Joseph C. Kvedar, MD, Director, Center for Connected Health, Partners HealthCare System, Inc.
In the last 12 years since I’ve been involved in the world of connected health, I’ve strived to read at least one important book each summer, while on holiday. In theory, this keeps one’s mind off of the Blackberry and enables transformative thinking in one’s approach to organizational leadership and strategy. Of course it doesn’t always work that way. Twelve years ago, Being Digital by Nicholas Negroponte fueled a real transformation in my thinking, and the following year Everett Rogers’ classic, The Diffusion of Innovations proved even more compelling. Two years later, it was The Innovator’s Dilemma by Clayton Christensen. The year in between, the best I could come up with was The Idiot’s Guide to an MBA, which wasn’t so hot. So, for me, not a speed reader, it’s a matter of choosing that one title that I think will achieve that goal.
This year, apart from catching up on back issues of Wired and Technology Review, I’m going to take a look at Wikinomics, by Dan Tapscott. Reason: I know that Web 2.0 technologies are going to have a profound effect on health care as it changes from an industry where knowledge and power are concentrated in the hands of a fraternal few (physicians) to one where there is more democratization of the care process. We have no choice but to encourage patients to take on the role of being their own primary care provider as much as possible. We don’t have enough PCPs to carry the burden and we’re not training them any faster as the tide of chronic illness rises daily. So I figure I can learn a bit more about the Web 2.0 phenomenon and more importantly, how businesses work in that environment. I’m betting we can apply that knowledge to the desperate need for new business models in health care and confident that connected health will play a central role in resolving the healthcare crisis.
Connected health uses monitoring, communications and adherence technologies to bring care to the patient where the patient is, when the patient needs it. This concept is just starting to gain mainstream acceptance in health care and were it not for our arcane fee-for-service business model, it’d be moving much faster.
Which brings me to the summer reading wish list. If I was better at what I do, I’d have more free time on my calendar to think; and if I was a speed reader, I would use some of that time to read multiple volumes. This would resolve my dilemma of choosing one title per summer and hoping that it will lead to breakthrough thinking.
Imagine for a moment the luxury of hedging one’s literary bets. I’d be looking for reading that covers the following topics: First and foremost, I would choose a book that would look at how in the world we can get the giant juggernaut of CMS to move through this demonstration project phase to a new model of reimbursement. We all know it’s coming. We are betting it will involve some combination of pay for performance (P4P) and possibly capitation. We are trying to prepare for the shoe to drop. If there was a book that would give us a window onto CMS’s strategy, when they expect to roll it out and how they expect to move it through the other government bureaucracies, that’d be on my list.
Likewise, what is the next evolution of managed care? Is P4P in the commercial sector here to stay? Will it co exist with HSAs, HRAs and the like, or will it dominate? Or, will it go the way of capitation in the 90s and leave us with a few more years of rising costs and the unacceptable consequences of that? If there was a book predicting this future, I’d read it (maybe even move it above Wikinomics on the list). Finally, we need the equivalent of Being Digital in the connected health technology space. While we can provide our patients with all three components of the connected health technology platform today (adherence, communications and monitoring), we can’t do so in any way that is efficient, user friendly or at a low enough price point. Negroponte’s book inspired a different way of thinking about how information is handled. The results are evident today in everything from on-demand television, to multimedia capability on mobile hand sets, to the growing daily traffic on YouTube. Health information technology needs an inspirational thinker to come up with an analogous call to action.
I’ll enjoy my summer reading. I know that back issues of Wired and Technology Review will yield nuggets of insight. We’ll see about Wikinomics. But really, we are in desperate need of thought leadership and inspirational writing in these other areas: new business models and a seamless, simple, innovative technology platform.
Joseph C. Kvedar, MD
Director, Center for Connected Health
Partners HealthCare System, Inc.
www.connected-health.org
Closely related to Wikinomics is Everything is Miscellaneous by David Weinberger. Blows away all traditional taxonomies and categorizations and talks about leaves on or off trees and the power of personal tagging.
Posted by: John Shar | July 27, 2007 at 03:27 PM
Posted by: John Sharp | July 27, 2007 at 03:29 PM