Reinventing Healthcare to Serve People, Not Institutions
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Transcript of Reinventing Healthcare to Serve People, Not Institutions
#SxSW @timoreilly
By People, For PeopleReinventing Healthcare to Serve People, Not Institutions
Tim O’Reilly
SxSW
March 16, 2015
@timoreilly
“The skill of writing is to create a context in which other people can think.”
-Edwin Schlossberg
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This is the key question
How do we use the capabilities of our devices
to build better human experiences?
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Look At Everything Uber Does For Me Lets me call a car from anywhere
Automatically tells available drivers where I am
Lets me know how long it will be till my car arrives
Lets me contact the driver by text or voice - anonymously
Lets me pay without having to pull out my wallet
Gives me a detailed receipt showing exactly where I went and how long it took - which lets me complain if the driver didn’t go the optimal route (and Uber gives refunds)
Lets me rate my driver, and uses that rating to manage the quality of service
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How a Doctor’s Visit Ought to Work•Phone detected on entry to office, hospital, or ER
•Insurance automatically checked
•Medical history automatically loaded into system
•Vitals and other quantified self info automatically loaded
•Data automatically used to sort queue and give wait times
•If ER, possible discharge to available nearby outpatient clinic or doctor’s office
•Portable medical record updated as patient exits
•(Aside: We also need payment reform!!!)
•Lets me rate my experience, and uses that rating to manage the quality of service
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“Why be distracted into looking backwards by the
commodity cloners of open source?...There is a new
frontier, where software "collectives" are being built with
ad hoc protocols and with clustered devices. Robotics
and automation of all sorts is exposing a demand for
sophisticated new ways of thinking....Useful software
written above the level of the single device will
command high margins for a long time to come.”
- Dave Stutz, On Leaving Microsoft, February 2003
http://www.synthesist.net/writing/onleavingms.html
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Data At the Heart of the Uber System
Real-time location tracking
Dispatch
Trip tracking
Names and faces
Payment
Dynamic Pricing
Reputation
PassengerDriver
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Minimum Viable Product
“that version of a new product which
allows a team to collect the maximum
amount of validated learning about
customers with the least effort.”
- Eric Ries
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We’ve taken this for granted in web
applications. But now, with Internet of Things
applications powered by big data back ends,
Lean Startup principles apply to every real
world service!
Text
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“Only 1% of healthcare spend now goes to
diagnosis. We need to shift from the idea that you
do diagnosis at the start, followed by treatment, to
a cycle of diagnosis, treatment, diagnosis...as we
explore what works.”
-Pascale Witz, GE Medical Diagnostics
Text
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“Half the money I spend on advertising is
wasted; the trouble is I don't know which
half.”
- John Wanamaker (1838-1922)
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“We know about all these new technologies. What we
don’t know is how to organize ourselves to use them
effectively.”
- An IT executive at Fidelity, during Q&A
after a talk I gave there in 2008
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“Uber is a $3.5 billion lesson in
building for how the world *should*
work instead of optimizing for how
the world *does* work” - Aaron
Levie of Box.net
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Rescuing healthcare.gov
A team of engineers. They came in and worked tech
wizardry, right?
Maybe some of that, but a lot of the work was debugging the
communications failures that led the contractors to build
software components that didn’t work together.
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17 hour days
100 days straight
Standup meetings focused on why people weren’t
able to keep the promises they’d made to each other
Mikey Dickerson
Google Site Reliability Engineer
Mikey Dickerson
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“…one privilege the insured and well-off have is to excuse the
terrible quality of services the government routinely delivers to
the poor. Too often, the press ignores — or simply never knows —
the pain and trouble of interfacing with government
bureaucracies that the poor struggle with daily.”
—Ezra Klein
@timoreilly
“User needs. An empathetic service would ground itself in the concrete needs of concrete people. It’s not about innovation, big data, government-as-a-platform, transparency, crowd-funding, open data, or civic tech. It’s about people. Learning to prioritize people and their needs will be a long slog. It’s the kind of change that happens slowly, one person at a time. But we should start.”
@timoreilly
“Unboxing” MediCal
Alan Williams
2012 Startup engineer
2013 Code for America Fellow
2014 On Food Stamps and MediCal
What we are going to cover today
Header 1
• Header 2• Bullet 1
Blah blah blah
• Bullet 2Blah blah blah
• Bullet 3Blah blah blah
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Government can work
for the people,
by the people,
in the 21st century,
if we make it so.Jennifer Pahlka
@timoreilly
Learn More About How You Can Help
Meetup tomorrow morning 9 am - 11 am
Halcyon, at 4th and Lavaca
c4a.me/sxsw15
codeforamerica.org/talent
whitehouse.gov/usds