Today, as I walked through the morning mist, I began thinking that music is a universal language -- specifically dependent on prevailing technology and social organization but in no way bound by them (it was a philosophical kind of morning -- freezing temperatures for four straight months tends to do that to a person). Later, reading Sachin Jain's blog about the promise of modern medicine, I reflected that in health care our expectations are typically defined by what we know is possible now, effectively looking as far as the horizon. The practice of medicine, my trade and arguably the central element of a health system, is very much rooted in prevailing technology and social organization. A health system itself is an organizational embodiment of the values of the people it serves (communitarian in Europe and predominantly libertarian in the U.S.) and the activities therein are determined by the technologies available and specifically how they are paid for.
Now with policy reform and the growth of accountable care in the U.S., billions of dollars are shifting from the payers for care to its providers who, in theory, are closer patients and have more flexibility in terms of what they choose to fund. Now it seems there exists the potential for emergent technologies to be deployed for the service of patients. The notion that the system can be organized in real time around the needs of the people it serves should no longer be beyond the horizon. In fact, through delivering personalized care plans to patients digitally where they are on Internet-enabled personal computing devices they increasingly have: mobile phones, smart watches, connected homes and vehicles, emergent health needs can be digitally defined in real-time through collecting and analyzing data from patients' granular interaction with their care plans. This data can be used to identify who needs what and how it can best be provided. This effectively turns the current paradigm on its head as the health system is dynamically organized around the needs of the people it serves rather than people organizing themselves around what the health system is able to provide. Crucially, if these technologies are used in the context of clinical relationships rather than as a discretionary appendage -- deeper connections can be enabled and care resources amplified. I believe that this will become the new normal -- health care will be digital and vigilant, personalized and imbued with humanity.
However, this model of care is very much dependent on the liquidity of health data. It is dependent on data sets automatically shared, dissected and disseminated to feed an army of new data driven innovations delivered over the internet. However, against the background of the calculated privacy invasions of the NSA, the bungled launch of healthcare.gov in the U.S. and the fractious roll out of care.data -- the U.K. government's health data sharing initiative -- most people are understandably skeptical about proactively sharing personal information with third parties, particularly governments. Trust, critical to any kind of relationship, is in short supply. Furthermore, there have thus far not been any emblematic successes directly attributable to data liquidity as service focused technologies in health care have thus far been laughably rudimentary and health data remains petrified behind arbitrary firewalls across a byzantine network of healthcare stakeholders.
It is important to remember that the practice of medicine is itself based on the iterative forensic examination of the experiences of millions of people over generations. From antiquity, patients, researchers and clinicians have worked together to build a bedrock of knowledge upon which the current practice of medicine stands. This foundation of knowledge is in many areas incomplete and in others overgeneralized and the time that it has taken to create this corpus has been unacceptably long. Furthermore billions of patient experiences have been wasted as until now, we have lacked the means to efficiently collect and analyze these experiences at scale. In this generation, through establishing the norms around the secure sharing of medical data, we have the potential to both personalize and fundamentally reinvent the practice of medicine by realigning experience and investigation through the use of distributed computational power. However, in spite of this immense promise we are faced with a near term "chicken and egg" problem -- the public are not convinced that there is enough value to give up data in the face of clear and present risks; however, without data it is not possible to build the new generation of services that will allow us to realize the promise of what Sachin describes as "modern medicine."
What will break this deadlock? In my opinion, it is when technology-based services give patients, real patients and not self-motivated fitness junkies, enough immediate value that they are happy to share their data in the context of a trusting relationship with their clinicians and the organizations they represent and in turn that data is treated with the respect it deserves, blended instantaneously at scale, across regional lines and arbitrary fiefdoms to produce novel inferences that can deliver even more value to patients such that they are willing to share even more about themselves and so a virtuous cycle of growth is created. This might seem like a distant abstract vision, but the technologies to do this are available today; however, the collaborative environment has been missing. Modern medicine, unlike music, is very much defined by prevailing social organization and technological possibilities, but just as in music, there is an ever-present opportunity to collaborate and reinvent.
Wellframe is a Boston-based Health IT company that has created a mobile platform for chronic disease management. This platform gives patients a GPS navigation system for their health that offers turn-by-turn guidance in order to empower patients to take control of chronic health conditions. Wellframe's Harvard and MIT trained team combines deep expertise in clinical medicine, consumer health technology and computer science.
Wellframe is one of the two Merck | Heritage Provider Network Innovation Challenge finalists. The sponsors have called on entrepreneurs, data scientists, designers, health care providers, and big thinkers to create the products or services that will support patients with diabetes and/or heart disease in adhering to their care plans and ultimately improving health. Finalists will enter the pilot phase in March 2014. Check out their progress, watch their Demo Day presentations, and find additional open innovation challenges by visiting Health Data Challenges.
This blog series is produced in partnership with Health Data Challenges, creators of The Health Data Challenge Series, a formal initiative of the Health Data Consortium, powered by Luminary Labs. The platform seeks to foster the use of data to drive innovation that will ultimately transform health and healthcare through high-stakes innovation challenges. Learn more at www.healthdatachallenges.com.