Placeme: A Creepy Model for Healthcare Information?

Data, information, interpretation and decision-making are among the vital components of prevention, diagnosis, management and treatment.

The problem we have today is how to gather and manage the data that our bodies radiate.

In order to solve this problem, we have to surmount other problems – which are not just technological but also behavioral, cultural and financial.

But if you want an idea of what an extreme version of data-collection might look like, check out the application Placeme.

Now Placeme is *not* a Healthcare application. What Placeme does do, however, is to continually (in almost real-time) track the places that you visit. No check-ins; no need to enter and data – the application simply runs in the background and does its magic.

When you think about that (from the cultural perspective of today), that’s creepy.

And yet, this “creepy” model is the future. It represents the technological and cultural arc that social software is throwing us. We can fight it (and should in order to flesh out the nuances so we can ensure safety) but in the long-run we shall have to accept the trend and work accordingly.

So think of Placeme in terms of what the ‘Quantitative Self’ movement is attempting to achieve. Let’s call a Healthcare analogue of Placeme Healthme. For example:

  • Recording glucose readings (from a ‘tweeting’ glucometer)
  • Cardiomuscular activity (pulse monitoring)
  • Environmental sensing (pollutants, pollen count, barometric pressure, etc.)
  • Visits to healthcare facilities (‘tweeting’ EMRs)
  • Social-bonding activities (support group meetings, online discussions, etc.)

The list of possible ‘Places’ goes on.

It’s a ‘creepy’ model in the sense that once this kind of collection begins, your life is being measured.

I’m not a big believer in applications for Healthcare as big parts of solving our problems.

Rather, I’m in favor of robust approaches that integrate the whole process of Healthcare Care – not just at the individual level, but also at the public level.

The problems in Healthcare are not the problems in front of us.

If we want to tackle the overal disease of bad health, we need to tackle the fundamental problems of Civilization Design.

What does Civilization Design mean? It means layering into the designs of our buildings, regulations, technologies, customs, etc. an understanding of their possible health and behavioral consequences.

In the meantime, however, models like Placeme – as creepy as they are – can help us intuit what’s possible.

What technologists who wish to develop Healthcare analogues need to do is to work with others in Healthcare to better understand what data is relevant.

That’s the hard part: sorting the relevant data from the irrelevant data.

That’s a major problem the Quantified Self movement has. The other is that it’s Self-based.

Healthme needs to be both. A technology that continually gathers an individual’s relevant data while integrating the world-wide pool of other relevant data to prevent, diagnose and treat the right problems at the right time within the right process.

@PhilBaumann@HealthIsSocial

484-362-0451

 

A Loving Death Among the Glittering Technology

All of the right diagnostics.

All of the right drugs infusing.

All of the right patient information available at the tips of fingers.

A clean white room with a hologramic entertainment center floating above the bed in Fowler’s.

Suple nanobots coursing through the veins, silently tweeting news of infection to other nanobots silently blocking the intruders.

A glittering scene of everything going right. Not much need for muscular lifting nor delicate palpation.

And there she lie – the tiny machinery propounding rhythmic streams of morphine to tame her breathing.

All her systems slow to their stop according to the symphony of medical algorithms.

All those electrons heralding memories of her fist kiss, her first loss, her first child…all just frost on a winter tree of dendrites.

If you were here now – like an invisible beetle in this room – you would see her as a pure-white statue: a once-living human being, given a loving death among the glittering technology, not a single person beside her in the pulsing glow.

Digital Physician, Analog Nurse

Digits are fingers. Digits used to represent the “On and Off” logic of computers.

Analog implies continuity.

An oversimplified conception of providers categorizing the schism beween doctors and nurses would go something like this:

  • Doctors are digital in the sense that their work is discrete – the logic of diagnosis and treatment follows lines of thought in accordance with well-defined and discrete knowledge and experience. You have this disease or not. You have this kind of diabetes or not. Thus the (stereotype?) conception of physicians as hands-off and more cerebral, computational and clinical
  • Nurses are analog in that their work is about the curvilinear flows of care. Yes, you have this disease, but the impact on your care isn’t so discrete. Thus the (stereotype?) conception of nurses as hands-on and more practical, compassionate and caring.

