By People, For People Reinventing Healthcare to Serve People, Not Institutions презентация

Содержание

@timoreilly “The skill of writing is to create a context in which other people can think.”

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By People, For People
Reinventing Healthcare to Serve People, Not

Institutions

Tim O’Reilly
SxSW
March 16, 2015


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“The skill of writing is to create a

context in which other people can think.”

-Edwin Schlossberg

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@timoreilly
The smartphone is the most widely distributed “Internet of

Things” platform.

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The Apple Store is magical!


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@timoreilly




“Any sufficiently advanced technology is indistinguishable from magic.”
Arthur C.

Clarke

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@conference @timoreilly


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Uber and Lyft and Cover are magical!


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Google Now is magical!


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Lesson #1:
Use technology to give people super powers



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Our Phones Used to Be the Tool of Superheroes

Dick

Tracy: 1946

Star Trek: 1964


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An Everyday Modern Superpower


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This is the key question
How do we use the

capabilities of our devices
to build better human experiences?

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Lesson #2:
Do Less!


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How often have you filled out
some version of

this form?

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20th Century Vital Sign Monitoring


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Lesson #3:
Do More!


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WTF?!


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Look At Everything Uber Does For Me
Lets me call

a car from anywhere
Automatically tells available drivers where I am
Lets me know how long it will be till my car arrives
Lets me contact the driver by text or voice - anonymously
Lets me pay without having to pull out my wallet
Gives me a detailed receipt showing exactly where I went and how long it took - which lets me complain if the driver didn’t go the optimal route (and Uber gives refunds)
Lets me rate my driver, and uses that rating to manage the quality of service

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How a Doctor’s Visit Ought to Work
Phone detected on

entry to office, hospital, or ER
Insurance automatically checked
Medical history automatically loaded into system
Vitals and other quantified self info automatically loaded
Data automatically used to sort queue and give wait times
If ER, possible discharge to available nearby outpatient clinic or doctor’s office
Portable medical record updated as patient exits
(Aside: We also need payment reform!!!)
Lets me rate my experience, and uses that rating to manage the quality of service

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Lesson #4:
Build software “above the level of a

single device”

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“Why be distracted into looking backwards by the commodity

cloners of open source?...There is a new frontier, where software "collectives" are being built with ad hoc protocols and with clustered devices. Robotics and automation of all sorts is exposing a demand for sophisticated new ways of thinking....Useful software written above the level of the single device will command high margins for a long time to come.”

- Dave Stutz, On Leaving Microsoft, February 2003
http://www.synthesist.net/writing/onleavingms.html

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Data At the Heart of the Uber System
Real-time location

tracking
Dispatch
Trip tracking
Names and faces
Payment
Dynamic Pricing
Reputation

Passenger

Driver



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Many of these data services are not run by

Uber

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Something about state of interoperability


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Lesson #5:
Measure and Respond


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The Lean Startup


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Minimum Viable Product
“that version of a new product

which allows a team to collect the maximum amount of validated learning about customers with the least effort.”

- Eric Ries

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We’ve taken this for granted in web applications. But

now, with Internet of Things applications powered by big data back ends, Lean Startup principles apply to every real world service!

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@timoreilly


“Only 1% of healthcare spend now goes to diagnosis.

We need to shift from the idea that you do diagnosis at the start, followed by treatment, to a cycle of diagnosis, treatment, diagnosis...as we explore what works.”
-Pascale Witz, GE Medical Diagnostics

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@timoreilly


“Half the money I spend on advertising is wasted;

the trouble is I don't know which half.”

- John Wanamaker (1838-1922)

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Lesson #6:
These are systems made up of
computers

and humans working together

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@conference @timoreilly


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“We know about all these new technologies. What we don’t know

is how to organize ourselves to use them effectively.”

- An IT executive at Fidelity, during Q&A
after a talk I gave there in 2008

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Слайд 53#VelocityConf @VelocityConf @timoreilly

@conference @timoreilly


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Are New Ways of Organizing People


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23andMe


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PatientsLikeMe


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“Uber is a $3.5 billion lesson in building for

how the world *should* work instead of optimizing for how the world *does* work” - Aaron Levie of Box.net

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That’s the bar we need to set
for reinventing

healthcare and health insurance

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Adding Digital To The Way the World Works Now


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Lesson #7:
Rethink Workflows and Experiences!


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Learning from Failure


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Rescuing healthcare.gov
A team of engineers. They came in and worked tech

wizardry, right?

Maybe some of that, but a lot of the work was debugging the communications failures that led the contractors to build software components that didn’t work together.

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17 hour days
100 days straight
Standup meetings focused on why people weren’t

able to keep the promises they’d made to each other

Mikey Dickerson
Google Site Reliability Engineer

Mikey Dickerson


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“…one privilege the insured and well-off have is to excuse the

terrible quality of services the government routinely delivers to the poor. Too often, the press ignores — or simply never knows — the pain and trouble of interfacing with government bureaucracies that the poor struggle with daily.”
— Ezra Klein


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“User needs. An empathetic service would ground itself in the concrete

needs of concrete people. It’s not about innovation, big data, government-as-a-platform, transparency, crowd-funding, open data, or civic tech. It’s about people. Learning to prioritize people and their needs will be a long slog. It’s the kind of change that happens slowly, one person at a time. But we should start.”

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“Unboxing” MediCal


Alan Williams
2012 Startup engineer
2013 Code for America Fellow
2014 On Food

Stamps and MediCal

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MediCal Unboxing


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The Failure Funnel


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GDS


Слайд 102What we are going to cover today
Header 1
Header 2
Bullet 1
Blah blah

blah
Bullet 2
Blah blah blah
Bullet 3
Blah blah blah

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Government can work for the people, by the people, in the

21st century, if we make it so.

Jennifer Pahlka


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for the people


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for people


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by people


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Build 21st century services
of people,
by people,
for

people

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Learn More About How You Can Help
Meetup tomorrow morning

9 am - 11 am
Halcyon, at 4th and Lavaca


c4a.me/sxsw15
codeforamerica.org/talent
whitehouse.gov/usds

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