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Healthcare finally catches down with the rest of the world

October 8, 2010

I’m currently in San Francisco at the Health 2.0 conference, presenting iWantGreatCare and taking part in a panel discussing how data from patient communities is being integrated “within the delivery system”.

This year’s meeting is substantially different from previous events I’ve been part of – and in ways that have real, practical immediate implications for all of healthcare, not just the “online bit”.

Three things that make what’s happening now different (and why everyone in Europe needs to sit up and take notice of what is happening in the States) can be summarised as follows:

Bottom-up. After years of hype and over-promise the time really is now for healthcare to crawl into the 21st century. I was going to say that the technology has caught up, but it’s more appropriate to say that the technology has caught down. It is not high-end, expensive, enterprise solutions that are making telehealth, personal health-records, self-management, wellness and massive data acquisition possible, rather it is the very bottom of the IT pyramid: free and cheap solutions. The most successful, effective and powerful solutions typically require patients to have no more than a mobile phone, doctors to be able to use email or Facebook, and organisations to kick their addiction that expensive must equal better when it comes to IT.
And the leaders in this? The US Government with their community data health and ‘Blue Button’ initiatives (I’ll highlight why these terrifyingly brilliant solutions show the way to the UK and European governments in subsequent posts).

Patients. Previous events have been hypnotised by flashy solutions to help doctors and organisations. Typically these never worked very well, cost a fortune and were solutions created by people a long way from the clinical frontline (those who know about the UK’s NHS IT programme might recognise this unhappy triad…). Thankfully most of these groups seem to have gone out of business and people have seen through the “emperor’s new (expensive) clothes” scenarios here in the US. The big. proven, impactful solutions are now all about empowering patients. Before it was electronic patient records for doctors, now it’s personal health records for patients; where once it was tools allowing doctors to send messages to patients, now it’s about mobile tools for patients to tell their doctor what they want, or to share information about their care with their peers. Typical example: PatientsLikeMe collating information for patients to let people make informed decisions about their medication side-effects and treatment choices, and working with pharma to improve outcomes and reduce costs of care.

Data transparency. For an industry that claims to be evidence-based the ability of the healthcare sector to keep data, information and outcome metrics buried and hidden from the internet has been remarkable. Healthcare is all about outcomes – and without clear, open, comparative data allowing everybody (not just doctors) to see, measure and understand the effects of care we will never make the quality improvements that are fundamental to meeting the challenges all health economies face. But the walls are coming tumbling down. As mentioned above the US government has switched from asking “can we release this data?” to “why can we not release all data?” (UK Department of Health please note this is totally aimed at you!). Innovative businesses are collecting data in incredible ways and then sharing this in a completely open and transparent way, and patients are using data to inform choices and hold providers to account in ways that were unimaginable just a few years ago. All sorts of outcome data is becoming available, but even more exciting is the way that it is being linked, shared and analysed to give new insights, whilst successfully tackling the thorny issues of privacy, identity and permissions.

Seeing a seventeen year old single-mum describe how she has fundamentally changed her life (and that of her new baby) by using a bespoke, secure Facebook application to communicate with her doctor throughout and following her pregnancy is incredibly moving for anyone who has a passion for health. There really are few limits to what can be achieved in healthcare right now by “catching down” with what the internet has enabled across so many other sectors.

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