Does healthcare have the prescription for valuing IoT?

A lot of techies are talking about the Silicon Valley prepper movement highlighted in the most recent issue of The New Yorker. But an article from the magazine’s Jan. 23 issue is probably more important for the future of technology lovers. It doesn’t have to do with overwrought tech executives getting LASIK to avoid wearing glasses post-apocalypse, but it gives a good idea of one of the psychological biases we’ll have to overcome as we implement the internet of things.

The article, “The Heroism of Incremental Care,” discusses how medicine has a savior complex that rewards heroic intervention while ignoring the value of incremental care. It ties that focus on valuing a big fix over incremental improvements by tying it to our national infrastructure. It points out that we have neglected the incremental maintenance of bridges, roads, water plants, etc. because politicians hate to spend on maintenance but love giant, new projects.

From the article, which spends a lot of time discussing  how we need to change the way we pay for healthcare to value the incremental efforts over the heroic ones:

The coming years will present us with a far larger concern, however. In this era of advancing information, it will become evident that, for everyone, life is a preexisting condition waiting to happen. We will all turn out to have—like the Silver Bridge and the growing crack in its critical steel link—a lurking heart condition or a tumor or a depression or some rare disease that needs to be managed. This is a problem for our health-care system. It doesn’t put great value on care that takes time to pay off. But this is also an opportunity. We have the chance to transform the course of our lives.

So how does this relate to the internet of things? Many of the insights that connected sensors and data analysis deliver are tied to preventing problems. Preventative maintenance is one of the most common rationales for deploying connected sensors in factories.

It’s also one of the most popular business models that companies consider when developing a connected product. The idea is that connected products will tell you before they fail and give consumers or the product’s provider a chance to fix it before it breaks. I’ve heard it from HVAC companies, from large appliance makers and even car manufacturers.

The challenge is that, just like with politicians, preventative maintenance isn’t something people want to pay for. And if it works, people forget there was even a potential problem in the first place.  That makes it less likely that people will value the prevention it for what it’s worth.

It also makes the savings harder to see when trying to defend a project or calculate a return on investment.  It’s hard to track something that doesn’t happen, whether it’s a machine that doesn’t break down or a heart attack that doesn’t happen because someone kept their blood pressure under better control.

The New Yorker article explains how the medical industry currently reimburses people more for heroic care while marginalizing the value of incremental care. For IoT, companies will need to figure out how to value improvements that gradually fade into the background.

People say that you don’t know what you have until it’s gone. But we’re moving to a world where you may never have to deal with something important that breaks down or goes missing.  So how will we ever know what we have?

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