Wired Health: Living by Numbers – a public health perspective

 

This past week, Wired magazine held it’s first ever conference on health. The speaker lineup was impressive, and the session moderators top notch at keeping the conversation both moving and on time. The goal of the conference was to gather thought leaders and create a forum for conversation on the future of health care. My own personal goal, aside from learning from others, was to inject public health into the conversation.

(You can see any of the talks here. For an excellent summary of the full event, go here.)

Prior to the conference itself, my colleagues and I caught a screening of How to Survive a Plague. I can’t recommend it highly enough. It is a moving reminder of the power of community – in this case those impacted by HIV – to make vital and lasting change in healthcare. I mention this film because it unexpectedly framed my entire experience at the ensuing conference, and helped to reaffirm my own personal definition of the intersection of technology and public health.

That is to say, health innovation is exciting, but it is at its best when the population as a whole benefits. If innovation only reaches those who are already advantaged, then we have ultimately failed.

My job is to help with that distribution in a way that gives anyone a shot at optimal health. And with that in mind I asked questions and considered each speaker’s talk with an eye towards how the ideas might be scaled up. So, when Eric Topol did a live demonstration of an iPhone app that can perform an electrocardiogram (EKG), I wondered when this type of technology could be employed by a community health center with little resources. After all, it’s not just cool, it can level the treatment playing field. When Steven Wolfram presented his computational knowledge engine, WolframAlpha, I asked him to consider how this might be a platform to support a more ecological approach to individual health.

This is similar to the adoption of electronic health records (EHRs): the question is not whether they are beneficial; the question is does everyone have access to that benefit. What I want to help avoid is the inadvertent creation of a digital divide that can have life changing consequences.

In a sense, this ties in well with Wired’s conference theme of “Living by Numbers.” However, it’s not just the numbers how they apply to individuals, but also the number of individuals that any given technology or intervention can serve.

To quote William Gibson, “The future is already here – it’s just not evenly distributed.” My colleagues and I think about this every day in our work at JSI, and look forward to future collaborations with others who share this vision.

 

5 responses to “Wired Health: Living by Numbers – a public health perspective”

  1. Well said.

    I do a presentation around this exact theme – which I call “The Tale of Two Cities.” Very Dickenesque (including the intro) – but highlights the disparity between the new, fun and sexy “futuremed” (where we all want to play), and the reality of a system that now has:

    50 million uninsured
    another 40 million under-insured
    A National Healthcare Expenditure of about $3 trillion per year
    Which is about 18% of our GDP
    And rising at about 5% per year

    In this “city” there are now about 100 million people living below, at or within 50% of the Federal Poverty Level ( http://hc4.us/100mpoverty ).

    Futuremed is really fun – and fun to watch – but it’s just not very real to me yet. It has to be more than on-stage demos and 14,000+ apps in an appstore (IMHO).

  2. Jodi, wonderful public health lens on the meeting! I’m sorry I didn’t get to spend time with you there. You are absolutely right — in the U.S., mobile and telehealth aren’t evenly distributed. Ironically, these tech’s are more evenly distributed in developing parts of the world. In the U.S., financial incentives need to align to drive adoption. You rightly point out that in settings like Federally Qualified Health Centers and clinics, there are already incentives to go mobile where people “live, work, play and pray.” Thanks for publishing your view on the meeting; well done! JSK

    • Thanks, Jane. Your summary of the event as a whole was particularly useful, and made for great memory trigger points. Much appreciated!

      I agree that incentives need to be there to get people to develop, promote, and use these tools. In resource poor settings the incentive is, at times, creativity driven by necessity. There is a lot we can learn from these experiences, and build upon it with additional incentives, including financial. Particularly in the US healthcare system, which doesn’t often reward innovation.

      @Dan, I responded to your post as well, but don’t see it here. So let me just thank you once again for the stats you put forth underscoring the dissonance that exists between where we are and where we aspire to be.

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