At SXSW, Hipsters Look for Healthcare Tech Tipping Point

South by Southwest, the conference that made Twitter a household word, now has its sights set squarely on the business of healthcare.

In other words, get ready for more technology-fueled disruption than ever before. At the expanded three-day health track at the annual three-ring film/music/tech circus in Austin, TX, healthcare payers were front and center this week, clamoring for change—or at least trying to get in front of the parade of patients.

"We have good doctors, and we have insurance companies that want to fund the right thing, but it's not working, and all the trends are going in the wrong direction," says Michael Golinkoff, executive vice president of specialty programs at Aetna.

In the current atmosphere of fear and loathing existing between payers, providers, and patients, Golinkoff and a small army of other speakers urge big and little actions to create an atmosphere of trust.

Aetna used SXSW to make a big splash, sponsoring an iTriage "PowerUp" Lounge stocked with healthy snacks, in stark contrast to the usual Texas fare. To create more buzz, Aetna sent a guy in a giant iPhone suit to walk around the SXSW lobby and at parties.

At SXSW, out on the digital frontier, it's all about creating buzz. This conference makes the recent HIMSS event in Las Vegas look like a convention of librarians.

At SXSW, Microsoft threw the biggest party and the entry ticket let you try out an array of cyber-experiments, including a Kinect-powered robot-boxing clash. For added kicks, there was even old-school Austin ladies' roller derby.

At the more sedate campus, where healthcare tech was being scrutinized, Golinkoff talked of Aetna's mission to "use information to try to help what the physician and patient are trying to accomplish be more likely to happen."

He echoed familiar payer themes such as making patients more active participants in their healthcare, and demanding both better quality and lower costs. The consumer tech industry is responding with a flurry of health-related apps.

Other apps are embracing healthcare uses. As many health plan deductibles top $1,000, consumers are turning to non-traditional resources such as Yelp, which sent a vice president to SXSW to defend its use to rate doctors.

No one here seemed to be able to predict exactly what tipping point will totally disrupt the current healthcare system, but strikingly, some were betting on some viral smartphone app like iTriage—a symptom tracker that rates healthcare facilities on their treatment records—having a bigger impact than any federal mandates or industry standards.

But smartphones are no panacea, not in a country where 10,000 people a day will turn 65 for the next 20 years, and where thousands of phones without passwords are lost or stolen annually.

There was a palpable sense of frustration here, of would-be killer apps that clinicians can't or won't deploy, of the hours wasted by physicians who would like to enable tech to do the repetitive tasks that it's good at, but which the current legal and reimbursement system won't support.

"The AMA code about the physician uses of social media is all about the risks you incur in doing so," says Wendy Sue Swanson, a pediatrician at Seattle Children's Hospital. "It isn't really about the opportunities for connecting with patients or curating information during a period of time between wellness visits.

"Two of my employees in my clinic were fired in the last ten days for HIPAA violations. You can imagine how the other 260 doctors in the clinic feel when I try to encourage them to comment on my blog," says Swanson, who is known for her online handle "Seattle Mama Doc."

More and more patients want to use tech to help caregivers. As one session description put it, it's easier for patients to update their status on Facebook than it is to update their health history.

Now, I know it's impossible to reduce all of healthcare to a Facebook or Yelp app. Rating your doctor is not like rating your mechanic. If the patient is being seen for a mental health disorder, how exactly is that supposed to work on a social network?

But in a country where Starbucks spends more money on healthcare than on coffee, and General Motors spends more on healthcare than it does on steel, some sort of tipping point is coming, and technology will play a pivotal role.

Patients are tweeting their conditions, assembling their own social networks without the benefit of doctors or insurers, and payers are seeing their tidy little world explode into a new firmament of small retail clinics and government mandates.

Aneesh Chopra, former CTO of the United States, told a room full of aspiring health tech innovators at SXSW that providers have productive scheduling and billing software, but little else to show patients for all their investment in IT.

Chopra, who left the U.S. CTO position last month to return to The Advisory Board research firm in a senior advisor role, says the "raw material is there. We've seen a doubling of the number of practices who've adopted electronic health records. We're seeing incentives change now, with the Affordable Care Act [with] hospitals paid for value, and we're seeing an unprecedented opening up of data."

For their part, payers are busy figuring out ways to go directly to patients, rather than their traditional interface to employers and providers. "More and more, we're selling to individuals," says Tom Noland, Humana senior vice president of corporate communications. Humana's goal is to "make healthy things fun and fun things healthy."

To that end, Humana built an innovation center at its Louisville, KY, headquarters and Noland brought his vice president of innovation Shankar Ram to his SXSW session.

Where all this really starts to click is when payers start to offer direct incentives to patients for healthy behaviors. A year ago, Humana launched a new subsidiary, HumanaVitality, to do just that. "It's just beginning," Noland says.

Launched in conjunction with Johannesburg-based Discovery Holdings, HumanaVitality builds on Discovery's success in South Africa, Noland says. Patients upload biometric screenings to HumanaVitality and receive rewards as well as a sobering Vitality Age to see how their lifestyle is affecting their health.

In the healthcare system to come, can everyone truly be held accountable in this way? It's too early to tell. But the same tech hipster community that took Twitter viral is now part of the conversation. Don't be surprised if they're increasingly up to speed on the fee-for-service versus accountable care issue. And as SXSW observers have learned from history, where those hipsters go, customers will follow.