What If Health Care Worked Like Social Media?

In Lloyd Mangnall’s data-driven future, patients update their health data alongside their Facebook status. The AMC Health CIO explores the ideas disrupting—and improving—­ ­health care.

What if health care worked more like Twitter? That’s a key question I’ve been exploring in my work at AMC Health as we strive for disruptive innovation in real-time patient management. Traditionally, that involved gathering each patient’s biometric readings from monitoring devices, then aggregating, analyzing, and presenting them to a clinician—with anomalies and trends highlighted—who will decide what level of interaction with the patient is appropriate. We want to expand that model to one where more collaborative interaction with the patient occurs—both in real time and asynchronously.

In the near future, we may have billions of low-cost, disposable sensors monitoring people’s vital signs while they are in the hospital, at home, and anywhere in between. All those readings are transmitted to their smartphones, which in turn stream the data to the cloud. Millions of patients may be outfitted with these devices and they may transmit data every few seconds or milliseconds. That is a huge amount of information streaming way too fast for humans to consume, creating a need for artificial intelligence to process the information, correlate it, and make relevant decisions about what’s interesting. We’re not concerned about what’s normal. We’re concerned with what’s abnormal, and we want to elevate the abnormal so a clinician can look at it.

“Utilizing mobile technology, we’ve started to enable more dynamic interaction with chronically ill patients, similar to what they would receive in a doctor’s office.”
 We’re working on the first phase of this disruptive new health-care platform right now, building out the infrastructure that will gather and transmit much more useful quantitative and qualitative information wirelessly to the clinician. Over the last year we’ve been working with strategic partners, such as our software development partner DevSpark, and Verizon and Qualcomm, to create what is essentially a “patient engagement social network.” Utilizing mobile technology, we’ve started to enable more dynamic interaction with chronically ill patients, similar to what they would receive in a doctor’s office: How do you feel right now? What did you eat today? And more specific questions to secure information related to their disease or condition.

We’re continuously enhancing the ability of patients to interact efficiently with their clinical team. As an example, we’ve all grown accustomed to websites that provide the option for live online service through chat sessions. We’re working to provide that same service option for the patients we serve, but connecting them quickly with the appropriate support and service—basic tech support for device issues and logistics, clinical support through registered nurses for simple patient health issues, and even direct connection to a physician if necessary. We like to say internally that if you normally go to your doctor every ninety days, we’ve got you covered the other eighty-nine days.

Eventually, we plan to create a global health-care platform that looks more like Facebook and LinkedIn. Patients and clinicians would be able to create dynamic circles of health with different perspectives on the same information. Patients may include their clinicians, their family and friends, and possibly even other patients who are dealing with the same condition. Clinicians will include patients of course, but maybe consulting or referring clinicians, and possibly even researchers. Data that is being monitored through those wearable devices or gathered via mobile interaction can be posted and would be available to different groups depending on the patient’s authorization. A son or daughter would be able to keep track of their parent’s heart condition remotely. Taken further, a clinician may be able to look across all of her patients with a specific type of cancer and identify trends, or a family could have control over its extended medical history.

Modern electronic health records are nothing more than detailed journals of the health-related events that occur across a lifetime. But currently, our health information is stored in many small pieces buried deep within multiple monolithic EHRs. As we liberate that wall and center it on the patient, we’ll start to see that each individual’s data is no longer locked away in the basements and back rooms of every hospital, clinic, and doctor’s office they ever visited, but begins to look like a highly secure version of their Facebook profile. And each individual can bring their information with them to any new health-care setting simply by inviting new friends into their dynamic circle of health.

Every great company must innovate to fundamentally differentiate themselves in the marketplace, and innovation by its very definition requires invention. We’re working hard to disrupt the status quo in health care and invent something truly transformative. At the heart of our work is the ability to build upon what others have done before. We’re learning from the models developed by Twitter and Facebook and Amazon. They have already solved many similar problems in a different context, so we’re adapting their approaches to the health-care space. The methods that we’re applying are applicable across the entire IT landscape.

We’re not trying to invent or reinvent everything, which means wherever we can, we leverage off-the-shelf components to satisfy commodity concerns. Unfortunately, I believe many technology leaders today are overly reliant on commercial off-the-shelf technology. I’ve learned never to accept what the vendors are pitching me outright. Everyone can buy the same commercial technology, so by default that makes everyone the same; focusing only on a specific vendor solution means doing only what everyone else is doing and omitting the critical differentiation that separates you from the pack and ultimately gains market share.

We’re utilizing the rich knowledge that’s already part of the open source domain and finding common patterns that we can use in a new way. When we see an opportunity to differentiate, we invent. Everyone on our team has the desire to create from what has come before, adding to the overall body of knowledge. As a result, innovation today is much easier and occurs much faster. In less than a year, we’ve been able to assemble a completely new platform from open source components, frameworks, and platforms. Health care is undergoing rapid and sweeping change and we can’t predict what’s beyond the next bend. Our ability to plug-and-play with major pieces in a matter of days allows us to pivot in response to a rapidly evolving industry.