Exploring Human Potential

What Do Steve Jobs, The NEJM and 18 to 29 Year Old’s Have In Common?

Mike Magee

Change is never easy. It always involves breaking through the status quo which of course holds on for dear life. But trend lines sooner or later do force adjustment. This is becoming more and more obvious in health care, troubled with high costs, variable quality and a fundamental locational disconnect – placement of resources and services far away from where the people live their lives and make their health and wellness decisions.
If we needed a reminder that health change is near, consider the news, just this week from three different worlds – the worlds of the health consumer, the health provider, and the health technologist. First the socially networking consumer. New data, released from the Pew Internet and American Life Project this week(1), show that 83% of American Internet users have now looked up health information through search engines. More importantly, nearly 1/3 of cell phone users, age 18 to 29 have done health searches on their mobile phones. There are over 250,000 apps on the iPhone and 30,000 apps for Android running smartphones, with health apps well represented.(1,2)  The take-away? Look for the number of health searches to continue to swing rapidly upward, providing greater sense of privacy and mobility then PC’s or Macs in the workplace or at home. The health consumer is on the move and broadband and mobile phone apps for health decision making are matching them stride for stride.

How about the health provider. Well consider the lead editorial in this week’s New England Journal of Medicine written by Dr. Steven Landers of the Cleveland Clinic.(3) In it he states, “In the past century, health care became highly concentrated in hospitals, clinics, and other facilities. But I believe that the venue of care for the future is the patient’s home, where clinicians can combine old-fashioned sensibilities and caring with the application of new technologies to respond to major demographic, epidemiologic, and health care trends. Five major forces are driving health care into the home: the aging of the U.S. population, epidemics of chronic diseases, technological advances, health care consumerism, and rapidly escalating health care costs….ultimately, health care organizations that do not adapt to the home care imperative risk becoming irrelevant. It seems inevitable that health care is going home.”

Last but by no means least is information technology itself. This week Steve Jobs announced refinements in the new ultra-thin MacBook Air models.(4) Jobs said, “We asked ourselves what would happen if a MacBook and an iPad hooked up?”  Taking technologies like the multitouch user interface from the iPhone and the iPad and using them to refresh its Mac business is not only good for business, it begins to already fulfill a Jobs prophecy from less then a year ago that the iPad approach to computing would change the way we interface with knowledge – faster, smarter, easier, more pleasurable and more equitable. PC goes to mobile and back to PC’s. (4)

These are just three bits of change in a single week. But consider for a moment their disruptive power when combined. Complex, mobile multi-generational families can plan and organize their families health while on the move. Arguably the most prestigious medical journal in the world features the opinion of a academician who says the action in health in the future will be in the home, and we providers need to go there. And the greatest IT innovator of all time says the information you need, by computer, Pad or phone, will now be literally at “the tips of your fingers”. Think it, feel it, get it.

All this – without any significant financial incentives – yet. My prediction? Within 12 months, modestly funded pilots will point the way toward significant rewriting of the way we fund health care. Care is most efficient when supported by accurate information with decisions made close to home. Efficient care costs less and delivers superior results. The technologists and the people know this. The NEJM article is now sending a clear signal that health professionals, too, have gotten the message, and their institutions are beginning to act on it.

For Health Commentary, I’m Mike Magee


1. Pew Internet and American Life Project. Mobile Health 2010.
2. Cohen E. Your top health searches, asked and answered.
3. Landers SH. Why Health Care Is Going Home. NEJM. October 21, 2010.
4. Helft M. Apple Flips The Playbook putting mobile in PC’s. NYT. October 21, 2010

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