Healthcare IT October 5, 2015

Living and Working in Two Worlds

by Barry P Chaiken, MD

In 1876, Alexander Graham Bell offered to sell his patent for the telephone to Western Union for

$100,000. After careful consideration the company rejected Bell’s offer.

They replied that they could see no good reason why people would want to speak to each other through such a device considering the quality of the transmitted speech. Western Union believed using the telegraph represented a superior alternative since a person could easily send a clear and readable message to anyone in any city in the country simply by sending a messenger to the telegraph office with a clearly written message. Although we consider this shortsightedness amusing, it represents a bias we all share. The authors of The Gen Z Effect describe it this way:

“the future never comes fully formed. It is always disguised in a clumsy package that doesn’t comfortably fit the behaviors we are accustomed to.”

The authors went on to say:

“It’s human nature to initially place “new” technologies into old behaviors since we have no other frame of reference.”

Technology always arrives before the behaviors required to realize the potential of the technology. Here are a few examples of technologies that at the time spurred “odd” behavior but now are considered mainstream.

    • Telephone on every employee’s desk – telephones were initially reserved for high level executives
    • Personal music device – it was considered anti-social and rude to listen to music through earphones in public
    • Portable computer – the term “luggable” was used to describe those 25+ pound first “laptops.” Why would someone need to use a computer outside the office?
    • Mobile phone – dubbed the “brick” due to their size and weight, most people could not understand why someone needs to be reachable all the time.
    • Email – initially limited to in-company communication, many wondered what is the value of email when you could send a letter or make a phone call to communicate with someone
    • Texting – once considered solely for personal communication, does a meeting go by where executives are not looking at their smartphones and texting responses to colleagues? Twitter anyone?

The problem of accepting and integrating new technology repeatedly challenges us humans to adapt. While generations defined by age categorized these behaviors, technology is advancing so quickly that age no longer adequately describes behavior differences. Today, the ways we utilize technology defines our generation and places us in a cohort that exists separate from our age group.

Although people today live in an online and offline world, the barrier between those two worlds is evaporating. People increasingly integrate what happens in their online and offline worlds so that both are ever present throughout their waking hours. This explains why a group of people out for lunch can be texting friends not with them while also speaking to those at their table. It even explains why they can be texting people AT the table. For this group, their online world of friends is also present in the offline, three dimensional world of their lunch table. For this generation, the lines between online and offline do not exist.

New modes of social collaboration

Although we impulsively consider collaboration using social media tools like Facebook, Instagram, and Twitter reserved for our personal online world, the value of such technology resides in our ability to imagine its potential. We cannot view these tools within our current framework of behaviors, but must conceive of new behaviors that leverage these technologies to impact health, wellness, and patient care. As a first step, we should consider the merging of our offline and online worlds and how social collaboration technology can impact on a regular basis how we and our caregivers manage care.

In healthcare our offline world consists of our points of care, the clinicians we interact with and the environment in which we obtain our care. To date, our usual online world may consist of a patient portal containing portions of our medical record or emails shared with caregivers. This typical non-integrated offline and online world represents poorly what we typically experience in most of our professional and personal life where being connected best describes the environment we live in.

Recognizing that behaviors adapt to technology and it is impossible to truly envision how the offline and online world will merge in the healthcare sphere, we can consider potential scenarios based upon evolving trends currently viewed in the marketplace.

Sites similar to “Patients Like Me” represent a first generation of online social collaboration bringing together people with similar disease states. Although unconnected to the offline points of care and the online patient portal, they provide a glimpse of what value may accrue through enhanced social collaboration.

Portal for healthcare social collaboration

The patient portal also represents a first generation of online social collaboration. While providing a silo of patient information, none of these portals deliver to patients or their caregivers a complete patient record. In addition, they lack much critical functionality essential to delivering enough value to users ( e.g., appointment scheduling, email to caregivers) to drive high levels of adoption and use.

Merging the offline and online worlds of social collaboration offers us a valuable strategy to empower patients and better inform caregivers. Patient care deserves to be part of the normal flow of information and parallel how we interact and collaborate with each other in our personal and professional life.

Applying technology inherent in Facebook and other social collaboration technologies offers a “street comer” focused on the patient where all caregivers, family, and friends can focus. Patient management of information access provides levels of privacy, and personalizes the environment to patient specific needs. The platform allows for the development of supporting applications that all “subscribers” can take advantage. The participation of caregivers brings in the offline world and links it to the online world creating a merged entity for collaboration. One vision of this world allows patients to interact with all their caregivers, schedule appointments, obtain medical information, purchase products, and share experiences with others hanging out on their “street comer.”

We can only guess how our behaviors will evolve to utilize technology to benefit the management of our health. We do know that the way we envision the use of technology and its impact on us is only a simple, unreliable guess.

  1. References

    Koulopoulos T, Keldsen D. The Gen Z Effect.© 2014 Biblimotion Press, Brookline, MA

Excerpts from “Living and Working in Two Worlds” published in Becker’s Health IT and CIO Review

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