Ten Years Later: What the Internet of Healthy Things Got Right -- and What’s Next

By Tara Menon and Joseph Kvedar

This year, I have been blogging about the 10th anniversary of my first book, The Internet of Healthy Things (IoHT). While taking a trip down memory lane, it has been fun to: 

• Assess how well my coauthors and I did in predicting the future.

• Wonder what people we interviewed are doing now. 

• Recall the companies we highlighted and ponder where they are today.

All of my previous posts have been focused on a specific chapter. This one takes a different tack.  My colleague and coauthor Tara Menon contacted people who were interviewed as part of the research for the book and quoted in the first several chapters. This post synthesizes those interviews thematically, organizing insights around the major shifts we've observed over the past decade--from ROI discipline to AI transformation to persistent system challenges.

1. The Great Pivot: From Connected Devices to Connected Intelligence

Perhaps the most striking revelation came from Bill Geary, Cofounder and Partner at Flare Capital Partners. When I asked about updating our original book, he told me bluntly: "I'd rename the book entirely. The Internet of Healthy Things assumed healthcare would evolve through connected devices. But what's really happened is a profound shift driven by AI."

Geary emphasized that ROI has become the “central driver--especially for enterprise buyers like payers, providers, pharmaceutical companies, and employers.” Health tech solutions must demonstrate either cost savings or increased revenue, “or they won’t scale.” His investor lens is clear: novel technology and payment models alike rise and fall on their prospects to deliver measurable impact.

The success story? Ambient AI--such as solutions replacing medical scribes--stood out as a technology that “saw slow adoption, then rapidly took off,” driving real behavioral change in provider workflows. Even Epic, the largest EHR vendor, has recently jumped in, unveiling its own ambient AI features and adding Ambience Healthcare’s AI scribing platform to its Toolbox for seamless integration into workflows.

Meanwhile, Rob Havasy, Senior Director at HIMSS declared AI was “always the missing link. For years, we generated too much data and had no capacity to analyze it.” The breakthrough, he says, is intelligent filtering--“the art of exclusion.” Instead of dumping data on clinicians, we now tailor information so each role only sees what matters to them most.

2. The Integration Imperative: Why Isolated Solutions Fail

The second major pattern reveals why so many promising pilot programs never reach scale. Promising pilots are everywhere in digital health but scaling them to mainstream adoption has proven elusive. All of our interviewees agree: true progress requires aligning payment models, workflows, organizational culture, and technology.

Dr. Gregg Meyer, Professor of Medicine at Massachusetts General Hospital and Harvard Medical School and Professor of Health Policy & Management at the Harvard Chan School of Public Health gave me the most candid assessment: "We're making progress. There's both excitement and disappointment." The excitement comes from CMS pushing value-based care forward, but commercial payers "have dragged their feet." The lesson? Integration works. During the pandemic, "systems with their own health plans fared better--they continued receiving premium dollars while others were left waiting."

Meyer also shared how his thinking about value has evolved: "I've come to appreciate how critical appropriateness is. The equation should be: Value = Appropriateness × Outcomes / Cost." It's not enough to improve outcomes -- care must also be appropriate to the clinical context.

But perhaps most importantly, Meyer emphasized that change management matters as much as the technology itself. "We still focus too much on the 'what' instead of the 'how.' The key is to explain the 'why' and bring people along." 

Rick Valencia, a global entrepreneur and corporate executive as well as Founder and President of Qualcomm Life echoed this theme--for successful digital health, “without domain expertise, you’ll fail.” Innovation, he said, requires “educating an entire ecosystem” and patience, sharing, “We were the pioneers getting shot at.”

3. The Consumer Experience Paradox: Aspiration Meets Reality

Our third insight addresses why patients still don't feel like true "consumers" of healthcare, despite a decade of rhetoric about patient empowerment.

Geary identified the core issue: "The fundamental issue is our fee-for-service system. Most healthcare interactions only happen when something goes wrong, which limits proactive engagement." Until payment models reward keeping people healthy, true consumer-grade experiences remain elusive.

Paul Puopolo, who now leads innovation at Dallas Fort Worth International Airport after years in healthcare (previously Vice President of Business, Innovation and Development at Highmark), offered a fascinating cross-industry perspective. "Airports are large ecosystems, more like cities," he told me. They manage millions of movements daily through personalized, data-driven processes that adapt to individual needs in real-time.

