Hello from the Galapagos

I stumbled across an article called A Management and Information Perspective on Healthcare. In the first part of the article, the author, Faisal Hoque, does a great job of illustrating the technology chasm between health care and other industries with which we interact.

The article is written to appeal to the business sensibilities of the reader. He appeals to the (business leadership) readership:

You would never put up with anything as inefficient as the US healthcare system in your own organization. Maybe we should apply some of the principles you use to the problem.

Faisal Hoque's vignette brings to life - in practical terms - the perverse evolution of the existing health care system. His article is a great read.

Meanwhile, Claudio Luis Vera has drawn parallels between the evolution of the health care system with Galapagos-style evolution:

While the rest of the world has been shaped by gut-wrenching change, healthcare has been on its own virtual Galapagos, evolving at its own pace.

The world has caught up to this island oasis, bringing with it the Darwinian forces of technology and the market, threatening the industry's very sustainability. It needs to cope quickly -- and embrace survival strategies that have worked for the rest of the world.

On the island, "healthcare IT" or HIT is the catchall term for any sort of information flow that happens between patients, clinicians, hospitals and insurers. It's a bit of a misnomer, as it places the emphasis on machines and protocols -- and not on the ways that information is structured and understood by humans.

Robert Fabricant of frog design also landed on the same metaphor with his Fast Company Design4Impact blog article MDR-TB: The Galapagos Effect in Health Care.

The health-care industry in this country has suffered hugely from the Galapagos Effect. It has evolved its own ecosystem and business practices that reflect this isolation. This can be seen in every link in the value chain, as consumption and payment are completely disassociated in this country. Health care has evolved in isolation from many of the forces that have re-shaped other industries in recent years. This isolation is readily apparent to each of us whenever we step into a doctor's office or hospital waiting room.

Despite their best efforts, industry leaders continue to betray an outdated, manufacturing mindset, referring to everything that has impact in the field--that touches communities and provides real human value--as "delivery." This one-way model of engagement is truly shocking in an age dominated by communications technologies and connectivity. Health is not 'delivered' to people. It relies on active engagement and participation. It is a dialogue.

The above authors bring different perspectives to understanding health care. All see the current system operating in isolation from other societal, business, and technology systems. What the Galapagos, I mean the health care system, needs is more fresh perspectives like these. The worlds of business, information architecture, usability, design, and open source have a wealth of information, experience, and expertise to offer as we build a better health care system. Let us listen to what they have to say.