Innovation in eHealth

I attended a presentation last week put on by Paul Artiuch and Tim Warner of Don Tapscott’s group New Paradigm, talking about the most important trends in Web 2.0, and in eHealth in particular. Some of the content is proprietary to members, but most of it was reasoned opinion, pointers to interesting websites, and intriguing trends and observations from their research that I thought might be worth sharing with readers. If your organization is one of the collaborators in the New Paradigm IT & Competitive Advantage program, you might want to contact your organization’s representatives in the consortium, and get involved.

What I like about them is their pragmatism ñ for example, they explain the value of social networking tools in a way that is accessible to senior executives and anticipates and addresses most executives’ lack of knowledge, common misconceptions and security/control fears about them. And they encourage multiple parallel small-scale experiments using these tools, in the context of addressing specific organizational problems, so that participating organizations can actually become leaders in the use of new technologies and ideas, instead of just abstractly understanding their potential.

Here were, for me, the shareable highlights of the presentation:

  • Focuses for New Paradigm’s current research include producer/customer/consumer co-development and peer production, the self-managed organization, implementing social networking applications in organizations, and understanding the buying and working behaviours of Generation Millennium.
  • ñ This is a free website used by US doctors (you have to be an AMA member to get in) where they share clinical information, ideas and problems. Sermo was credited with the first detection of a recent e coli outbreak in the US. It is primarily used as a self-help, peer-to-peer information-sharing and second-opinion forum among small town and rural MDs in the US (urban doctors presumably have stronger physical networks they can call on to do this). It’s now monitored by the CDC and the FDA.
  • ñ This is a free, global public website which allows family members to post the status of convalescents (in hospitals, long-term care facilities, or even at home), and receive condolences, messages etc. It includes a blog-like interface for the patient or their rep to send messages once, that everyone can read (so the patients can save their energy to get well, and their families can save their energy to be caregivers, instead of having to tell 100 callers the same news). Very simple, very innovative.
  • Organized Wisdom ñ This site enables peer-to-peer matching of health care information against stories of healthcare problems. Very imaginative use of stories (as context-rich problem definitions) and natural language algorithms to do the ‘matching’ to possible health solutions.
  • New Paradigm sees further evolution of the Web towards a self-managed, collaborative space. Sites that merely offer content without conversation (collaboration tools embedded), mobility (access anytime from anywhere), broadband (full multimedia capability) and pervasiveness (ability to interact with sensors and other machines in real time and space) will not survive.
  • Revolution Health Group ñ Steve Case (ex AOL-Time Warner) plans to make his site(s)/tools/media the premiere destination for the entire US healthcare system, and is investing millions to do so. It is free (ad-sponsored), but offers a $129/year intermediary/concierge service that will do all your searches, news synopsis and answer all questions for you, including creating and maintaining a personal electronic health record for you and interfacing it with other systems as required. Revolution Health has just bought Wondir’s Health categories and ported them to their site (Wondir is a website that lets people ask and answer questions on any subject peer-to-peer on a caveat emptor basis, and Health was its #1 category). Interestingly, Wondir Health users seem unhappy with the new, less intuitive Revolution Health interface ñ is there a lesson here? Meanwhile, the top 5 healthcare web destinations remain: WebMD, NIH, Health, Yahoo Health/Yahoo Health Answers, and (sigh) the South Beach Diet site.
  • Nike+ ñ Nike plans to put its Nike+ RFID sensors in all their shoes ‘standard’ by next year (over three million sold already). These sensors send wireless GPS and other information to your iPod and other equipped devices, which info can then be relayed anywhere else over the Internet (and as the link above shows, can also be used to keep tabs on you). This could be the fore-runner of environmental/health/security sensors everywhere, that can be monitored by automated environmental, health and security information systems 24/7 (and by Big Brother). Note: The US apparently has more Nike shoes than cellphones.
  • Some of the big healthcare e-challenges and e-opportunities:
    • auto-detecting medical errors at point-of-care (“beep ñ you have just attached the patient’s anesthesia tube to a non-anesthetic tank”)
    • reducing unnecessary visits/treatments (teleheath and other technology-enabled ways of pre-screening)
    • comparative public ‘ratings’ of doctors and hospitals
    • enabling more home-based end-of-life care (’cause folks, we’ll soon be running out of room in nursing homes and hospices, big time)
    • auto-alerting of flare-ups of chronic diseases (carrying the drug monitors in Japanese toilets to the next level)
    • enabling health self-management to reduce walk-in visit costs (monitoring, measuring, diagnostic and even therapeutic devices you can hook up to your laptop and the Internet)
    • accelerating the development of generic drugs
    • collection and publication of more accurate waiting-queue numbers and average wait times (since what gets measured gets action)
    • better, automated coordination of medical activities involving multiple specialties/institutions (synchronizing schedules automatically)
  • Research to date has found no evidence that introducing electronic personal health records (where a ton of money is being spent these days) have any impact on ultimate health outcomes, except for the detection of adverse drug reactions.
  • It would appear that healthcare quality and cost are adversely affected by what New Paradigm calls ‘demand distortions’ (the expectation and insistence on unnecessary interventions) driven largely by (a) drug and healthcare device supplier advertising hype (“ask your doctor if zybloxithon is right for you”), (b) some medical laziness (over-prescription), and (c) our ‘learned helplessness‘ culture (“Iím sick, give me a drug”).

New Paradigm is quite positive on social networking applications in organizations, especially internal applications within healthcare organizations (rather than aimed at the general public), and especially blogs, wikis, IM and social networking apps similar in approach and structure to Sermo, theStatus, and OrganizedWisdom.

As mentioned in a previous post, if you’re interested in a summary of Tapscott’s book Wikinomics, it’s available free online as a 2-hour videopresentation here.

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2 Responses to Innovation in eHealth

  1. James Munro says:

    Thanks for this really interesting set of examples around web 2.0 and health care. Just picking up on one of your “big healthcare e-challenges”, in the UK we have set up Patient Opinion, a site where patients can come and rate the care they received – and also share their experience of care online for the benefit of others.Our focus is very much also on the idea of using these raw accounts of patient experience to help health services improve what they do, in big and small ways. So health care managers and clinicians can subscribe to the site, set up data feeds and get near real-time feedback filtered down to, for example, cardiology at their own hospital, or diabetes care across the region.Still very early days, we’re learning plenty, our traffic is building, and we are already getting examples of how hospitals are making changes in response to this feedback. So we think it can be done.

  2. Kay Rogers says:

    Hi, thanks for the wealth of information in your site. Hope you can check my website out and give a little feedback. Thanks again.RegardsKay

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