A curious note here is that “digital” implies “touch”. Digits are fingers. So one would think that a “digital doctor” would be more hands-on – more High Touch.

There are justifiable reasons for this schism – in fact, it wasn’t meant to be a schism as much as a result of division-of-labor required of surgical procedures, diagnostic logics and ultimately quality care.

But as we enter a time where digital technologies explode the abilities to share medical knowledge, connect with colleagues and design applications which close gaps in the *continuity* of care, we may need to re-visit the schism.

That is, we may see more more cross-pollination, as it were, between the digital physicians and the analog nurses. A flowering of more integrated care.

Notice: I bold-faced *continuity*. That’s the key and vital difference between analog and digital.

Your body – and the thoughts and feelings and experiences it creates – are not digital. They are analog.

We are all becoming more and more digital. Healthcare is (slowly) becoming more and more digital. Physicians are going digital – and so are nurses. (Well, at least slowly).

That’s all cool and great and useful.

But Healthcare must always remain analog. Our fingers may be digital – but they depend on analog brains.

Phil Baumann

484-362-0451

The Flipboard Medical Chart

Flipboard Medical ChartYou want convenience.

By You, I mean you. You as patient. Or as physician. Or as nurse.

Guess what? Healthcare is still stuck on paper medical records. Ain’t gonna change soon.

It’s all in the wrist and finger tips.

Practitioners love to flip flip flip through medical charts.

So why not have it both ways?

Make the paper-clingers and the tech-savvy’s get their cake to eat?

Yeah, user design (the front end) is critical. The backend? Well, that’s for people way smarter than me to sort out. And that’s pretty smart.

Enter the iPad app Flipboard.

Let me flip through charts.

Let me click open a record; drill down to the data I’m looking for; give me the numbers meaningfully, colorfully, relevantly; let me share – at the press of button – images, notes, orders to my colleagues, students and family members; let me securely live-stream/tweet what matters to my team.

(Click the image above or here to enlarge.)

Here’s the genius part: Once it’s built, you can then layer and bake-in new features which, among many many other things, narrow the gap in the continua of care.

I’m biased: Flipboard (and Zite) have become my main portals into the world around me. And I know where Flipboard is going – what they have goes deeper than what’s on that glittery surface.

So, health tech people – Flipboard is your inspiration. That’s it.

It’s right under your nose.

If you’re a VC, give me a call.

Phil Baumann

484-362-0451

(And if you use Flipboard, you can read my posts, tweets and other content by adding a search for HealthIsSocial to your Favorites 🙂

 

 

Are Healthcare Games Overrated?

What we call Healthcare encompasses so much that the industry can be hard to define. Same thing with Health Care (“Healthcare” referring to an industry, “Health Care” referring to the arts, sciences and humanities of care).

As digital technologies like mobile applications proliferate in adoption and evolve in purpose, it’s becoming clear that games and gaming have important roles to play within our health.

Further enhancing these technologies are social capacities engendered by today’s media – social gaming in other words.

THE NEXT BIG THING IS BIGGER THAN AN APP

I think there may be a temptation to think that games can be the “next big thing”. Indeed they can be – from simple games focused on weight or exercise to games designed for physical, cardiac or post-CVA rehabilitation.

These kinds of uses are, for the most part, about behavioral change and learning and feedback.

Yes, behavior and learning and education are vital elements in Health Care. But…

…But so are: genetics, pathologies, environmental pollutants, psychiatric conditions, medical knowledge and experience, core willingnesses to healthy lifestyles and so on.

Yes, mobile will continue to play important roles in Healthcare and Health Care – and so too will applications designed for mobility.

THE LONG UNWINDING STRAND OF CARE

When you step back at the larger picture, however, technologies like mobile and applications and social media are highly transient in their nature.

Gaming applications are not final destinations.

We are living in a Technological Stream – there are no final points, only currents and turns and turbulence and – with hope – moments of calm.

Why am I writing this post?

Opportunity Cost.

There are opportunity costs when paying too much attention to a small set of problems and solutions when so many pass by us.

I think it’s wonderful that Gaming will play a role in our wellness and in our not-so-wellness.

Are healthcare games overrated? The answer is subjective. But a tendency towards hype certainly exists . There are, after all, business interests involved – and that’s OK, but we do have to manage our attention investments.

