Tuesday, October 23, 2007

Open Source Health Care

Okay, call me a geek.
Or a nerd.
Just don't call me late for dinner.
I've been noodling something new:
As regular readers of IB have no doubt ascertained, I'm an enthusiastic supporter of Consumer Driven Health Care. The basic premise of CDH is that, when consumers have "skin in the game," they're more likely to make informed, rational, effective health care decisions.
My friend Dmitriy Kruglyak, editor of Trusted.MD, proposes an alternative: People Powered Health(care).
Okay, freeze-frame.
Recently, I had the privilege of addressing a large group of local medical practice managers (and some of the doctors whose practices they manage). Since my reputation as an expert in CDH preceded me, that's the subject on which I spent the most time. As I was researching my presentation, though, something began to bother me:
Okay, I admit it: I am a geek. Whenever family members or friends need help fixing their PC's, I'm the first one they call. And I've begun learning about things like Linux, which is part of a (relatively) new movement collectively known as "Open Source Software."
The more I consider this, the more applicable it seems to become to the future of health care (and the financing thereof). What if, instead of focusing on "consumer driven" or "people powered" health care, we turned our efforts instead to "Open Source Health Care?"
So what would OSHC look like?
I'm not really sure. But it seems to me that it would encompass all that's "good" about CDH (consumer empowerment, personal responsibility, transparency and outcomes) and what Dimitry likes about PPHC (peer-to-peer support networks, emphasis on wellness programs, online resources) while encouraging personal responsibility and provider (and carrier) information management.
Not bad, but how would it work?
Well, let’s start with some basic premises:
1) I have a visceral distrust of gummint-run health care systems. OTOH, my own industry has to be pulled, kicking and screaming, into making things "work."
2) As much as I advocate CDH, it's slow in "taking off." Part of that is our cultural reluctance to take personal responsibility, but a part is also that we lack both the tools and the incentive to empower ourselves.
3) Dimitry's PPH relies on tech & wellness programs, but seems to emphasize the provider angle.
4) What we need is a catalyst: something to drive us forward, to give people an incentive to make changes in lifestyle, care delivery AND funding (insurance) choices.
5) It occurs to me that we're using outdated models for all of these things. We should be looking at what's currently driving our economy and society: information. And how do we access that information? Computers. But it's not about Windows and Mac's. The real action is in the Open Source community.
Why? Because there's a synergy there: folks share info and code, try out new ideas (some of which flame out, but some of which stick). The bottom line is, they're driving information delivery tech forward.
What’s appealing about Open Source Software is that emphasis on sharing: new ideas, new tech, new code. Seems to me, Open Source Health Care could emphasize sharing, too: resources, information, outcomes and pricing. The culture of OS is one which embraces and encourages change, not for its own sake, but for a specific purpose.
Could we co-opt that culture, and apply it to health care delivery (docs, hospitals, pharma, etc) and funding (insurance)? You’ll have noticed that I’m not proposing any specific ways in which this could be implemented; right now I’m primarily interested in whether the concept makes any sense.
Well, dear readers?
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