Reflections on the World as It Is, and as It Could Be
I was happy to attend the 2019 Rock Health Summit (#RHSUM) in San Francisco, a preeminent gathering of entrepreneurs and practice leaders in the rapidly-growing field of digital health. Attendees included a wide range of people: startup founders, advisors, venture capitalists, solution developers and product managers, designers and consultants, and more besides. I myself have founded & sold a digital health company (Find Wellness) and advised startups, while today I’m a consultant who specializes in digital health Design and Product Management.
The two-day event was filled with interesting panels, insights, and networking around tackling various difficult and pressing health-related challenges in our world. People are working on fantastic innovations in areas such as managing diabetes, coping with an aging population, delivering digital therapeutics, diagnosing Alzheimer’s, dealing with employer-sponsored health insurance, increasing diversity & inclusion in digital health ventures and solutions — and all while ensuring consumer privacy, clinical efficacy, and regulatory compliance.
Broken Sick Care System
A few days on, however, I’m still mentally dwelling on the vast scope of the underlying problems with our “healthcare” system in the United States. It’s actually a broken “sick care” system that devotes relatively little time to human-centered discourse. We have no unified or effective approach to delivering preventive care, and are neither addressing the scale of such needs nor are we typically tailoring approaches to each individual. The western medical system is accomplished at diagnosing conditions with increasingly sophisticated apparatus and treating acute disease and injury with interventions and procedures. It is, however, also riddled with failures in this arena which include, to name just a few, frighteningly high (and continually rising) costs that strain individuals’ resources; multiple for-profit entities pulling at the levers of treatment decisions and reimbursement; deeply stressed providers and overburdened delivery systems; and medical access and health outcomes that vary wildly by one’s demographics and geography.
The current western medical system is also not particularly good at managing most chronic diseases or keeping society as a whole balanced and flourishing, as witnessed by three years of declining life expectancy in the U.S. [NOTE 2] — largely due to a rise in suicide and drug-related deaths (most especially, opioids). Most people in western society are also deeply scared of dying, and frankly unwilling to face their own inevitable mortality. (Yep, I’m a regular laugh riot sometimes!)
We Can Do Better
Once upon a time, in China, people would see their doctors regularly, paying their healthcare providers as long as they were well. These patients would not pay their providers as soon as they became sick — the illness was deemed the responsibility of the doctor, even a failure in preventive care or in catching an issue early before it became serious. [NOTE 3] The entire “traditional Chinese medicine” (TCM) system, well over 2500 years in the making, is one that engages with each individual’s immune system to promote optimal wellness and eliminate illnesses as they inevitably arise. Having a fundamental view of sickness as a blockage or breakdown in the body’s inherent ability to maintain a healthy balance means that each TCM provider works with the individual’s current state to combat illness from the inside out — and such treatment more directly addresses root causes, rather than ameliorating symptoms. Please note, I’m not promoting a wholesale shift to TCM in the U.S., but rather pointing out that alternative models of care have existed that are viable for large populations.
As a designer, I see problems as opportunities to identify new conceptual or structural solutions that provide desirable human-centered outcomes. I believe that a better “new” model for maintaining health throughout the journey of life would involve people seeing physicians and other healers on a regular basis, from birth to death, with the goal of obtaining and sustaining wellness in all its dimensions: physical, mental, social, and even spiritual. Having a trusted relationship with our healers, through regular visits we would establish healthy habits of exercise, nutrition, and sleep from our earliest days. These best practices would be personalized to the specific context and needs of each individual. We would learn to practice vital coping skills such as meditation and self-compassion. We would value and maintain robust community connections throughout our lives, creating and appreciating beauty, while loving ourselves and caring for each other in equal measure. People would move more gracefully through the various stages of life with their eyes open and accepting — from the hormonal shifts of teenagers coming-of-age through to women’s experience of menopause, and everybody’s changing physical capacities in old age.
Many types of helpers exist for each of these needs, far too many to list here comprehensively. However, consider that in addition to doctors and nurses they include professionals such as teachers; sports coaches and trainers; massage therapists; occupational therapists; minsters and social workers; and even, musicians and poets. Helpers also include roles in the community such as leaders who keep groups connected; empathic individuals who identify, sympathize with, and guide those most in need; and wise elders who can foster and share the deeper knowing of humankind.
Big-Picture Design Thinking
I dream of a world where our innovative digital health solutions can be linked together as a diverse net of interconnected resources made available to everybody as and when they need them. We’d have an accessible ecosystem of didactic (and fun!) games that teach and guide our youngest members alongside memory tools that engage the brain and prevent dementia in our aging members. We’d very routinely collect physical and mental diagnostic measurements that lead people whenever indicated, as early as possible, to a robust collection of interventional approaches and tools that address acute and chronic disease states, including mental illness. We would better integrate data and treatments from various medical professionals and specialties so that all work together around the patient’s common good. We’d foster community among people who are engaged in similar pursuits and concerns, sharing knowledge and supporting each other through whatever health challenge or life opportunity is at hand: from pregnancy & birth to facing the end of life, from managing depression to training for a marathon. All these digital therapies and related systems would play well together, yet be tailored to each individual’s evolving needs. Thusly, a rising tide could lift all our boats.
“Healthcare” is a wicked problem if there ever was one. I’d like to be of service to establish the systems and frameworks that will replace our broken “sick care” system with something far more human-centered, positive and personalized in nature, reflecting the beautiful diversity and breadth of our multi-faceted society. Please get in touch if any of this viewpoint resonates with you and if you’d like to work together on any facet of such opportunities we have to make this world a better place.