But I do think we aught to consider more than just behavior. We have in front of us fantastic science and technologies that can vastly expand our knowledge of the human body – from our consciousness to the tiny mechanisms that compose our DNA and RNA. So much to learn.

And therein perhaps lies one area where gaming – or, more specifically, Game Theory – may have a role to play in Healthcare: helping us to better understand the fundamental governing structures, patterns and processes of Health – of wholeness…of the wonders and woes of being alive.

@PhilBaumann – @HealthIsSocial – Newsletter

484-362-0451

Healthcare Apps Do Not A Business Make

One Healthcare app to rule them all!!!

If only it were so easy.

Applications for smartphones and tablets have become the rage – a rage which perhaps has yet to reach the zenith of its catharsis.

So many startups are investing the bulk of their resources on developing applications and hoping to build a business around the apps.

That’s an inverted business model.

Yes, developing stand-aloned apps – for joy or profit – can be a successful endeavor in itself.

But applications are kind of like tweets – maybe they get a bunch of retweets, but eventually they just fade down the stream of inattention.

A more sustainable healthcare business is to latch on to the idea driving the app. No, latch on to the BIG idea behind the app.

Three – three of many – suggested ingredients to a successful healthcare enterprise:

  • Service
  • Motivation
  • Feedback

Those are elements contained within most successful applications. But a wider business proposition that ties all three together robustly and effectively – ah, there’s a happy moment.

If you’re in the business of developing healthcare applications and don’t know how to build a larger business out of them, consider this model: become the preferred provider of applications for existing enterprises.

@PhilBaumann – @HealthIsSocial – Newsletter

484-362-0451

 

 

The Alarm Fatigue of Social and Digital Media

We have in social and digital media impressive ways to connect and share and learn. You can get instant notifications of breaking news and brand-mentions. You can set filters of curated feeds tailored to your interests. You can, in a manner, feel your way around the world just by sliding the tips of your fingers over a glass pane.

With these media – mobile technologies in particular – we are witnessing a relentless rocketing of healthcare-related applications. Almost each one includes some type of notification system: check your glucose, monitor your weight, record the number of miles you ran, take your neuroleptic…

Today’s (and tomorrow’s) technologies, however, are utterly and increasingly infiltrative. They pervade every facet of life and culture and business – and we ain’t seen nothing yet.

The more benefits accrue; the more conveniences available; and the more targeted and customized these social and digital media, the more alerts and alarms absorb our attention.

It’s not that these are bad things.

But for all of the opportunities which they create, the higher costs rise. (This is in accordance with eternal economic principles – everything has opportunity costs. Except get-rich schemes, of course 😉

So if we extrapolate the effects of these technologies on our health and awareness, the trend is not good if left to itself. If we do not apply discipline and focus and mindfulness, we’re cooked – and the net of the benefits over their costs goes into the red.

What can be done?

I think there’s actually a very simple response to this: mindfulness.  Simple is not easy. Mindfulness is both the easiest and hardest things we can maintain.

Curious: for all of our technological accomplishments, for all of our scientific advances, for all of our insights into medicine and nursing and other healthcare , we are – in the end – left with one refuge against the “wreckful siege of battering” tweets: our minds.

You will not survive the 21st Century if you do not have a spiritual central (note: spirituality is not the same as religion, although the two can overlap).

You will, if you do not pay strong enough attention, succumb to Social and Digital Media Alarm Fatigue.

For those of us who have worked in an ICU or telemetry floor, we know the high-costs of alarm fatigue: increased patient risk, increase staff stress, attention-fragmentation. In those situations, the best cope by being mindful of what they do – they have a clinical center so-to-speak.

For those of you who have never had to combat alarm fatigue in the clinical setting: get ready, it’s coming your way.

@PhilBaumann@HealthIsSocialNewsletter

Band-aid Solutions for Healthcare Problems

“Let’s not put band-aids to our problems.” It’s a great way of saying: don’t use short-cuts when you have to cover long distances.

But there is another way to use the metaphor of the band-aid: develop ingenious, simple solutions that can cover a wide area of deployment. We take the band-aid for granted today. But a century ago nobody heard of one – it had to be specifically invented.

