I recently obtained Christensen, Hwang, and Grossman’s book, but have not had a chance to read it. I have been thinking a lot in these areas, as I have been working on my research into the behavioral sciences and the emerging peer commons revolution.

This includes health care, as well, but I suspect it will come in many versions, including some bottom-up systems. Forgive my pessimism, but ultimately, these are the only way for real reform, rather than the shell games on Capitol Hill, because they allow patients to vote with their voices and dollars, which will undermine existing power structures (not without a fight, I’m sure). In addition to the points mentioned in the blog post:
1) Fact-finding and wellness / preventive care programs that do not require licensing and can employ cheaper labor, but are informational. Based on information, the patient decides whether to “escalate” the problem immediately, and the information is there to pass on to a physician or specialist immediately.
2) Quick-consult along the lines of Jay Parkinson’s work, enabled in part by technology, and in part by “lean thinking” that goes outside the box we’re all used to.
3) Involve tech and medical students in solving common problems shared by many clinics, using other peer methods, including open source software, and open design.

Seattle + Portland + San Francisco is certainly a great place to try to seed such things. We 3 are the “techbasket” of the West Coast. I suspect the early adopters of putting medical records online will be the young and tech-savvy (they’re more open, so it’s not a big deal), and those with chronic diseases, particularly rare ones (by consolidating information, they can make the biggest gains in quality of care).

Andrew, I was not aware of your site, but I am very impressed, and very glad to make its acquaintance. I’m very glad you stopped by and commented.

Perhaps it would be possible to create an “open, peer medical” small conference on the west coast? Perhaps Portland as a midway point (lot of open source here, and OHSU of course)?

On the pure tech side, there have been BarCamp HealthCamps, but I don’t know what they’ve resulted in. Perhaps, a “winter of code,” (like Google’s “Summer of Code”) or a “winter of open health startups” would give the students and freshly unemployed some challenging problems to tackle.

— Stan

Dear Andrew, feel free to also offer us an article about your project, it would fit well with the topics that we monitor here. More also at http://del.icio.us/mbauwens/P2P-Healthcare,

Michel

Andrew Schorr
Seattle