For those that have already gotten to know CLOUD and our vision, you know that the new Internet we seek to usher in is a big vision. Every so often, we like to “come out of the clouds” and look at a day-in-the-life scenario in a pre- and post-CLOUD world to illustrate these big ideas. Our good friends at HL7Standards have given us the opportunity to provide another guest post to do just this.
If you have watched my talk at TEDxAustin from 2011, “Reweaving the Fabric of the Internet to Transform Humanity,” then you know that CLOUD is not only a big vision, but also a deeply personal one. As a result, I frequently use personal experiences from my family’s interactions with the healthcare system to paint the picture. I do so again here.
Today (Before CLOUD)
During a recent visit with my wife to the wound center, I was reminded just how flawed our use of information is in healthcare. Our visit to the wound center was necessary because a small spot under my wife’s arm won’t heal due to damage to her skin from radiation for breast cancer seven years ago. More on that story in Survivorship is Not a Phase.
A few things struck me during our visit that relate to this day in the life and how it could be different with a CLOUD-enabled Internet. The first was that the nurse, doctor and technician all asked my wife the same questions as they came in and out of the room. They also each wrote the answers on their own pieces of paper. Of course, even the digital paper many facilities are deploying in the form of EHRs is disconnected, too, so the issue isn’t the paper, per se. It is the thinking about process and information.
It was also intriguing to watch the nurse (who did a great job) use a truly hi-tech blood pressure and pulse machine and then write down the data on a post-it note certain to be re-entered on some chart somewhere.
As we discussed the possible use of a hyperbaric chamber as a therapy for the wound, the question arose as to the types and dosages of Herceptin and other chemotherapy Maureen (my wife) is undergoing. More unassembled data, more phone calls, more chances for multiple instances (and possible errors) of the same data.
This experience with disconnected data occurs during just one visit to a healthcare professional and doesn’t include the other visits over seven years that were required for Maureen’s care, much less our three children. I also know that we are not unique, nor is this disconnected data problem unique to health.
Tomorrow (CLOUD-enabled Internet)
So, can it really be different? As we noted in our day in the life scenario for prescriptions, “we not only must use 21st Century tools, but we must use 21st Century thinking to solve problems, too.” CLOUD is not just about updating the way we craft a web page or creating a new iPad app, it is about fundamentally rethinking the whole paradigm. It is about putting in place a core suite of open tools for privacy, security, identity and data that not only crosses silos but unleashes the capacity of innovators across industries.
CLOUD’s thinking says that simply using email to set up an appointment is but a rudimentary step forward. In the case of this visit, there is an interlocking fabric of data and people that need to be orchestrated.
Like the weaving analogy used in my talk at TEDxAustin, there are certain threads of information that the wound specialist needs for their diagnosis, their prescribed therapy and who will be paying what (i.e., copay and insurance). This isn’t just moving the waiting room to the Internet but completely rethinking how information is assembled and scarce healthcare resources used.
There is no reason, other than broken connections, that much of our health information can’t be assembled ahead of time – we’re not talking USB sticks with digital versions of paper, nor data from iPad apps – those approaches are 21st-century tools with 19th-century thinking. CLOUD is not another product but another way of thinking.
For example, CLOUD is not Cisco or Akami, it is the standards upon which products like these are built. However, when CLOUD completes its work, these routers will be capable of moving around a whole new kind of digital traffic and, CLOUD’s work will be at the plumbing level and at the interface level. Once you pull together all of this info, you need another way to look at it all. Digital weaving is different than browsing.
So, enough about the plumbing. How does the experience at the appointment itself change?
Rather than my experience starting in the waiting room, it can now start before I ever arrive, freeing up valuable time for everyone. Based on the WHO I Am™ of the wound specialist, their CLOUD-enabled digital footprint will determine which WHAT I Am™ elements from my wife’s health fabric will be needed for their piece of our health puzzle.
This isn’t moving whole documents around. This is assembling the necessary info contextually into a unique document, woven together especially for this interaction. Their WHO my WHO and my WHATs coming together are no longer three separate pieces of paper or a post-it note.
When I arrive for my appointment, either my smartphone “showing up” or a swipe of any card with a magnetic strip (like checking in for a flight) will signal my WHERE I Am™. This is a big step beyond checking in with Foursquare at your favorite bar! Since CLOUD is not a web-restricted paradigm, a credit card can be part of the new infrastructure too. The ability to tag our info shouldn’t be constrained to one mode or interface.
For that matter, that fancy hi-tech blood pressure machine could also be CLOUD-enabled. Based on my WHO I Am, after it reads my pulse and other vitals, these new discrete WHAT I Am elements can be properly tagged with my WHO, as well as the WHO of my health practitioner. The addition of their credentialed WHO as a tag to this WHAT will further validate this reading from the ones I take myself at home.
If you remember the videos, this is the idea of “cross-tagging” data. In this case, I am cross-tagging a WHAT with two WHOs – mine and the WHO of the nurse. The nurse’s WHO is cross-tagged with the WHO of the clinic, distinguishing this data from that of their own personal connections, outside of work.
We’re excited about this future and look forward to welcoming more voices into the dialogue and community to be part of the journey to a new Internet with us. We have launched CLOUDCircles as the mechanism for not only crowd-funding CLOUD’s work, but also as the foundation for various online communities to share more scenarios like the one above. If you would like to be a part of this future and our work, check out CLOUDCircles at www.cloudcircles.org, where you can support and join the CLOUD community and help spread the word.
Latest posts by Guest Author (see all)
- A Day in the Life: A Doctor’s Visit (Before and After CLOUD) - May 3, 2012
- Are ACOs Like Chasing Unicorns? 32 Health Systems Don’t Believe So - January 17, 2012
- IT’s Role in Measuring Social Media ROI For Health Care Organizations - November 8, 2011