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Intel’s prescription for national healthcare reform: x86 Rx

The rising cost of healthcare is on everyone's mind right now, and Intel has …

With healthcare reform currently the number one topic of discussion in Washington DC, chipmaker Intel is seizing the moment in order to gain exposure for its own health product, the Intel Health Guide. In a recent Politico op-ed, Intel CEO Paul Otellini argued for moving personal, preventative care into the digital age (with Intel inside, of course). At yesterday's Intel Technology Summit, Louis Burns, VP and General Manager of Intel's Digital Health Group, also spent some time talking in detail about the product.

You're probably wondering why Intel, which is a fab-driven component company, is building not just an end-user gadget, but an entire enterprise-class IT system. Intel may have the expertise to do this, but to say that it falls well outside the chipmaker's wheelhouse is an understatement. It's worth taking a look at the larger dynamics that are driving Intel into the health systems market, because it says something important about the present moment in computing. In short, insofar as Intel's capacity to produce cheap transistors is exploding faster than the existing computer industry's ability to absorb those transistors, Intel is fast becoming a victim of its own success in driving Moore's Law.

Keeping tabs

We've covered the Intel Health Guide before, when Intel and GE announced their partnership on the project this past April, but this time Burns gave the audience a practical look at how it works. The user-facing component of the system is a small, touchscreen-based unit, designed for the elderly, that can be loaded with data like treatment, exercise, and diet plans by a healthcare provider.�

The IHG uses data input by the senior himself in the form of answered questions (e.g., "does your chest feel tight this morning?") to offer up small interventions.�For instance, the unit may determine that the senior needs more of a specific type of exercise, so it will show him the appropriate exercise video. Or it might put out a reminder to take medication. The unit also keeps an off-site nurse apprised of the senior's status and, if necessary, it can start a video chat directly between the senior and his healthcare provider.

The IHG unit is just one part of the larger system that includes remote management tools that let the care provider monitor large numbers of seniors at once, and perform updates and maintenance to the units. In short, Burns described the whole package as an enterprise-class IT system, which Intel has designed from the ground up.

Intel's medical device plans are bigger is more than just the current IHG, though. Intel's medical anthropologists have identified a number of interesting aspects of seniors' behavior that the system as a whole can exploit. For instance, Burns claims that seniors appear to be much more comfortable and candid with the IHG than they are with their actual doctor. They feel some obligation to show the doctor that they're improving; so, for instance, if they're having trouble walking, they'll actually practice walking before the appointment so that they can put on a good show for their doctor.

To address this, Intel is working on a future medical technology that might include gait analysis, so that the a device can spot that the senior is leaning on the furniture a bit more than normal. The machine can then let the doctor know the real story before the senior shows up for the appointment. Burns even said that Intel's gait analysis is close to the point where they can actually predict a fall right before it happens. (I'm not sure what they could do with this, though, since it's not like the unit has some robot arm that could reach out and grab the person to hold them up.)

Future devices might have sensors to monitor the senior's activity, and it develops a feel for his daily rhythms—normal wake and sleep times, visits to the refrigerator, TV-watching sessions, etc.

I wasn't surprised that the first audience question spoke precisely to what I was wondering as I watched Burns' presentation: why is Intel, of all companies, doing all of the work (market research, product development, manufacturing and sales) itself? Wouldn't Intel Capital, the chipmaker's VC arm, be a better venue for this type of thing?

Another go at the next billion users

"When we waded in, we thought we would do reference designs," Burns told the audience. But Intel ended up just doing the whole thing, since they had the in-house software and hardware expertise.

A lot of Burns' talk was taken up with discussions of Intel's design process—the company is quite proud of all its ethnographers and anthropologists, and of the amount of iterating it did on the IHG design. But throughout the presentation, I couldn't help but feel that Intel was using all of these anthropologists to essentially accelerate not just a product development process, but a whole market's worth of basic inventing of the sort that would normally be done by traditional entrepreneurs. It's almost as if Intel doesn't have time to wait around for entrepreneurs in garages to come up with various PC-technology-based home health ideas, and let the market work to weed out the failures.

Ultimately, what Intel needs are new, non-PC and non-IT verticals into which it can sell the very cheap 32nm transistors that it's about to flood the market with. So, a few years back, the company looked at the aging baby boomer population, and, in much the same way that it did with the rural Chinese (who are also tripping over Intel anthropologists and ethnographers as we speak), identified a massive, largely untapped market for transistors. But instead of waiting for the traditional crop of entrepreneurs to develop this untapped market, Intel is forging in, pushed ahead by the mounting pressure of its own tidal wave of transistors for which it needs enough demand to sustain its margins.

This company-wide "next billion users" mission was also what gave us the Classmate PC, which was supposed to supply third-world schoolchildren with computer access. But instead, the basic platform saw success in its netbook incarnation—in spite of what Intel claims, it is now cannibalizing the company's more profitable notebook sales.

The IHG is essentially an Internet-connected nettop—a netbook in all but form factor—and it's possible that an ASUS could come up with a mass-market use for the reference design that would eat into low-end desktop PC sales. But at this point, with Intel promoting the nettop already as a low-end PC alternative, it's not clear that this matters.

Intel needs to sell lots and lots of its 32nm SoCs, however it can get them out there. In the case of the IHG the real barrier to widespread adoption isn't likely to be the price. As Otellini's editorial points out, the real problem is our medical infrastructure, which is clinic- and hospital-centered, not oriented toward illness prevention, and in the midst of a messy transition to electronic medical records. Unfortunately for Intel, this is not a problem that you can throw money and ethnographers at; these structural changes to American medicine cannot be timed to the 32nm transition.

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