A holiday reminder of the dismal state of Healthcare IT

I’m home in the Bay Area for thanksgiving with the fam’, which means my attempts to work from my old bedroom are periodically punctuated by that most classic of family rituals – driving my mom around to run errands.

Thus, I find myself tapping this out on my iPhone as I find myself stuck for the n-th time waiting FOREVER at a pharmacy as some mystifying process glitch has thrown the normally “well-oiled” @Walgreens machine into befuddled disarray.

You see, the Walgreens system can’t seem to figure out that my mother has actually been prescribed one of the medicines she’s getting a refill of. Or that a second refill has been authorized, even though she handed them a physical prescription slip yesterday. One suspects that dealing with such nonsense takes up a substantial portion of at least one of these pharmacists day.

Now let’s imagine a different world. A better world.

You walk into your doctor’s office, complaining of a sore throat and unsightly discharge. The doctor presses a button, and up comes your entire health history, including all the medicines you’ve ever taken and all the procedures you’ve had. She enters your symptoms, and an “expert system” like IBM’s Watson automatically checks data published by the Center for Disease Control and prepares a report showing the empirical probability you have various diseases given your symptoms and history, and proposes the most effective tests to narrow down the options. As a bonus, the system checks your personal genetic information to identify the ideal diagnosis and treatment.

The doctor appraises the automated results and decides that you must have…let’s just say…Lupus (in the spirit of House, MD). This can be easily treated with a few pills of Silver&Garliceral. The doctor presses a button, and the system, which has your address and insurance information, automatically connects with the nearest pharmacy to put in a prescription authorization. The pharmacy system automatically estimates the wait time, and sends you a text when your prescription is ready, or if it’s not urgently needed (which it knows based on the disease it’s prescribed for), just mails it to you.

This world saves a massive amount of time both for patients and administrators, and also substantially reduces the risk that patients will get the wrong medicine, or the wrong dose, or simply neglect to pick up their prescription at all.

And here’s the thing – the world I describe is not fantasy. We could do all of the things I describe just by cobbling together existing technology. In a world where healthcare costs are constantly rising faster than inflation, fixing this completely fixable mess (by fighting the institutional dynamics / inertia that allow it to continue) seems like a great place to start.

Forgive typos…I literally wrote this on my iPhone.

Advertising in online video

I watch a lot of online video.

My schedule doesn’t really allow me to be available during “prime-time”, nor can I commit the every-week-consistency that following a serial TV show requires.

So streaming TV shows online is, theoretically, great for letting me watch 10 minute chunks of my favorite shows while I devour Honey Nut Cheerios at 1am. But by-and-large, the experience is just frustratingly awful, given how easy it is to imagine a better solution using only slight re-arrangements of currently available technology. 

So let me throw a few exhortations out into the ether, for all you online video executives who surely have nothing better to do than read my tumblr.

1. The exact content I want must be available immediately, in high quality, exactly when I want it and in the format I want it. I know studios want control over how viewers receive their content so they can control brands or whatever blah blah blah. Too bad. That war is already lost. If your customer is sophisticated enough to find your official streaming version, they’re sophisticated enough to find a restriction-free pirated version. And within ten years, nearly every viewer will be that sophisticated.Pass PROTECT-IP or whatever Orwellian-appellated laws you want, you’ll just hasten the advent of strongly encrypted P2P, and it’s game over. Get on the right side of history.

2. I prefer official versions. I don’t want to pirate, and I do want the creators of the content I enjoy to get paid lots of money so that they keep producing those magical moving images. So make the official version clearly better than the pirated version! Make it easy to find! Make it high resolution! Build interactive content in or around the player-window (e.g. make it easy to tweet about an episode, or find facebook friends who are watching the same thing). Provide behind the scenes photos or directors commentary IN AN EASY TO FIND place.

3. And the big point. Don’t suck at advertising! If I try to watch three episodes of South Park online in a row, I’ll see probably five different advertisements. But I’ll see each of them repeated four times! Even if I wanted to buy Redbull, and even if I liked the ad, seeing it four times will make me hate Redbull, and hate you. 

I can only assume that the extremely thin selection of ads in most online video is because advertisers just aren’t buying the spots in quantity. That’s mystifying to me. Online video seems like such a better place to advertise than TV.

You have:

1. Demographic information about the viewers (especially if they’ve used facebook to log into the viewer). You may have the site they redirected from. You know what time they’re watching the show, and probably their location.

2. You know they’re already at a computer, and are literally two lazy clicks away from buying whatever your advertising in the ad, instead of having to remember it until next time they’re at a computer (and actively track down and buy your random product.) 

It seems pretty inevitable to me that within a few years, we’re going to have all of TV available instantly online, supported by ads that are delivered in HD, tailored to the audience, relevant and entertaining enough that users would rather watch them than find pirated sources, and full of compelling “oh I want to click that” elements that will directly drive sales. Cf. Spotify.

Whoever makes that happen is going to make some serious money, and make it seriously easier for me to hate myself for watching another episode of “The Only Way Is Essex.”