2017-01-03



“The most exciting phrase to hear in science, the one that heralds new discoveries, is not ‘Eureka!’… but (hmm), ‘That’s funny.'” — Isaac Asimov

How humans perceive, intuit, find patterns and connect ideas is still basically a mystery. Kyna Leski attempts to unravel this messy process of creativity in her new book, “The Storm of Creativity“. In it, she shares an interesting story from a friend in medicine:

A healthy young man had come into the hospital complaining of back pain. He had fallen earlier in the day, but didn’t think he was injured. However, in the middle of the night, his pain was suddenly severe enough to alarm him. A receptionist and a nurse await the ER doctor’s diagnosis,

I told them the young man had a collapsed lung and I needed to talk to the surgeon on call. I don’t know what sort of reaction I expected from these two women (they had been doing the night shift together for at least ten years) but the receptionist burst out laughing and slapped her friend on the back in a sort of high-five gesture. ‘See, what did I tell you? she said. I looked at her in disbelief, ‘Dodi. you knew he had a pneumothorax? How?!’ She grinned with a sort of feigned shyness, and said, ‘The way he walked. They all walked that way.

Often, solutions to problems can come from unexpected places. Sometimes, what we need is a different understanding of the problem to be solved — a reframing.

Consider this example by Thomas Wedell-Wedellsborg from the Harvard Business Review: Tenants are threatening to break their leases because the elevator in their building is too slow. People are quick to point out some solutions: replace the lift, install a stronger motor, or perhaps upgrade the algorithm that runs the lift.



However, building managers suggest a much simpler and elegant solution: putting up mirrors next to the elevator. Why did this prove so effective? Because people were found to lose track of time when given something fascinating to look at. In this case, themselves.

The mirror solution is particularly interesting because in fact it is not a solution to the stated problem: It doesn’t make the elevator faster. Instead it proposes a different understanding of the problem. — Thomas Wedell-Wedellsborg

Healthcare trends for 2017

During this time of year, there is no shortage of predictions on the trends we can expect for 2017. I’ve curated a few key trends from various health IT and consumer resources. As you look at making changes in 2017, you need to look across silos to innovate and see things differently.

Health IT industry trends

1. GROWTH OF BLOCKCHAIN

“Healthcare on the blockchain moves from theory to practice.” – via Pokitdok

“In a new report about blockchains in healthcare, the IBM Institute for Business Value collaborated with The Economist Intelligence Unit on a survey of 200 healthcare executives, both payers and providers in 16 countries. The survey found that 16 percent of healthcare organizations, identified as ‘trailblazers,’ plan to have a commercial blockchain solution at scale in 2017.” – Heather Landi, Healthcare Informatics

2.  FOCUS ON CYBERSECURITY

“Healthcare will spend more on IT security in 2017 than ever before, and chief information security officers (CISO) will reign supreme.” – Paddy Padmanabhan, CEO Damo Consulting

Healthcare IT News found the largest spend, 52 percent, is budgeted for health IT security in 2017. Employees are the greatest security risk in an organization. Consider uncovering workarounds as opportunities to improve your system.

Workarounds are almost always indications of an inefficient system, not a lazy provider. – Sociologist Ross Koppel, from Penn’s Perelman School of Medicine

Koppel says, “If you go into a med supply room, you’ll see a forest of yellow stickies with everybody’s work-related passwords, because people need to get their work done and they don’t like being hassled by rules that don’t make sense to them.”

In case you missed it, David Chou offers some security basics for healthcare CIOs here.

3. WAIT FOR FHIR ADVANCEMENTS

“Increased adoption of vendor-neutral FHIR standards, developed by the HL7 organization, as an alternative to proprietary interfaces by leading vendor EHR systems has 94 percent of standalone hospital administrators patiently waiting for FHIR advancements before earmarking more budget dollars for improved connectivity.” – Black Book Market Research survey results

Consumer healthcare trends

According to StartUp Health, a record $7.9 billion was invested in digital health for 2016 with the majority of funding going towards the patient/consumer experience.

4.  THE VOICE-ASSISTED CONVERSATIONAL UI

“One of the things we are doing that a lot of people are not doing right now is a continuous conversation.” – Cathy Pearl, Director of User Experience at Sense.ly, and author of “Designing Voice User Interfaces, The Secrets of Voice UX From A Practitioner’s Point of View”

The growth of Amazon’s Alexa is already unprecedented and represents new opportunities for healthcare development. But according to Pearl, we are poised for the next level of two-way conversational user interfaces in 2017,

Alexa or Siri are responding to commands. Our solution is not about tap to speak. It is turn taking. It is a back and forth, more like a human-to-human interaction. You are not there saying, ‘Alexa,’ every time you want to continue the conversation. I built an Alexa skill (Daily Wellness Check) for fun. It represented one of our daily wellness checks [for Sense.ly]. I learned that the way the Echo thinks about voice user interactions are different from a Sensely model. It is designed more for simple interactions. You can make a request or two. It is not a continuous conversation.

5.  DIGITAL AVATARS, AUTOMATION AND AI

“The introduction of automation and artificial intelligence that take over routine cognitive tasks will allow us to extend the reach of our professional workforce without having to train and deploy more professionals.” – Kaveh Safavi, M.D., J.D. Senior Managing Director, Global Health Industry. Accenture Consulting

For certain tasks, Sense.ly has a virtual nurse avatar. We have no intention of replacing nurses or assistants, but we would like to enhance what they can do. – Cathy Pearl

“The holographic projection of a human doctor, backed by artificial intelligence technologies, will allow for it to handle several queries simultaneously. Beyond answering queries, it could schedule appointments for a physical checkup with a doctor in your network, and share notes of your conversation with a doctor, in a digital-physical care coordination model.” – Reenita Das of Frost & Sullivan’s Transformation Health practice

6. CONSUMERS TO ABSORB RISING COST OF PRESCRIPTIONS

“The rising cost of prescription drugs, particularly brand name pharmaceuticals, has become a major driver of the increasing cost of care.” – Beth Braverman, MONEY Magazine

Braverman says that the overall cost of drugs prescribed to workers under age 65 is expected to grow 11.6 percent in 2017, on top of an 11.3 percent hike from 2016, “In response, insurers are limiting their formularies and shifting away from co-pays to co-insurance, which transfers part of that cost onto consumers.”

Cost is the biggest barrier to medication adherence and this problem will cascade into a host of others that will affect outcomes and value-based care.

Nonadherence can lead to bad outcomes. Some 125,000 deaths and 10 to 20 percent of hospital and nursing home admissions each year are directly attributed to medication non-adherence. It’s ironic non-adherence accounts for some $300 billion a year in additional U.S. health care spending, yet the biggest factor behind this failure is the cost of medications. – CVS Health

Sovaldi by Gilead Pharmaceuticals is the most expensive prescription in America, costing over $75,000 for a 30-day supply to treat Hepatitis C.

Scott Galloway, founder of L2Inc and faculty of NYU Stern, routinely offers an incisive take on consumer digital commerce trends. Although not specifically related to healthcare, it is important to have a pulse on innovations consumers will experience in other industries, and another opportunity to see things differently.

If you are interested in a framework for reframing problems, see Wedell-Wedellsborg’s  seven practices here. Cheers to the innovators who will positively shape 2017!

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