Invited talk for the "Health Care of the Future" meeting, sponsored by the Portland Business Journal.

1. Building Individualized, Deep Support for
Patients at Scale
Bradford W. Hesse, PhD

2. Excerpts from 21st Century Life
Mobile Banking
Navigation
Aids
Smart, Connected
Objects
Daily
Weather
Apps

3. 3
Common Themes
 Ubiquitous supports for the tasks and challenges of
daily life in the 21st Century.
 These seemingly pervasive and “easy-to-use”
applications are the product of careful data
integration and standards for interoperability.
 Interfaces have been carefully designed to support a
broad swath of consumers, across socioeconomic
characteristics and across literacy levels.
 Designed to “augment” human intelligence – not to
replace it.

4. Can We Offer Same Benefits in Health Care?
Mobile Care Support
Care
Coordination,
Navigation
Passive
Monitoring &
RemindersDaily
Health
Apps

5. 5
Building the
Infrastructure to
Support P4 Medicine

6. Joint Commission Highlights Role of
Communication Errors
 Total number of preventable
medical errors from all
sources exceeds 17 million
each year
 Joint Commission’s Sentinel
Database reports 70% of all
reported events had
communication as root cause
http://www.jointcommission.org/assets/1/18/Root_Causes_by_Event_Type_2004-2014.pdf

7. A Crisis of Communication in Health
Care
Source: Hesse, B. W., Beckjord, E., & Ahern, D. K. (2018). Role of Technology in Behavior Change to Expand Reach and
Impact on Public Health. In M. Hilliard, K. A. Riekert, J. K. Ockene & L. Pbert (Eds.), The Handbook of Health Behavior Change
(Fifth ed., pp. 525-544). New York, NY: Springer.

8. The Last Mile Problem: Getting Current
Evidence to All Patients
See: Siegel, R. L., Jemal, A., Wender, R. C., Gansler, T., Ma, J., & Brawley, O. W. (2018). An Assessment
of Progress in Cancer Control. CA Cancer, epub ahead of print, 1-11.

9. Solution: Move from Industrial to
Information Age Platforms
Source: Zuboff, S., & Maxmin, J. (2002). The support economy : why corporations are failing individuals and the next episode
of capitalism. New York: Viking.
“Deep support provides for an
ongoing relationship based on
advocacy, mutual respect, trust, and
the acute alignment of interests.”
- Zuboff & Maxmin, 2002.

10. Connected data technologies allow for
personalization & participation … at scale.

11. Connecting Healthcare: The HITECH Act
of 2009 & Meaningful Use
Prelude to Healthcare Reform
Meaningful Use
Safety, Quality
Improvement
Privacy,
Security
Patient
Engagement
Continuity of
Care
Population
Health
Management
Source: Hesse, B. W., Ahern, D. K., & Beckjord, E. (Eds.). (2016). Oncology Informatics: Using Health Information Technology
to Improve Processes and Outcomes in Cancer. Boston, MA: Elsevier.

12. Non-federal Acute Care Hospital
Electronic Health Record Adoption
Source: https://dashboard.healthit.gov/quickstats/quickstats.php

13. Patient Trends for Interacting with
Healthcare System Online
Source: Hesse, B. W., Greenberg, A. J., & Rutten, L. J. F. (2016). The role of Internet resources in clinical oncology: promises
and challenges. Nat Rev Clin Oncol. doi:10.1038/nrclinonc.2016.78

14. The Need for Innovation, Adaptation is
Stronger than Ever
Source: Wachter, R. M. (2017). The digital doctor : hope, hype, and harm at the dawn of medicine's computer age. New
York: McGraw-Hill Education.
“We’ve mistakenly treated (the wiring of
healthcare) as a technical problem: simply buy
the computer system, … take off the shrink-
wrap, and flip the switch.
We were wrong – “The wiring of healthcare
has proven to be the Mother of All Adaptive
Problems.”
- Robert Wachter, 2017.

15. 15
What if?

16. 16
We could enable a
communications “safety net”
to ensure that we left no
patient behind.

17. 17
We could help clinical teams work
together more efficiently, reduce
burden, and protect the joy of
medicine.

18. 18
We could provide unyielding communication support
for a patient over a lifetime.

19. 19
We could apply industry-level engagement techniques to
help individuals and communities improve their health.

20. 20
We could make contributing to science easy, enabling,
and a sincere expression of altruism.

21. 21
We could cover healing both here …
and here.