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There is an interesting opportunity and threat that results from partnerships between companies like IBM and healthcare organizations like MSK. On the one hand, patients able to receive care at MSK receive the most advanced cancer care available. This is of course a positive outcome. On the other hand, patients who are not able to receive care at MSK are relegated to treatment centers with less advanced diagnosis and treatment protocols. This triggers the potential for inequality in care, and threatens the democratization of healthcare that healthcare IOT promises to promote. IBM and MSK should be measured on how quickly they can help disseminate the lessons and best practices they have developed to other centers, so that more patients can benefit. While researching my post I came across a similar strategic alliance between Radboud University Medical Center and Philips (See Shipilov, A. A Better Way to Manage Corporate Alliances. Harv. Bus. Rev. (2014).) While providing substantial benefits to patients at the pilot center, such alliances can drive the most benefit if they are complementary and not exclusive. It would be a shame if IBM could not partner with other medical centers because they have already entered into another partnership with a similar digital partner. As healthcare IOT matures, there is an opportunity for business model innovation. Structuring win-win alliances that are complementary, and help to accelerate the positive impact of healthcare IOT would accelerate the overall uptake of healthcare IOT and maximize value for patients, healthcare providers and payers.

On November 20, 2016, mar commented on Evaluating New Drugs with Wearable Technology :

This is an interesting example of how regulatory bodies and healthcare innovators can work together to help drive positive change. I was encouraged when I came across FDA approved applications for mobile phones (See The FDA’s flexibility in approaching healthcare IOT is commendable. I wonder if there is room for more cross-company collaboration in developing standards for how data can be collected, managed and analyzed as part of clinical trials that leverage healthcare IOT. Such standards could help accelerate the regulatory review process. The last thing we want is to slow-down the FDA with multiple competing platforms designed to speed up drug development in their own way!

On November 20, 2016, mar commented on Medtronic: Adding an “M” to “IoT” :

This is an interesting analysis of how Medronic is evaluating its role as part of the healthcare IOT ecosystem. One area where I would like to see Medtronic (and other firms) take a more active role is in the development of standard platforms for customer facing applications. For example, there is likely to be increasing customer confusion as individual companies develop healthcare IOT platforms. Apple, Samsung, Google and Philips have developed HealthKit, SAMI, Google Fit, and HealthSuite, respectively. (See Sullivan, M. Salesforce and Philips partner in ambitious health data venture. Available at: for more information). Each platform has merits and is appropriate for various usage scenarios, and each has relative weaknesses. The ease with which a healthcare provider and patient can use a platform that powers a medical device or sensor may help determine uptake and use of such technologies. For now, the proliferation of platforms may actually be slowing growth of the segment as healthcare providers and patients wait on the sidelines until a market leader emerges. This is an opportunity for the industry to work together to accelerate progress!

The third challenge you raise (lack of standardization) is very interesting. Based on some research I read as part of my post (Dimitrov, D. V. Medical Internet of Things and Big Data in Healthcare. 22, 156–163 (2016).), it is clear that legacy EHRs are the root cause of some information sharing hurdles. These legacy EHRs fragment data into organizational silos. In my view the recent healthcare reform did not do enough to force the transition of old, siloed EHR systems, to more modern and open systems. EHR companies will always resist a fully open system because they want to increase the cost of switching away from their platform. I think it is the role of regulators to introduce some tension into this equation, and force a degree of openness that maximizes value for healthcare institutions, payers and patients. Your action plan to enhance standardization across institutions would be a great industry-driven step forward!

This is a thought-provoking analysis. is taking an interesting approach in tracking “passive” data via a mobile phone. I wonder if they could also leverage external sensors to further help evaluate patient health status? While doing research for my post I came across the CareCensus platform ( which integrates a high touch interaction model with in-home sensors that can detect when a patient is experiencing distress. My main criticism of the model is that it is overly reliant on mobile phone use as a proxy for good health. As the population ages, more and more patients will experience mild cognitive decline and mental health issues. These patients may not use their phone on a regular basis, decreasing the value of a phone as an input source. I think there is an opportunity for a wearable device that can be integrated into the platform, and which extends its utility. There is research to suggest wearable technology could be used to greater effect in this context (Hentschel, M. A., Haaksma, M. L. & van de Belt, T. H. Wearable technology for the elderly: Underutilized solutions. Eur. Geriatr. Med. 7, 9–11 (2016).)

On November 7, 2016, mar commented on Can the Miracles of Science(TM) Deliver Another Miracle? :

I thought this was a very interesting post. You made great use of evidence to support your views. DuPont is a unique position in that it is able to implement both climate change adaptation and mitigation strategies. The areas you’ve focused on (food security, alternative energy, energy efficiency) can have a great impact on other areas likely to be stressed by climate change (e.g. health, local and international conflict, etc.). In response to the question you pose in your last paragraph, I think factoring in these “knock-on” effects can help businesses focus on the long-term impact of their climate change initiatives, despite constant pressure to deliver near-term results.

I think the potential solutions you’ve outlined are very creative. Thus far, many of the posts have focused exclusively on the risks of failing to adapt climate change adaptation and mitigation strategies. There are significant direct and indirect benefits associated with taking on such strategies, however! It is clear cities will play an important role in climate change mitigation and adaptation. One article I read (Lancet 2015; 386: 1861–914) even suggests that by forming networks with other cities, cities can “…address climate change in ways that are often more flexible and more directly applied than those of the national or international levels.” It is encouraging and inspiring to see Detroit leverage its capabilities to turn a potential threat into an opportunity.

I think the idea of partnering/collaborating to advance climate change mitigation/adaptation efforts should be expanded. There are a few examples of this taking place (See United Nations Global Compact (UNGC). Business and Climate Change Adaptation: Toward Resilient Companies and Communities. (2012).), but in general they are rare. It’s great to see two industrial giants see the light! There is substantial value that can be gained from these kinds of partnerships. Personally, I’d like to see more stakeholders get involved. Industry-academic and government partnerships may yield even better results.

On November 7, 2016, mar commented on Aramco: Oil Giant Feels the Heat :

I agree with your suggestion for self-imposed, stringent emissions standards. In completing this assignment I was able to find surprisingly detailed climate change mitigation and adaptation goals outlined by multinational conglomerates. What gets measured gets managed, and it would be fascinating to see Aramco quantify the positive impact it could have on climate change. As seen in this video (, clear climate change mitigation and adaptation goals can be good for the planet, but also good publicity.

On November 7, 2016, mar commented on Climate Change & Whisky: The Sobering Realities :

This is a great post that highlights an interesting question. What will be the ultimate impetus for highly impactful climate change efforts: Government regulation or strict self-policing? The former seems more likely, but countries like Scotland, with a delicate ecological balance and entire industries that depend heavily on the natural environment, may demonstrate otherwise. My personal view is it will be some hybrid. See
for American companies that have voluntarily made commitments to climate change mitigation in response to the US American Business Act on Climate.