually seeing the patient in-person. Based on that assumption, AmericanWell offers an interactive service that lets patients talk to a physician in real time, anytime.

The service went live in January this year and initially focusing on Hawaii. The basic ‘interactive consultation’ uses two-way video conferencing, audio and secure text chat. It’s a step-up from the usual definition of a ‘e-visit’ which are mostly asynchronous text-based communication. Patients join for a fee, as I understand (what frustrated me was that I couldn’t find how much the fee was. I would have expected that to be extremely obvious!). Physicians sign up and make themselves available in aggregated pools of their respective discipline, which in turn are tapped into by patient demand.

So will the health plans pay for this? Until now they had signed up only two customers- the Blue Cross-Blue Shield plans in Hawaii and Minnesota. Last month, United Health Group, the largest private health insurer in the U.S., said it would begin deploying American Well’s platform across its huge network of more than 70 million members.

The concept has some viability for sure. But like anything else, it remains to be seen how well it can permeate through the tough, unyielding US healthcare system. I’m sure we’ll see many more startups with similar approaches soon.

PharmaSurveyor is a free service that analyzes your medications to point out potential drug interaction and side-effect risks. It was founded in 2006 by Linda and Erick Von Schweber to commercialize the ‘knowledge surveying’ technology they have developed over the last 25 years or so.

Given the fact that Adverse Drug Effects (ADE) are one of the leading cause of death in the US, there is significant market opportunity in consumer education and support around it. Couple of nifty features that I like:

• Direct meds import from Healthvault
• Community Knowledge Base – an aggregation of information and experiences from people who are on multiple drugs. This feature is currently in private beta, but I think that it can be a great revenue opportunity once it gets some traction in terms of number of users. There are plenty of pharma companies who would pay good money for getting early (even though informal) insight into side-effects, efficacy, interactions, and usage patterns of their drugs.

Seems like they are planning to integrate with DestinationRx and Polka, which is a good idea since the traffic from those sites will already be primed for the services that PharmaSurveyor provides. The advisory board has some significant names, including Barney Pell, Matthew Holt and Mark Musen.

They do have some interesting marketing techniques like analyzing celebrity cocktails, not requiring registrations, etc. Business model seems to be only google ads for now, which is no surprise given their research-oriented background. The site is more a proof-of-concept for the underlying technology (although I’m not sure what it is exactly). It’ll make a lot of sense to integrate this service with commercial CIS offerings, and take it one step beyond just using RxNorm.

As I mentioned previously, the hype of personalized medicine is breeding a new industry-direct to consumer (DTC) Genetic Testing. These companies offer to test, analyze and store your genetic information for you. Navigenics entered this arena in April’08, with some stellar credentials in terms of team, funding (KPCB, Sequoia among others) and collaborations (Mayo, Partners, Duke, Scripps, MedScape, etc.).

Here is a simple overview of their offering: pay $500 to be tested for 10 common conditions or upgrade to $2,500 for all conditions (28 currently). The upgraded package has perks of genetic counseling, personalized updates and educational content for a year.  Beyond  that you pay $250/year to keep it going. What sets Navigenics apart (as I understand) is that they only tell you your results from the perspective of these 28 (and growing) conditions whereas others (deCODEme, 23andMe) let you ‘explore’ your results for every trait/condition they are continuously covering.

Regardless of what company it is, the question remains that how much can you learn from you genetic profile? If you are at 64% risk for Diabetes type 2 and 47% risk for macular degeneration, what can you do about it?  Well, the advice would mostly include one or more of- exercise,  dont smoke, eat healthy, avoid alcohol, sleep well, vitamins, lookout for warning signs etc. So why get the test; you should be doing all that anyways. I’m not knocking down genetic testing per se, just trying to find utility for it in a DTC model.

The future of healtcare is more personalized, for sure. I’m happy that the commercial foundation for it is being laid down right now. But personally, I wouldnt invest in these services till we firmly and clearly establish an end-to-end causal linkage between genes, diasease, and therapy. We havent even agreed on how important is the role of enviornment and habits (is it only genes that determine a disease outcome?) Heck, who said it’s genes- what about proteomics?

Consumerism is on the rise in healthcare, and MyMedLab brings that trend to the Lab testing space. With their service users can self-order wellness lab exams online and walk-in to the lab nearest to their zip code. Note that this doesn’t include all possible lab tests, but only the subset that don’t require direct physician order.

The price they charge includes collection fee for sample draw, ordering physician fee (i.e. lab order approval, result review, consultation) and a Personal Health Record (where you can view and store the results, among other things). Users pay upfront for the tests and have the option to receive a receipt to submit for reimbursement from an insurance company or a health savings account.

There are several other players in this direct-to-consumer lab testing, like DirectLabs, HealthCheckUSA, MedLabUSA. The benefits of these services are tangible- lower cost (specially for the uninsured, who don’t want to pay for the visit to the doctor), convenience, speed and privacy.

But not everything is that straight-forward. Most insurance companies will not reimburse patients for tests that were not ordered by a physician, so the target market is restricted to people who are health-conscious and rich enough to pay for self-initiated disease monitoring. Jury is still out on many aspects- who approves these tests medically? Who carries the legal burden? Is it okay to let patients self-diagnose themselves? what about misinterpretation of results? IMHO, there is a market and advantage for direct-to-consumer lab testing, even if the healthcare system doesnt recognize or reimburse for it yet. Also, these services would look pretty good as applications on PHR platforms like Google Health.