The contrast with healthcare is stark. While "industries such as retail, financial services and travel have conditioned people to expect personalized content," healthcare's execution "has varied across the industry" due to "business silos, lack of accountability," and legacy systems that "slow down innovation."

Puopolo's vision for the future? A "single pane of glass" platform that combines health, financial, and social data, with AI providing unified insights regardless of which services you use. He adds: “Generic messaging doesn’t work… Personalized, proactive connection is key to keeping loyal customers.”

4. The Two-Speed Problem: A Digital Divide in Healthcare

Perhaps the most concerning pattern that emerged was evidence of a widening digital divide within healthcare itself.

Havasy shared sobering HIMSS data: Only about 4.6% of U.S. hospitals have ever reached Stage 7--the highest level of HIMSS digital maturity--showing how rare true digital transformation still is. Most hospitals are still far behind, and that divide will have to close if patients everywhere are going to benefit.  There's "no robust 'middle class' in health IT," Havasy shares, which creates a two-tiered system that will limit equitable access to AI and connected health benefits.

Meanwhile, the “wearables revolution” has reached some, but not the highest-need patients. As Geary reflected, “Wearables are widely used by healthier consumers, but they’re not yet targeting the people with costly chronic conditions--the population that drives the bulk of healthcare spending.” 

Business models haven’t kept up, Havasy noted: “Fitbits end up in drawers.” The challenge? “Recurring revenue is at odds with consumers who only want occasional nudges.”

5. The Cultural Challenge: Why Healthcare Is Different

The fifth pattern explains why so many technology solutions that work in other industries struggle in healthcare. 

Havasy layered on the need for role-based design, recalling, “12 endocrinologists will want 14 different ways to view glucose data.” Now, the field is moving away from “handing over too much choice,” instead focusing on workflow-informed interfaces for each member of the care team.

Valencia, reflecting on his experience bridging telecom, healthcare, and tech, put it most clearly: "Healthcare is unlike any other industry. In tech, you 'move fast and break things.' In healthcare, harm isn't an option."

Valencia's advice to entrepreneurs? "Without domain expertise, you'll fail." The most successful approaches combine technological innovation with deep clinical credibility. Being "pioneers by design" meant accepting that "we were 'the pioneers getting shot at'" while educating an entire ecosystem about new possibilities.

But Valencia remains optimistic. When I asked what he'd tell his 2015 self, he said simply: "It's worth the fight. Qualcomm Life's work helped move the industry toward better access and quality of care."

Key Takeaways for Healthcare Leaders and Founders

Five clear themes emerged from these conversations:

1. The AI Reality: Intelligence, not devices, is driving transformation. Leaders should invest in AI as core infrastructure, not an add-on.

2. The Integration Imperative: Partial solutions don't scale. Success requires alignment across payment, workflow, culture, and technology.

3. The Personalization Challenge: Consumer-grade experiences are possible but require unified data platforms and intentional design that breaks down silos.

4. The Equity Gap: The digital divide in healthcare is real and growing. Addressing it is both a moral and strategic imperative.

5. The Culture Factor: Change management and domain expertise often matter more than pure technology innovation.

   
   

The Road Ahead: A Cautious but Optimistic Prognosis

Looking ahead, everyone I spoke with agreed: change in healthcare is often non-linear, uneven and unpredictable, but it's unmistakably accelerating. The convergence of AI, payment reform, and consumer expectations isn't coincidental: it suggests we're at an inflection point.

The original Internet of Healthy Things vision wasn't really about gadgets; it was about rethinking care around people and outcomes. That vision remains valid, but the path has proven different than we expected. What began as a wave of connected devices has matured into an era defined by connected intelligence. What we thought would be driven by consumer adoption is being led by enterprise ROI. What we hoped would be rapid transformation is proving to be steady, persistent change.

The prognosis? As Dr. Meyer predicted, "Things move slowly... until they don't. I think the next five years will be breathtaking." Progress is uneven, but the ambition for care that is intelligent, integrated, personal, and human is more real than ever before.

Ten years on, we have reason for cautious optimism--and a clearer roadmap for the work ahead.

Special Thanks: A heartfelt thank you to Bill Geary, Rob Havasy, Rick Valencia, Dr. Gregg Meyer, and Paul Puopolo for taking the time once again to share their insights and reflections. Speaking with you all was a true honor, and your perspectives continue to shape how we think about the Internet of Healthy Things ten years on.