Google and Fitbit: A Data Play?

We learned not long ago that Google is acquiring Fitbit. It’s easy to see why.

Data and users may sound like the main consideration for this deal, but there is more at play. 

Hardware meets software

Over the last several years, Google has shown its appetite to increase hardware offerings. The idea is that consumers are attached to their gadgets and creating detailed transactions in such devices. Products such as Nest, Google Pixel (mobiles) show the promise of hardware for Google. Combined with Google Assistant software, it becomes clear how data from such devices can influence behavior or empower you with new information or new actions. 

Expanding hardware – wearables

It is no secret that Google plans on bolstering its presence in wearables – notably smart watches. According to the FT, the deal for Fitbit is an attempt by Google to catch up with the Apple Watch by buying a consumer wearables company. 

This allows the company to expand into the wearables category while feeding it algorithms from search and products that it’s famous for.

Healthcare Play

Yet, before the Fitbit acquisition, it wasn’t clear how this all aligns specifically to healthcare for Google especially considering public knowledge of the company’s laser focus on Google Cloud B2B offerings. 

Notwithstanding, moonshot research projects in diabetes and kidney disease prediction via Verily, it was still years out with a go to market product. 

With B2C in the company’s DNA, it was in dire need of a healthcare product already in the market. As such Fitbit fits the bill – a wearable product, direct to consumer, ability to integrate existing software ie Google Assistant, captive user base and an enterprise customer base that includes rich insurance payers and government entities who manage millions of consumers.

EHR Data interoperability: Apple, Google, CMS and FHIR

Data interoperability is the flavor of the month. Everyone is working on it.

Different EHR providers mean ‘proprietary data’ and impact to revenue hence naturally system A can’t talk to system B when patient changes health plan, provider or employer benefits

Apple may be bringing disruption with its consumer play.

Apple launched its Health Records platform with over a dozen partners.

While about 40 health systems are now primed to sharing their medical records with patients through the iPhone Health Records app is impressive, what’s particularly interesting is Apple’s bet that consumers will be empowered to share this data with an ecosystem of digital health apps (developers) on their phones and providers and drive their own insights.

This is particularly a new approach with EHR portability which is usually system led rather than consumer led.

To make this all possible, the industry had to agree to one standard – Fast Healthcare Interoperability Resources (FHIR). This then serves as a connector to read and port data to/from from an EHR. Apple’s partners include top tier systems such as NYU langone Health, Stanford Medicine, The University of Chicago Medicine and John Hopkins hospital.

While Apple is pursing a B2C play, Google continues it’s domination in B2B via acquisitions.

Google’s Apigee (acquired in 2016) has apparently been working with several healthcare companies, including Walgreens, Kaiser Permanente to build links between data streams connecting existing data sets in disparate systems and finding new ways to ingest data from other sources. It’s strategy is to build an ecosystem of developers that are native to Apigee’s API.

There isn’t much data yet on adoption except in the single payer UK NHS where Deepmind (another acquisition) and Google’s AI arm has rolled out a number of limited hospital rollouts of it’s Streams app.

With use of the Apigee API, come storage requirements. Apigee sits under Google’s relatively new Cloud division so naturally it’s aim is to sell cloud services to these organizations to catchup up to Amazon’s Web Services and Microsoft Azure.

Lastly, the government has taken a stand to accelerate interoperability. Championed by White House advisor Jared Kushner, CMS debuted blue button 2.0 in March. The premise is patients should have access to their medical data wherever they go throughout their lifetime. As such it is requiring health plans to share data on Medicare participants. CMS requirements include requiring providers to update their systems to ensure data sharing, allowing patient’s data to follow them after they are discharged from a hospital and streamlined documentation and billing for providers.

As data becomes a commodity, non differentiated EHR incumbent providers such as Epic, Allscripts, Cerner will have to revisit their business models due to competitive new entrants and reduced revenue.