Fred Truman
Design & Code Creative
Reactions to DIY Health Readings
September 16, 2011
Alright! In an effort to stay focussed and excited after spending the better part of my afternoon reading, I’ve decided to be completely cheesy here with an image chosen to represent how I feel about self-tracking and self-care. As a symbol freedom and independence I think the eagle embodies the spirit of what I see in the trend towards placing the responsibilities of personal health care in the hands of the individual. I’m not going to blow anyone’s mind here with some killer insight, but after reading:
- “The Cost Conundrum” – Atul Gawande, New Yorker, June 2009
- “A Billion Little Experiments” – Rajiv Mehta (2009). An essay on the power of all the experiments carried out by individuals.
- “Reframing Health to Embrace Design of Our Own Well-being” – with Hugh Dubberly, Shelley Evenson, and Paul Pangaro, Interactions, ACM, New York, May-June 2010
- “The Data-Driven Life” – Gary Wolf, NY Times, April 2010
…it’s obvious that we in America (especially) are moving towards a critical inflection point in how we think and act towards our personal health. If you can picture the problems of our national healthcare system on a rapidly increasing curve reflecting costs and a confounding increase in disease correlation - there is an equal and opposite graph that reflects the way in which common (and now nearly ubiquitos) technologies can aid our personal data collection and thus allow us to make smarter choices about our health. Knowing more about the human body and crazy procedures to rescue it from critical situations is great, but we could benefit so much more by knowing more about our human body and how to anticipate and prevent ailments by tracking changes in ourselves and being proactive with existing forms of care. It makes a lot of sense.
Yes, it’s very clear that our healthcare system is very broken. No, I’m not sure if we can do a whole lot about before it completely crashes. I would say that by focussing on what we can productively do as individuals is doing the larger society a greater service than trying to jump into the boxing arena with the stooges in Washington. There was one great analogy for healthcare from “The Cost Conundrum”, however:
“Providing health care is like building a house. The task requires experts, expensive equipment and materials, and a huge amount of coördination. Imagine that, instead of paying a contractor to pull a team together and keep them on track, you paid an electrician for every outlet he recommends, a plumber for every faucet, and a carpenter for every cabinet. Would you be surprised if you got a house with a thousand outlets, faucets, and cabinets, at three times the cost you expected, and the whole thing fell apart a couple of years later? Getting the country’s best electrician on the job (he trained at Harvard, somebody tells you) isn’t going to solve this problem. Nor will changing the person who writes him the check.”
This sums it up pretty well. Healthcare has unfortunately become just another business under the current dogma. It adds:
“Here’s how this whole debate goes. Advocates of a public option say government financing would save the most money by having leaner administrative costs and forcing doctors and hospitals to take lower payments than they get from private insurance. Opponents say doctors would skimp, quit, or game the system, and make us wait in line for our care; they maintain that private insurers are better at policing doctors. No, the skeptics say: all insurance companies do is reject applicants who need health care and stall on paying their bills. Then we have the economists who say that the people who should pay the doctors are the ones who use them. Have consumers pay with their own dollars, make sure that they have some “skin in the game,” and then they’ll get the care they deserve. These arguments miss the main issue. When it comes to making care better and cheaper, changing who pays the doctor will make no more difference than changing who pays the electrician. The lesson of the high-quality, low-cost communities is that someone has to be accountable for the totality of care. Otherwise, you get a system that has no brakes.”
Yeah. You get it. But interestingly, “A Billion Little Experiments” adds this great quote from Thomas Edison:
“Vision without execution is hallucination”
So why waste our breath on the nuts and bolts of a broken system when we can get down to business? Huh? I’d like to participate by starting to commit myself to some sort health-tracking regimen, at least on parameter. I’m excited to think more about the ways in which ambient and ubiquitous tracking can be a reality in our lives. How comprehensive must a list of trackable parameters be to represent a “holistic” look at our health? Which of these parameters is easily attainable and which present greater challenges? And what does this data-driven dashboard look like?
[image credit: Tamabako the Jaguar]