Disruptive technologies follow a similar societal pattern, where geeky mavericks often clueless about the implications of their own inventions inspire early adopters who pave the way for revolution and eventual institutional transformation.
In retrospect these technological paradigm shifts seem as inevitable as they once were surprising, an evolution from custom design to mass production, or shift from product to information-based economies quickly considered de rigueur.
But institutions have the tendency to perpetuate problems they ostensibly are meant solve, even overtly beneficial advances typically met with stubborn, furious resistance. With every change, money and livelihoods are at stake.
A powerful example of tech disruption being opposed by an industry despite beckoning possibilities is book publishing, where all the promise and potential of digital is frequently dismissed as threatening the very essence of good writing.
A captivating and timely essay “What is the Business of Literature?” by Richard Nash (@R_Nash) and affectionately summarized in TechCrunch presents the historical context and captures the essence of the ongoing conflict.
Nash’s point is brilliant and long overdue: Despite tech’s seemingly adversarial relationship with book writing, editing, distribution, and marketing, digital’s disruptive power is identical to literature’s role as a radical agent of change.
In other words, the driving creative spirit, eagerness for experimentation, exploration, and revolution so characteristic of the digital age embody the same ideas and emotions that have fueled writers and editors of great books for millennia.
The takeaway is that publishing, long succumbing to “hard copy fetishism” and the market forces of a bygone era is at a critical juncture; but instead of dying at the hands of digital, the industry can actually become reinvigorated and reinvented.
What might that mean for healthcare in the face of digital?
Healthcare Industry Analog
As digital experts, we’ve seen a very similar pattern in the institutional resistance to technology exhibited by the healthcare communications industry in general, and pharmaceutical and device manufacturers in particular.
Notice the emphasis on “communications” rather than research and development, diagnostics, practice management, and other core competencies where technology has instead taken an active, frequently central role in medicine for generations.
Sit on any healthcare company investor call and you’re most likely to hear news about pipeline development for products or drugs, M&As and divestments, number of scripts sold or beds filled: Technology is welcome and supported in all these areas.
But what about the end-user—the patient—and the physicians who treat them? The soul of medicine is the Hippocratic oath, whereby healthcare professionals promise to benefit the sick, each doctor according to their own ability and judgment.
Once limited to enterprise-level capabilities, digital health has since migrated from mainframe computers in cool rooms to smartphones packing computational punch at the point of care. “Ability and judgment” is now personal and peer-driven, right?
In principle, yes, but in practice, still an epic struggle. The healthcare industry’s qualified love affair with tech has hardly changed a patient’s doctor visit, or encouraged any dialogue like that between consumer brands and their targets.
Future generations will smirk at our restrictions on peer-to-peer healthcare communication and our haphazard oversight of mobile health devices. They will wonder why billions are spent on drug development, and apps are expected to be free
Akin to the challenges facing publishing in the wake of the digital revolution, healthcare must adapt to this brave new world of electronically empowered patients, caregivers, clinicians, physicians, hospital administrators, and others.
How will digital health eventually transform all of healthcare?
“What is the Business of Healthcare?”
The stakes couldn’t be higher, the timing more urgent. Sprawled between a handwritten insurance form and the Quantified Self are regulatory, privacy, and infrastructure challenges that frequently dampen the high tech excitement.
We should look no further than what motivates us in the first place: Sickness that has touched every family, all of us in one way or another current or future patients, as the need for affordable and effective healthcare is universally paramount.
That being said, risk taking, experimentation, and a tireless willingness to do what it takes to heal all lie at the very heart of medicine—and these same characteristics drive the way we develop and use the latest digital health technologies and tools.
We know that responding to unsolicited, off-label requests for information is actually in the best interest of public health. We know that a typical smartphone has a thousand times the computational power of the lunar lander.
We know that integrating social media networks with point of care diagnostic devices and electronic medical records will vastly improve both the patient’s experience and the physician’s capacity to improve quality of life.
We know that the integration of mobile health technologies throughout the healthcare system will bring the point of care everywhere, reducing the need for hospital stays, in-office doctor visits, while helping under-served and regional areas.
We know what it takes and can begin to visualize a feasible and effective solution. Similar to the publishing industry, sacred cows need slaughtering, but few seem to have the power or blasphemous wherewithal to shake the foundation to its core.
As Nash suggests in his essay, book publishing is a culture, not a methodology. Healthcare is innately even more vulnerable, sensitive, and human. So the answer to digital health disruption is welcoming and encouraging that same spirit of change.
How can healthcare companies, orgs, agencies, and advocacy groups facilitate the digital health revolution? Let’s continue the conversation!