There are so many problems to solve in Healthcare. How many of them are solvable by band-aids? Are we trying too hard? Are we investing too much time looking for big solutions to big problems at the expense of being inventive at the small scale?

This week is SXSW (I know, regular readers think I hate on it – which isn’t true), but what if we had an idea bank where nurses, physicians, engineers, educators, investors, small and large enterprises….anybody who could deposit problems and withdraw solutions?

Or, what if we had small, local idea banks which – over time – could develop networks with each other, seeking system-wide connections to common problems?

I don’t know if something like what I have in mind has been done. But I believe that we may need to re-think Intellectual Property rights – their history, purpose and proper place.

Technological innovation moves at such a rapid pace these days, that traditional IP models may hold us back. An alternative model may speed up the development of band-aid solutions – and actually create new markets and incentives and rewards for all involved: think interest earned, interest paid on deposits and withdrawals.

So the next time someone says “Let’s not put a band-aid to the problem”, challenge her and say: “Hmm, actually a band-aid just might work – let’s see if we can fine one”.

@PhilBaumann – @HealthIsSocial – Newsletter

484-362-0451

 

 

Six Considerations for Adopting Technologies in Healthcare

The issue with adopting QR codes is a bit more fascinating than at first glance because it poses an interesting adoption dilema: on one hand, QR codes can be seen as fads; on the other hand they do have their uses (yes, I’m writing about QR codes again – but this post is more about general adoption of tech for Healthcare; I’m citing QR codes as an example because of all the recent attention they’ve received).

Here are the considerations:

  • Properties of the tech – what specifically does it do; what are limits/possibilities
  • Public recognition (and actual use) of the tech – if there’s not enough awareness (especially by targeted audience), or if they just don’t use them enough
  • Standardization – Which standard is optimal? Given different tech, which ones suit most needs optimally?
  • Obsolescence – How quickly might the tech become obsolete. Not just technologically but also in use?
  • Deployability/Distribution – At the point of service, who distributes, when and where?
  • Security – One issue with respect to QR codes or MS Tags which I don’t see raised much is security. When you look at a QR code, you don’t know what you’re opening up – what if someone tampers with the code (either on the backen or by physically replacing the actual tag) with redirects to malware, indecent material or corporate vandalism (say a redirect to MerckIsEvil.com)? For companies in Healthcare and Pharma, this is definitely something to consider.

There are others. But they’re basic ones which anyone aught to consider and work-through before just either blindly jumping on the latest gadget – or rejecting outright.

@PhilBaumann @HealthIsSocial – Newsletter

484-362-0451

The Killer Healthcare App

It would be nice to have one healthcare application to rule them all, wouldn’t it? A killer healthcare app that you could carry around on your iPhone or Android device.

There isn’t one. Not for a long while.

First, healthcare is such an enormous process that the very word is almost meaningless. How would you even define all-inclusive?

Second, today’s technology pales in comparison to what we can imagine into the future. Currently, the iPhone and Android applications are mostly about content.

We are seeing glimpses of going beyond just content – there are apps that can determine heart rate, for example. That’s a small, but promising example of what’s possible.

But a killer healthcare app can’t be “killer” because no application can replace the holistic process demanded of proper care.

Rather, healthcare applications – robust and powerful and social as they may become – can only go so far in and of themselves.

So what would a kill app look like if we were forced to create one – not so much in its specifics, but in essences? Here are some short-felled thoughts:

  • Fully mobile with data available securely anytime anywhere
  • Extensible with tiny medical sensory devices (e.g. glucometer)
  • Continuous dynamic capturing of aggregated health data
  • Background monitoring of health data to identify possible pathologies – think IBM’s Deep QA NLP & ML with Nuance’s CLU
  • Pan-social connectivity, including robotics – e.g. mechanical limbs, nanotechnology ipmplants

Clearly, these are wild ideas.

They will come to pass, just not yet.

Still, here’s the thing about a “killer healthcare app” – it won’t be an “app”.

It will be a system.

A system holistically designed with everybody’s involvement – robots included – elegantly worked in.

If it works, it will be called Care.

Ergo, the killer healthcare app will be – and always has been – Care. #CheeeseyButTrue and #EasyToForget

@PhilBaumann @HealthIsSocial – Newletter

484-362-0451