Design’s impact on wellness, prevention, and healthcare.
It's a banality to state that Healthcare IT is hopelessly out-of-date. Actually, hospitals are often full of gleaming new equipment and are constantly upgrading their infrastructure. The problem is that while the assorted blocks of hardware and software in a healthcare system are often very sophisticated in themselves, they typically don't connect to each other, or to their users, in a very effective manner. Printers, faxes, and paper filing cabinets form the real backbone of the system.
To date, much of the industry focus on addressing this has been to:
1. painstakingly join together the existing pieces, in a never-ending integration project
2. create a new, overarching backbone which all pieces connect to (NHIN, Microsoft Vault, etc)
On the sidelines of these behemoth activities, however, are some smart companies with a different approach, taking ubiquitous connectivity as a starting point and offering simple SaaS solutions to the healthcare industry.
What does this really change?
- The flexibility of the web allows an ease of continuous improvement to functionality and user experience that is otherwise impossible
- You still have lots of specialist blocks of functionality to join together, but they're all in the cloud already. Connect them once, and they're connected for all users. Update them once, and they're updated for all users.
- Healthcare professionals can collaborate by working on the SAME data, not different copies of it
- Every connected device can become a health IT entry point. With 3.5B cellphones and 1B+ PCs out there, that's just huge.
So where do Netbooks come in?
Well, basically Netbooks have two characteristics:
1. They're really, really cheap
2. They're made for doing everything online (and aren't really powerful enough to do anything locally)
The positive reinforcement loop I hope for from these 2 characteristics are:
1. Healthcare institutions start buying netbooks as a cheap Point-of-Care computing solution
2. Due to the inherent nature of the netbook, SaaS and cloud computing solutions will be preferred for them
3. Users will discover, accidentally, the other advantages of SaaS solutions and start to demand them also on other computing platforms
4. Solution providers will discover an endless variety of innovation opportunities that spring from data being available on the internet and easily sharable with standard security protocols
5. We finally get the long dreamed-of 'medical mash-up ': systems that pull together relevant health and non-health data from a plethora of sources and present it in a way that is meaningful for a given user, for purposes ranging from clinical decision-making to behavioural motivation, education to epidemiological analysis
The resulting potential to reduce error, improve collaboration, and drive efficiency needs a much longer and more learned analysis than I can provide: but I am convinced it can be measured not only in billions of dollars, but also thousands of lives.
- Thomas Sutton
Netbooks
Nathaniel Flick - July 9, 2009
I think Google hopes Netbooks will save Health IT (Chrome OS). However, doctors don't want to carry Netbooks around the hospital, too cumbersome.
They want to carry around iPhones...
And the problem isn't the software to access the data, it's the data itself; it exists in fractured, non connected form. It's absolutely necessary to "normalise" all this data, but no one seems to be facing this huge problem head on.
Mainly because normalising data is really boring, tedious, expensive work.
Chrome OS / iPhones / data normalisation
DesignWell - July 9, 2009
Hi Nathaniel,
thanks for raising some interesting points.
I'm glad you mentioned Chrome OS (in fact the initial stimulus for writing this post was Google's public announcement of the Chrome OS article). However, the Chrome OS vs XXX playoff is still to come, so I decided to avoid any explicit predictions on how much impact Chrome OS will have. It certainly looks promising.
Sure, doctors carry iPhone around, and I certainly don't want to diminish the role that iPhones are having and will have in the future of hospitals. However, they're explicitly a mobile solution - and netbooks are not. To me at least, the netbook is the reincarnation of the 'network terminal' not the laptop. It's more about taking the server-client architecture to the extreme in the age of internet, than it is about mobility. So I see netbooks replacing COWs (Computers on wheels), bedside terminals, and desktop computers in the hospital environment in the near future, while coexisting with iPhones and other mobile devices (who can take advantage of the web-based architecture that netbooks encourage).
Last but not least, data normalisation.
Well, firstly I think it's not true that no-one's giving this any effort - take a look at HL7 (http://www.hl7.org/) and Continua Alliance (http://www.continuaalliance.org/) as just a couple of examples of industry initiatives in this sense. The success of the DICOM standards in Radiology, for example, prove that the healthcare industry IS capable of normalising when there's a commercial advantage.
Secondly, and this was my 'hint' when I talked about mash-ups, there are alternatives to data normalisation that can be just as effective and much faster to implement - for example, providing APIs that allow third party applications to query your system and get out what they need.
My forecast (and we're in the realm of opinion here, I could be wildly wrong) is that our health data will never be consolidated into a unified database, or even a unified data model. But that won't stop us from viewing and accessing it in unified form(s), because it is almost always advantageous on both sides to share data between systems.
So basically, I put my money on interoperability and open architectures, rather than integration and normalisation. An ever-evolving imperfect web full of redundancy but incredibly robust. Just like the Internet.
- Thomas