Do We Need Doctors Or Algorithms?

robot medic

Image credit: Shutterstock/koya979

By Vinod Khosla, founder of Khosla Ventures
(original on

I was asked about a year ago at a talk about energy what I was doing about the other large social problems, namely health care and education. Surprised, I flippantly responded that the best solution was to get rid of doctors and teachers and let your computers do the work, 24/7 and with consistent quality.

Later, I got to thinking about what I had said and why, and how embarrassingly wrong that might be. But the more I think about it the more I feel my gut reaction was probably right. The beginnings of “Doctor Algorithm” or Dr. A for short, most likely (and that does not mean “certainly” or “maybe”) will be much criticized. We’ll see all sorts of press wisdom decrying “they don’t work” or “look at all the silly things they come up with.” But Dr A. will get better and better and will go from providing “bionic assistance” to second opinions to assisting doctors to providing first opinions and as referral computers (with complete and accurate synopses and all possible hypotheses of the hardest cases) to the best 20% of the human breed doctors. And who knows what will happen beyond that?

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Let me down Easy is a must-watch performance

image from Let Me Down Easy on PBS.orgYvonne and I loved Anna Deavere Smith’s solo performance of Let Me Down Easy, which blends theatrics, journalism and social commentary about Healthcare, and I highly recommend watching it. PBS aired the program as part of its Great Performances series this week on Friday the 13th, how fitting with the state of our nation’s healthcare system. Here’s what they said about it.

She performs 19 characters in the course of an hour and thirty five minutes. Their stories are alternately humorous and heart-wrenching, and often a blend of both. Building upon each other with hypnotic force, her subjects recount personal encounters with the frailty of the human body, ranging from a mere brush with mortality, coping with an uncertain future in today’s medical establishment, to confronting an end of life transition. The testimony of health care professionals adds further texture to a vivid portrayal of the cultural and societal attitudes to matters of health.

Watch this 2:10 min video preview;

Read about what PBS had to say and what New York Times critics said.

mHealth and Child Abuse

child abuseby David Lee Scher, MD (11/9/2011)

There has not been a more horrific scandal in the world of sports that I can remember than the child abuse scandal (the mainstream media calls it a sex abuse scandal) surrounding The Pennsylvania State University.  Let it be said that I am very impressed with the reaction of much of the student body which is one of shock and disdain for the administration charged with covering up alleged abuses of children by a former assistant football coach. According to the grand jury’s report, the school demonstrated willful blindness to the allegations brought to it, none going to state officials. Some of the fans at Saturday’s PSU-Nebraska football game are organizing a blue shirt campaign to show solidarity for the victims (blue ribbon being a symbol of child abuse).

As this blogger is an evangelist for wireless technologies and the noble things it will deliver (efficient, dignified, cost-effective and better continuous healthcare), I think it fitting to discuss how mHealth technologies may, in the future, be useful tools for subjects of child abuse and their loved ones.  Read More …

Innovator’s Prescription: Disruptive Healthcare Solution

book cover of The Innovator's PrescriptionHarvard Business School’s Clayton M. Christensen — whose bestselling book, The Innovator’s Dilemma, revolutionized the business world — now presents The Innovator’s Prescription, a comprehensive analysis of the strategies that will improve health care and make it affordable.

In this meaty 87-min lecture at MIT, Professor Christensen explains how you can’t believe everything you learn in business school and reveals insights into such socially significant and complex industries as health care. “It’s the principles of good management that can cause successful companies to fail,” he says.

The lecture introduced concepts from his latest book, where Christensen applies his principles of disruptive innovation to the broken health care system. With collaboration from two pioneers in the field — Dr. Jerome Grossman and Dr. Jason Hwang — he examines a range of symptoms and offers proven solutions.

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GE, Microsoft to Launch Global Healthcare Venture

GE, Microsoft to Launch Joint Venture Aimed at Global Healthcare System Transformation

BARRINGTON, Ill., and REDMOND, Wash. – Dec. 7, 2011 – General Electric Co., through its healthcare IT business, and Microsoft Corp. today announced plans to create a joint venture aimed at helping healthcare organizations and professionals use real-time, systemwide intelligence to improve healthcare quality and the patient experience. Upon formation, the new company will develop and market an open, interoperable technology platform and innovative clinical applications focused on enabling better population health management to improve outcomes and the overall economics of health and wellness.

