What’s still missing as we reform healthcare: simplification

December 11, 2014

Innovation is so often based on simplification — to take what would seem undoable or difficult and make it not only possible, but easy. Yet, for all of the effort involved in improving our healthcare system, the goal of simplification has proven notoriously difficult to achieve.

The reasons are many, starting with the concept of risk-benefit. In other domains, simplification is achieved through trial and error to find what works and replicate it. When we are talking about our well-being, however, this kind of trial and error is often unacceptable.

The second major reason relates to complexity: biology is messy. Although we are making wonderful progress, the practice of medicine remains an “art,” with as many exceptions as rules, making the kind of algorithmic simplification common in other pursuits more difficult to achieve.

IBM's Watson computer, Yorktown Heights, NY

IBM’s Watson computer, Yorktown Heights, NY

Yet, impressive things are happening. IBM has put its Watson supercomputer to work to help to make medical recommendations, and is moving toward direct interaction with consumers on health decisions.

More and more data are being captured via electronic health records and these are being impressively coupled with outcomes — together providing much deeper, real-world evidence data sets on which treatment recommendations can be built.

In areas such as compliance, new tools are emerging to help patients take their medications reliably — a major problem in chronic diseases, like schizophrenia and others.  In health and wellness, simplification tools that remind and reward us of helpful activities are becoming commonplace.

As we look at other segments that have yielded to simplification, the rewards are clear. Banking, commerce, transportation — even art — have been transformed by simplification and disintermediation.

In banking, linked e-communication systems connect us to our money; enabling instantaneous and seamless purchases while making automatic teller machines (ATMs) and printed currency in general seem old school. Here, the key breakthrough was about authentication. Once encryption and authentication algorithms were designed to replace the verification function of the bank teller, there was a clear path of progression to ATMs, to cashless systems…maybe even to approaches that take us beyond sovereign currencies like Bitcoin.

In transportation, we now dash from our homes without a map or a clue of the path to our destinations, confident that our GPS-enabled cars or phones will guide us — placing printed maps and road atlases in the parking lot of history.

Similarly, data and simplification have transformed the marketing, advertising and retail industries to where our purchases are highly influenced by our specific buying trends and demographics, and made simpler by removing steps, complexity and cost. Soon, we will be guided precisely to the shelves containing the items we desire as GPS-driven purchasing takes hold and further transforms retailing — and with it our shopping experience.

Even the art of making and sharing a picture has been transformed. This year, the number of internet enabled digital cameras in operation is expected to exceed the world’s population, as we all become accustomed to capturing anything we see and sharing it instantly with anyone, anywhere, anytime.

Even the creation of “art” — made simple — can be transformed if it is reduced to clearly defined steps and a set of instructions. Only 60 years ago, the “Paint by Numbers” craze swept the world after being invented by Max Klein, owner of the Palmer Paint Company and artist Dan Robbins. A few years after the Palmer Paint began distributing paint-by-number kits in 1951, more than 12 million had been sold, and these “works of art” were gracing the walls of homes everywhere – even including the West Wing of the Eisenhower White House.

Painting a new landscape (number-by-number) for healthcare will require that we bring patients and customers into the process and it certainly will be driven by data. Our initial steps toward simplification in healthcare demonstrate the benefit of defining clear new roles for each of us to play in managing our own health. If following a series of clear instructions can turn mere mortals into artists, it ought to enable us to finally tackle the costs and inefficacies that currently plague healthcare.

Next up — ‘Tis the season and the gift of giving; observations on 2014 innovations that are poised to change the world.