Max Lugavere wants to know: Where is our iCloud for Medicine?
I don’t claim to have a 30,000-foot view of the current state of the healthcare system — I am neither a medical doctor nor a politician. I do have a greater-than-average interest in both fields, I studied psychology in school, read often, and pursue — however informally — an education in science and technology every day. I take whatever opportunity I can to advance science-related discourse through various forms of media. An expert I’m not — I’m just an enthusiast and commentator — but I do see the potential and wonder in the field of medicine. And I also see the disconnect between what can be, and what is.
What can be? For one, there is a large number of people who are optimistic that within our lifetimes, we will unsheathe a vast array of unchartered medical potentialities. Countless pathologies discovered and cured, faulty genomes re-written with deft ease, even aging itself cured! — all made possible by our steadily advancing technologies. We are on the cusp of a sort-of neo-evolution say the some; that we are at the precipice of a radical shift in the way we relate to technology, and even ourselves. Technology, long thought of dualistically as the hammer we hold, the television we watch, or the iPad we peruse, is increasing in capability as quickly as it is decreasing in size. Eventually these devices will be blood-cell sized or smaller — operating not at our fingertips but at the scale of life — manipulating the stuff of our makeup as easily as the processor does the pixel.
If there really is so much potential, why is the current state of healthcare, at the patient level, such an uninspired mess? The sense one gets when one is actually taken into medical care, generally speaking, does not reflect the momentum alleged above. Take something as fundamental to one’s own health care as their medical records. Why, in the age of the iCloud (to borrow a term from my favorite computer company), are medical records — simultaneously one of the most powerful resources and biggest sources of frustration for anyone trying to get a whole-systems view of their health — stuck in the analog and disorganized at best? Why is it that my Facebook wall can be one of the most pristinely-organized, meticulously-curated, highly-integrated and streamlined experiences in my life, whereas my medical data, quite possibly the future-most-valuable-documents-I-own (though, admittedly few), seem like they’re frozen in an MS-DOS-like abyss? That or printed on stacks of dead tree, gathering dust in a closet somewhere in my mom’s house.
Granted, there are some attempts a revolution underway, unrealized as they are. Earlier last month, Google announced that it was closing down Google Health, its foray into personal health records, because it “failed to find a way to translate limited usage into widespread adoption in the daily health routines of millions of people.” However, rouge start-ups like Remedy Systems, “a healthcare services company built by artists and entrepreneurs” to empower doctors and patients alike via a fully-integrated mobile platform using Facebook’s technology backbone, are certainly a step in the right direction. And of course, there are stand-out medical establishments that are ahead of the curve as well.
There are some speed bumps on the road to a total digital makeover. One is that, as always, change is uncomfortable, and made even more so by the “labrynthine, confusing FDA regulatory hurdles often complicated by moving targets and rules.” Daniel Kraft, Stanford and Harvard-trained physician-scientist, chair of the Medicine track for Singularity University, and TED speaker continues: “While many technologies advance at an exponential pace, the regulatory path, including clinical trials, has become slower, more expensive and risk averse.” Secondly, as a recent New York Times article points out, hospitals are indeed very complex decision-making settings, and when dealing with the kinds of records that involve countless variables where even the slightest overlooked nuance can have huge consequences, software versatility is going to be key — a feature that a pen and a piece of paper, for now, own the market on. Thirdly, design and interfacing. A click or a swipe too many, and you’re using a doctor’s precious cognitive energy. Lastly, for some patients, the storage of data isn’t so much the ideal as the ability to mine it for useful information — something which will surely become easier with more intelligent computer algorithms.
Having said all that, there are currently interfaces in place to facilitate environments as complex as, say, nuclear power plant control rooms and the cockpits of passenger jets. Also, most peoples’ records live currently on paper. Paper, of the domestic variety, typically a standardized 8.5″ by 11″, made usually of cellulose pulp derived from wood, is a substrate for data that surely we are used to working with by now. If an iPhone can graphically translate the foreign text on road signs in real time, perhaps it’s not too much to ask for system by which paper records can be scanned, cataloged, made even more useful?
I share the optimism echoed earlier — that our calling as a species is to seek out knowledge, to play Sherlock Holmes to the larger-than-life mysteries of the universe, and to ultimately transcend the more faulty aspects of our biology. But getting there is not going to be easy, or seamless. It’s going to take some motivation, good design and some pressure from those who, if not experts, understand nonetheless the potential of technology and demand more from the people we’re paying to look after us. If not now, when?
photo by joost-IJmuiden / Flickr