Bringing the Principles of Couchsurfing to Healthcare

This post originally appeared on HIStalk. 

For the uninitiated, couchsurfing is literally sleeping on a stranger’s couch for free. It’s an incredible global movement in which millions of people have participated.

My friend Alex Liss just produced a new documentary, One Couch at a Time, in which she couchsurfed six continents spanning 20 countries over the course of six months. She funded the trip via Kickstarter; directed, filmed, and produced the movie; and is now distributing the movie. Congratulations to Alex!

I always try to apply knowledge and insight across domains. How would couchsurfing work in healthcare? Can it work? Or is healthcare too rigid and bureaucratic for such a liberal and free-thinking movement like couchsurfing to succeed?

Couchsurfing is about openness, sharing, and cultural exchange. It’s about community. Slowly, these traits are taking root in the healthcare system:

• PatientsLikeMe provides community and support for patients who deal with similar lifestyle and clinical challenges.
• Doximity connects doctors to share and learn from each other.
• ZocDoc empowers patients to find and compare doctors.
• NewChoiceHealth allows the public to see and compare procedure costs across care providers.
• Happtique and Healthtap are helping patients and doctors discover and use healthcare apps more effectively.
• The entire quantified self and wearable computing movement is all about collecting, understanding, and sharing our personal data.

There will always be personal and intimate relationships between patients and doctors. But patients will also develop online and online-to-offline relationships with a host of others to complement the patient-physician relationship. Some of the best doctors will mobilize patients to engage with others to provide continued support and success overtime. These doctors understand that they provide the foundation to springboard their patients into complementary activities and relationships.

These complementary sharing networks and relationships are potent. It’s widely known that social pressure pushes people to lead healthier lifestyles, which turn reduces healthcare expenses.

Couchsurfing is one of the most powerful movements on the Internet. It fosters some of the best beliefs and practices in human nature and culture. It’s about time that healthcare and couchsurfing collide.

What if I Could?

Every Sunday, I re read a suite of blog posts that I collectively refer to as my rules of life. I hope that by re reading them weekly, I will absorb, and ultimately adhere to them at all times. Perfect practice makes perfect.

This post, by the infamous and awesome James Altucher, is my favorite. The final paragraph sums it up quite nicely:

"My only New Year’s resolution for 2013 is to dot the landscape of my life once more with question marks instead of periods. To turn judgments into queries. To turn “this” into “that?”. To make every problem a maze. To be like a six year old. The next time the President of Chile wants me to get run over by a tank  I might say yes. Or I might ride away on my spaceship and french kiss the angel on the moon. “Lips are beautiful,” I might say, before finally falling back to Earth."

I often joke with friends (and girls) that I'm an overgrown child in a sandbox who just wants to play with toys and build sandcastles. I definitely have quite a few computing toys: Google Glass, Leap Motion, Oculus Rift, iPad, Nexus 7, Apple TV, Retina Macbook Pro, iPhone, and Fitbit Flex. By the end of the year, I'll have Atheer, Meta-View, and MYO too.

I love dreaming about what I could do if I were to combine these toys. Before I heard about Meta-View and Atheer, I duct-taped Leap to my head while wearing Google Glass to see if I could simulate Atheer and Meta-View. Sadly, it didn't work. Leap's sensors weren't designed to be moved.

I've been trying to apply that same framework to marketing and self-branding. What if I could reach a million people, what would I say? What if everyone that I know had an opportunity to wear Google Glass? What would they think, and what ideas would they have? What would they think of my ideas? What if I could spend $50,000? $500,000? $5,000,000? What would I do?

When I think about what I could do with that money, I start dreaming about big parties, big events, big everything. Big big big. I love dreaming. Once I think I know what I would do with that kind of money, I can translate that into a message. The what isn't important. The message, the feeling, the memory is important. How else can I get everyone else to feel, to remember me, my idea, or my insanity? Who else have I read about who invoked that same feeling? How did they do it? Did they have $5,000,000?

From there, I work backwards. I cut. I revise. I edit. And after enough thinking and iteration, I usually discover that I can achieve my desired result at 1/100th, and in some cases 1/10000th the cost. You don't need money to achieve big results. You just need big ideas. Ideas are cheap.

Google, Thanks for Listening

Just a few days ago, I wrote a blog post defending email. I argued that email is structurally sound because it models how people think about disparate information in their lives. Social streams don't reflect that.