We notice that Microsoft continues to make inroads into the healthcare field. The Surgeon General’s “My Family Health Portrait” is an internet-based tool [built on Microsoft HealthVault] that makes it easy for you to record your family health history. — Wayne Caswell, Modern Health Talk

As healthcare providers and payers around the globe shift from episodic single-patient care to continuous population management, new requirements have emerged for integrated care processes, greater insight and engaging Read More …

My Family Health Portrait, a tool from the Surgeon General

Image from NIHTalking with your health care worker about your family health history can help you stay healthy!

Using My Family Health Portrait you can:

  • Enter your family health history.
  • Print your family health history to share with family or your health care worker.
  • Save your family health history so you can update it over time.

Selected Q&A

Why is family health history useful?

Your family health history can help your health care practitioner provide better care for you. It can help identify whether you have higher risk for some diseases. It can help your health care practitioner recommend actions for reducing your personal risk of disease. And it can help in looking for early warning signs of disease.

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Why mHealth is the Holy Grail of Participatory Medicine

David Lee Scher, MD (mHealth consultant)

David Lee Scher, MD (mHealth consultant)

By David Lee Scher, MD

mHealth has been utilized in underdeveloped countries for many years due to inaccessibility to scarce health care resources as well as the widespread use of cell phones. Developments in health care in the Western world have  recently spurned interest in mHealth in developed countries too.

1. A present and worsening shortage of primary care physicians, and an even greater shortage of specialists, coupled with health care reform which is aimed at increasing access of health care will make face to face care more difficult. This, in some areas, has spurned the telehealth industry, whereby a physician will literally see you over the Internet. Physician shortages and the cost of this technology (most services charge as an office visit and require insurance) limit the widespread potential success of such endeavors. MHealth initiatives will actually increase contact of the provider and patient via text messaging, email, and communication of sensor-derived physiologic data (see below).
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Maintaining Personal Health Records

Medical Alert Options

What would you want the ER doctor to know about you, or your loved one? And how would you tell them? Let us know in the comments below.

Lee Howard produced this YouTube video to share her experience and endorse electronic medical records as an alternative to paper. She had scheduled a visit to the Mayo Clinic to help with a difficult diagnosis and was worried sick because her twin sister died earlier. She thought she might have the same thing. The clinic asked for a thorough medical history, but the records were spread everywhere and were in paper form. Lee’s nursing background gave her insight into how to gather and present them in a binder for the medical staff.

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Google Health end is near

Google HealthOn June 24th, Google announced that it’s retiring its Electronic Medical Records (EMR) project, Google Health, with personal data available for download through 2012. Google created the service to give people access to their personal health and wellness information. They hoped to translate their success in other consumer-centered domains into healthcare but were apparently disappointed in slower than expected adoption rates.

Google Health was one of several EHR/EMR products described in an article by Shannon Martin, Choosing a service for Electronic Personal Health Records.

The e-Connected Family Caregiver

The e-Connected Family Caregiver is a market research report based on a study of 1,000 technology‑using family caregivers to assess how helpful 12 technologies would be in supporting the caregivers or helping them provide care. The study report is published by the National Alliance for Caregiving with funding from UnitedHealthcare.

Top Findings include

“The top expected benefits are saving time (77% believe they would benefit somewhat or a great deal), making caregiving easier logistically (76%), making the care recipient feel safer (75%), increasing feelings of being effective (74%), and reducing stress (74%). The technologies with the greatest potential can best be seen by plotting a graph of the percentage of caregivers who think a technology is helpful by the percentage who report that one or more barriers would prevent them from trying it.”

Helpfulness Versus Barriers of 12 Caregiver Technologies

Helpfulness Versus Barriers of 12 Caregiver Technologies

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Electronic Personal Health Records

This article is republished with permission from Shannon Martin, Aging Wisely, LLC. The original article is available here.

Personal Health Records (PHRs) or Electronic Medical Records (EMRs) are undoubtedly the next wave in our ever expanding “online life”. According to, “ A personal health record (PHR) is a confidential and easy-to-use tool for managing information about your health. A PHR is usually an electronic file or record of your health information and recent services, such as your medical conditions, allergies, medications, and doctor or hospital visits that can be stored in one place, and then shared with others, as you see fit. You control how the information in your PHR is used and who can access it. PHRs are usually used on the Internet so that you can look up your information wherever you are.” Typically the term EMR is used to refer to the records held by other parties (doctor, hospital, insurance company), just like you old medical chart. However, you will often see the terms used interchangeably.

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