What Healthcare Innovators Can Learn From Intelligence Community Geeks

Mark Drapeau (Philadelphia, PA) —

At the recent MedCity CONVERGE health innovation summit, a panel discussion about online collaboration opined that many “futuristic” innovations in health and life sciences already exist, but are simply not part of the regular workflow of doctors, bioscientists, and other health professionals. To tweak author William Gibson’s famous phrase, the future of healthcare innovation is here, it’s just not evenly distributed yet. What will get us there?

Toward the end of CONVERGE, an interesting panel titled “Online Collaboration: Where the Puck is Going” discussed the future of healthcare and how it would incorporate advances in things like crowdsourcing, social media, cloud computing, and more. The panelists were Jane Sarasohn-Kahn, the founder of THINK-Health (moderator), Dr. David Delaney, the Chief Medical Officer of SAP America, Dr. Harry Greenspun, a Senior Advisor to the Deloitte Center for Healthcare Solutions, and Joel Selzer, the CEO and Co-founder of Ozmosis.

Greenspun, the most dynamic and hilarious of the bunch (I couldn’t possibly quote all his one-liners here), began with the premise that, “Healthcare is becoming a team sport involving multiple locations and many people,” making it inherently a collaborative process between patients, families, various kinds of specialized doctors, various assistants like nurses, and other professionals – pharmacists, say, or people who write for and edit resources like WebMD. This is collaboration, all right, but it’s complicated — we’re not talking about crowdsourcing funds to start a chair design business, or working on a Google Doc to get your group homework done on time. We’re talking about human bodies, complex diseases, and literally life-of-death.

At some point during the conversation, Sarasohn-Kahn even mentioned that doctors and patients more than ever are “co-creating health,” an interesting phrase to contemplate.

The future of healthcare is like the present day of other fields

So if healthcare is gradually becoming more open and collaborative, and is gradually incorporating technological innovations to make it so, we can ask, What does the future of healthcare look like? Interestingly, according to Greenspun, it looks a lot like the present day of virtually any other industry.

Greenspun did a small experiment with the audience, asking them: “How many of you use OpenTable? How many of you have online banking?” (probably about 80-90% of hands raised). But then he also asked, “How many of you can make an appointment with your doctor online? How many of you can access your health records online?” (significantly less hands, but actually a surprising number – perhaps 40% raised). He concluded, “And we don’t go ballistic about this kind of thing.”

When it’s put in those terms, it makes you wonder why indeed it’s so easy to get online services from Citibank and Bank of America, and how easy it is to get restaurant services from OpenTable and Seamless, but why a visit to the doctor’s office is so…old fashioned. Paper forms that need to be filled out after you arrive, files that need to be transferred to other doctors offices, conversations taking place between a patients’ healthcare providers on the phone without being documented, stored, and accessible by a patient or future doctors, and so on.

Selzer summed it up nicely: “Everything we have in social [media] is nice to have but not necessary until we integrate social into the healthcare workflow.” The technology is not the hard part. The hard part is finding the right sticks and carrots to create incentives for experimentation, risk-taking, and change in what is a relatively conservative and high-stress field of endeavor. How can “connected care” become more of a reality for more people?

How healthcare innovation is like the Intelligence Community

The discussion of a traditionally-minded, high-pressure industry resisting widespread adoption of new technologies reminds me a lot about how the U.S. Intelligence Community (the CIA, NSA and about 14 other agencies which do intelligence collection and analysis) has been learning about, experimenting, and adopting Web 2.0 and related technologies during the last five years or so. Although numerous people in their own ways have been responsible for this evolution, perhaps no one has been more visible than a young IC specialist named Chris Rasmussen, who among other things has one of the most popular Top Secret blogs in the U.S. government. No, literally: His blog is classified and you can’t see it. (Well, some of Publicyte’s readers can see it.)

As author and academic Andrew McCafee wrote about Rasmussen about a year and a half ago,

He had (and still has) a geek’s passion for cool digital tools, and an organizational innovator’s frustration with the status quo – with the IC’s shortcomings in collaboration, knowledge sharing, and expertise location. He was a vocal proponent of Intellipedia and the Community’s other 2.0 initiatives, and came to spend a lot of his time as a kind of internal Johnny Appleseed, spreading the word and delivering the tools throughout the NGA and its peers.

He also kept thinking about how to use technology to better accomplish the work of the IC, and in particular how to address two nagging problems: the huge amount of redundant work…and the fact that for all their popularity and strengths, the Community’s 2.0 tools are still not seen as the ‘finished product’ — they’re not official word of any agency on any topic at any point in time. Intellipedia, in other words, might be a useful non-official input to the work of the CIA, FBI, NSA, ONI, etc., but it’s never their official output. In Rasmussen’s view, Enterprise 2.o at the IC consisted largely of building a digital water cooler where informal conversations could happen throughout the community. This was valuable and robust, but more was possible.

Here are two public videos about some of Rasmussen’s (and others’) ideas. They are really worth the ~10 minutes to watch both.

The original ‘Toward Living Intelligence’ video (2009). See also: Using YouTube to Push Intelligence Reform, by Marc Ambinder.

Framework for a ‘Living Intelligence System’ (2011). Chris Rasmussen is currently the LIS program manager for the IC.

The key point here is that while social media in the form of wikis, blogs, video sharing and commenting and more have been experimented with extensively within the Intelligence Community — take for example their wiki Intellipedia, which is basically a Wikipedia about stuff related to people, places and things of interest to them — none of the information within, say, the Intellipedia entry about the Egyption revolution means anything whatsoever for the official, vetted report from a given agency about these topics.

The overarching goal of the Living Intelligence System is put simply at the end of the second video: “We aim to change the underlying process of how content is created, and to get living, breathing, vetted content into the official channels of the intelligence community.”

Circling back to healthcare, the same could be said of that industry, except that as a whole it’s probably a bit behind the NSA (not considered one of the more open organizations around). While there are lots of experiments with technological and Web innovation in the health community — take for example Medstartr, a crowdsourcing site for health, or FitBit, essentially a sophisticated health data collection system that goes where you go, or the Your Shape: Fitness Evolved game for Xbox, a collaboration between Humana and gamemaker Ubisoft — for the most part, the tactical process of how you make a doctor’s appointment, fill out forms, get follow up information, pick up prescriptions, deal with health insurance, and so on is pretty much the same as it was 50 years ago.

What the heath industry needs is an internal “Chris Rasmussen” who can envision and relentlessly promote, and perhaps someday take ownership of, a large vision of how to redesign the health care process, not in a way good enough for a science fiction movie, but in a holistic, meaningful way that pushes people a bit out of their comfort zones yet takes into account the issues of different diverse stakeholders and ultimately rises all boats.

Dr. Mark Drapeau is part of the Microsoft Office of Civic Innovation, based in Washington, DC. You can follow him on Twitter at @cheeky_geeky.

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