Earlier today, Google unveiled the new Gmail. The most heavily-marketed new feature is automatic sorting by type of email. Effectively, it's automatic intelligent tagging that requires no setup or maintenance. It's quite elegant. For example, all emails containing receipts or product shipment details are automatically placed into a tag, represented by a tab at the top of the inbox. All social-networking status updates, including photos, comments, groups, and more are sorted into a single tab.

Google figured out that the senders were the problem, not the medium. Google altered the medium to accomodate the obnoxious tendencies of the senders.

Google, good thinking and thanks for listening :)

The Third Screen Revolution in Healthcare is Before Us

This post was originally featured on HIStalk.​

For the past few years, there’s been a lot of innovation and discussion about the second screen – primarily smartphones and tablets – while watching TV. Most second screen apps provide information and services to complement the content on the big screen.

Microsoft CEO Steve Ballmer has outlined Microsoft’s three screens and a cloud strategy. Microsoft wants to be your technology vendor across all three screens — smartphone, PC, and TV– and connect all of them via the cloud. Apple, Google, Amazon, Microsoft, and to some extent Facebook are all converging on slight variations of a shared vision to be the super-mega technology company across all computing form factors.

Doctors are already making use of EHRs and other clinical data across two screens. Most doctors are looking up ancillary information on their smartphones during the clinical exam. It’s convenient because doctors can leave the clinical note in sight and in mind while looking up any other information on their smartphone. They key is that they don’t change screens away from the active clinical note. Some of the information that doctors are looking up on smartphones is coming straight from the EHR via a mobile app, while other information is from the Internet more broadly, such as Epocrates.

For once, healthcare is actually ahead of the mainstream in technology adoption. Clinicians have beaten consumers to semi-ubiquitous use of the second screen. So what about the third screen? When will inpatient clinicians make use of the large screen in most patient rooms more effectively?

They probably won’t. It’s generally difficult to read large amounts of text and numerical data (think labs, allergies, meds, etc.) based content from 10 feet away. Try hooking up your PC to your living room TV to find out for yourself. But there will be an incredible third screen revolution in healthcare. It will happen on eyeware computing platforms, including Google Glass and Meta-View, and I’m sure there will be many others as well.

Each form factor has its strengths and weaknesses. Broadly speaking, form factors can be thought of in terms of the amount of friction between the human and the computer. Laptops and tablets provide larger screens, but aren’t that mobile. Smartphones are mobile, but don’t offer robust data entry options. Eyeware computers can in time offer screens that can present vast quantities of data efficiently and effectively through three dimensions.

I wore Google Glass for the first time last week. Unfortunately, the screen just isn’t very large, which presents serious limitations to developers looking to develop point-of-care applications on the Glass platform. Of course, Glass is a consumer-focused, first- generation product.

As eyeware platforms emerge and mature, we’re going to see a huge wave of innovation point of care healthcare application innovation on these platforms. Someone has to solve the EHR backlash problem.

Where is the Aereo of the Hospital EHR Industry?

This post was originally featured on HIStalk.​

Aereo, the startup that’s looking to disintermediate content providers from cable providers, is making waves, lighting fires, and prompting competitive responses from the incumbents. I love it.

How does Aereo work? They pickup ambient signals from the content providers in the air, convert to digital, and republish the content digitally on the Internet. Aereo is effectively undermining the cable providers by delivering content on the infrastructure of ISPs at a fraction of the cost of legacy cable networks and technologies.

From a technical perspective, there’s nothing the content or cable providers can do about it. Their solution is ingenious because it’s unstoppable. I hope they have a superb legal team to battle the impending litigation from the cable companies. Threats will draw lawsuits.

ABC felt compelled to respond to Aereo. They are going to live stream the raw ABC feed to iOS users who already have a cable subscription. The TV industry has been notoriously difficult to crack, and Aereo is among the first to successfully expose a crevice. Aereo is for real: they solicited a non-litigious response from an incumbent. That is the ultimate sign of legitimacy.

The hospital EHR industry is awfully similar to the cable industry. Entrenched players are using ancient and outrageously expensive technologies and dubious business practices to try to maintain relevancy by attempting to limit competition and innovation.

Please leave some comments if you know of any promising companies that are asymmetrically disrupting the hospital EHR industry.