The global narrative for “digital health” is relatively easy because the opportunities are so enormous. The only real limit is our imagination. Some of the more recent developments have been breathtaking – and include everything from genomics and personalized medicine to 3-D printing to putting healthcare literally in the palm of our hands (or the embedded sensors we will all wear or consume). At the core of it all is a single strategic component – data.
But the challenges are equally enormous – and nowhere is that more evident than data interoperability. This key alignment is at the heart of enormous (often competing) financial interests, true patient engagement and the health (both financial and clinical) of nations – including our own. The lack of this alignment is more than just inconvenient because it often results in gross inefficiencies, fraud, misaligned incentives and errors – all of which result in outcomes that are more expensive and less than desirable (including death).
There were a fair number of healthcare events last month including the largest healthcare IT event of the year – HIMSS. Now in its 53rd year, HIMSS attendance is nearing 40,000 with about 1,000 vendors and hundreds of educational tracks – all of which descended on Orlando, Florida for the better part of last week. As the CEO of Aetna Aetna, Mark Bertolini’s keynote stood out (here) and Hillary Clinton was standing room only.
But HIMSS wasn’t the only significant event last month. There was a second, smaller event that took place in the nation’s O.R. of healthcare policy – Washington, D.C.
Sponsored by West Health Institute (previous coverage by Forbes colleague Zina Moukheiber here), the daylong event – Health Care Innovation Day – was notable for three reasons. First, it had a singular focus on healthcare data interoperability; second because it was co-sponsored by the Office of the National Coordinator (ONC); and third because it included a compelling keynote by master storyteller and serial-bestselling author Malcolm Gladwell.
Gladwell’s latest book – David and Goliath – is the biblical metaphor for many modern endeavors and industries – including, of course, healthcare. In fact, the event itself was a kind of David in the shadows of the HIMSS Goliath.
Gladwell’s healthcare credentials are often overlooked but he did reference them in his opening remarks. From 1987 to 1996 he covered the healthcare industry for the Washington Post and so he openly wondered what his coverage would have been in his former capacity.
He often generates controversy, but whatever else, he is a master storyteller and there were three compelling vignettes for this keynote. They weren’t cut from healthcare cloth, but an opening line helped to frame their relevance.
But I’m only going to spend a little time talking about healthcare proper – both because I think it’s often more useful to approach some of these issues from an angle by looking at the world outside of the one you’re engaged in – and secondly because I have a rule that I never talk about something my audience knows more about than I do. Malcolm Gladwell – Author
It’s that skewed angle – punctuated with relevant stories – as told by a master storyteller – that really puts Gladwell at the forefront as a speaker. Relative to data interoperability, Gladwell recounted the stories to help “reframe” the data interoperability dialog that continues to gridlock much of the healthcare industry – and the promise of digital health.
The first was The Beqaa Valley Turkey Shoot in reference to the rapid defeat of Syria by Israeli air supremacy in 1982. The swift and decisive victory was orchestrated by bringing different technologies together in a new and far more integrated way.
Using drones, AWAC’s and laser-guided missiles, the Israeli’s were among the first to carefully orchestrate their coordinated use in real time. The Israeli’s didn’t invent any of the component technologies, but they “integrated” their use in a new way that revolutionized military strategy with an exponentially lethal capacity.
The second story was The Shipping Container and recounted the story of Malcolm McLean – who revolutionized the shipping industry. He didn’t invent the shipping container, but he re-framed the problem in a way that transformed both domestic and international shipping.
By standardizing all of the components (containers, trucks, trailers, railways, docks, cranes and ships) in a new way (Lego at an industrialized scale), he effectively reduced the cost of loading and unloading from $5.50 a ton to $0.15 a ton. From his recognition that the problem required a broader systemic solution (not a component solution in isolation), domestic and international trade mushroomed exponentially.
The third story was The MP3 Player and how digitizing music revolutionized every aspect of the music industry. The effect of digitizing music was to make it interchangeable and interoperable. Almost overnight, music was transformed from being an album and episodic experience into one of personal and continuous use. Individual devices like record, cassette and CD “players” artificially constrained the way music was consumed.
Music stores, a dominate part of the retail landscape (and music experience) disappeared entirely within about 5 years. By un-tethering music from a rigid distribution model around proprietary formats, music enjoyment and sales exploded. From 2000 to 2010, growth in live performances and album sales both tripled.
In all three cases, it’s the combined interoperability that has the truly disruptive and exponential effect. The underlying component technology isn’t always a new invention – or exponentially disruptive.
“Sometimes when we look at innovation we make the mistake of thinking that innovation is specific to an individual invention or device. But all of those [individual] views miss the greatest transformation that’s brought about by technology – and that’s when you bring these various pieces and have them work together in combination – it’s the synergies between these tools that bring about the greatest changes in the world that we live in. You are on to something very crucial here – and I wish you all the best.” Malcolm Gladwell – Author
The urgent need for interoperability in healthcare is well understood. It could well be that interoperability isn’t the biggest problem in healthcare today – it’s just the first.
The HCI-DC conference was really designed to emphasize and accelerate the much needed national dialogue on driving medical interoperability to enable a smarter healthcare system across all the different interests. Ultimately, we’re all patients and we all deserve better care than the chaotic, proprietary and unconnected system we experience today. Together, we are working with key stakeholders to transform healthcare delivery in this country to make high-quality healthcare more accessible at a lower cost.” Nick Valeriani – CEO, Gary and Mary West Health Institute
The archived content for the day long event Sponsored by West Health and ONC (including Gladwell’s keynote) is now available in it’s entirety online (free but registration required) here.