Will the social web save health care and the larger economy?

I’ve been using Twitter for almost a year now, and I’d say that my knowledge of my industry and related industries has acceleratand dramatically, probably 3-5x. There isn’t much big news or industry chatter that slips by with the people I follow and the information they so graciously provide. In the coming decade, sharing info online will be a strong professional advantage not just because of the economy of information you will receive in return, but because of how we connect with the participants in the knowledge economy. Your audience matters. They always have but now they’re more available.

So, too, has my social intelligence improved. I’m now connected to about half of the people that present at the major conferences, close to all of those that are using twitter. I get feedback from them daily that helps me refine and extend my knowledge base. It took a great deal of effort to get here, but it is priceless.

Which brings us to the question at hand. Reading the astonishingly cogent principles of the HIT standards committee this morning, I couldn’t help but wonder how much social media has provided the platform and the feedback to lead to principles that make this much sense? I’ve seen a lot of discussion online about what the role of the HIT standards committee should be, and I have the distinct sense that they listened. Call me an optimist by nature, but I also wonder if we are becoming smarter as as a society, in terms of people, context and information? And further, what will this will mean for health care and the economy at large?

As far as health care is concerned, the social sphere must, and will, get pulled into health care and the work that providers do. Just as sharing info professionally has and will define a large chunk of professional success going forward, sharing medical information with the right audience will lead to improved outcomes. The simple fact is that collaboration saves lives both through better communication, better coordination and better knowledge transfer across the many boundaries between various health care providers and their patients, as I’ve written before.

Today, seeing that SalesForce just launched an enterprise social app, Chatter, that will bring in a social element to the over 13,000 Sales Force apps, I can’t help but wonder what might happen if we had the same for health care. What if all applications, caregivers and patients were connected online. How fast would our understanding of medicine and the delivery of care improve? We can only hope that we’ll soon find out.

Still, I’m left wondering, will these various ecosystems connect or will we also be stuck with various silos of software, just web-based silos?

Part of the reason we haven’t seen social medicine take off yet (and part of the reason HIT hasn’t taken off) is that we can’t expect physicians  to do more work, manage more complexity or spend more money. These are significant barriers to adoption. Solutions must be simpler, more convenient and less expensive to be considered disruptive.

Sure, there are physician social networks (Sermo, et al), but relatively few are about getting actual work done. Those that are focused on getting work done ad extra steps.The ideal social/collaborative platform in medicine will be an extension of an EHR.

In order to to have collaboration and the social sphere as an extension of the EHR, we need to spend considerable time and energy working out the permissions and rights of medical information. Several articles and studies have recently documented that without sharing information beyond the traditional silos of health care, the benefits of EHRs are minimal if any. We need rights that act as a default for the society at large, and can be changed by patients.

We need a sort of creative commons for medical information. Patients must have the final say in how their information is shared, but there also needs to be a reasonable default to information sharing.

I have a hunch most people will not take the reigns on their health info unless they have clear benefits to doing so. For most people the benefits of managing health info are unclear, but the risks are readily apparent. The benefits of managing health info, possibly through tax incentives, must be clear, and the risks of sharing info must be minimized. Having a plan where people cannot be declined insurance for preexisting conditions will be a godsend to information sharing in medicine.

We need this so that doctors can collaborate more effectively. HIPAA has not helped collaboration. Collaboration is part of the fiber of the practice of medicine. Think Grand Rounds and Tumor Boards. Yet it has lacked a real patient focus using the power of the web in specific clinical cases. When physicians can collaborate about specific cases at the point of care (on some portable device) we will see incredible results.

Eventually, physicians will have EHRs at the point of care with subsets of the EHR shared withing a large community of physicians eager to share their knowledge. Why will be the incentives to sharing? As this brilliant set of presentations points out: People love to share when they have the right audience. Right now, EHRs have very little to do with sharing, they are more about process and correcting errors within a very local setting. When physicians know they have the right audience, they will be eager to share, and improve, their knowledge. Once it gets started, it’s a self-propogating cycle.

As far as the economy at large goes, nobody says it better than Juan Enriquez in this brilliant presentation. We are saddled with a mountain of debt, but we live in an open society capable of innovating quickly and rapidly increasing our collective intelligence. The collaborative web may be our saving grace in profound ways that we are only now beginning to realize from healthcare to government to everywhere. And this can only happen in a free society where there is little fear of sharing information, health-related or not.

(Thanks to all those on twitter who made this post possible by sharing information that I would likely have never seen otherwise.)



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