My Robot Doctor

How I learned to stop worrying and love my robot doctor

Life first. Health a distant second.

Humans don't want to think about health. But we can train robots to think about it, to be hypervigilant for us. It's the mundane, the everyday, the minute details, the mindless, the invisible tasks. Crappy for humans, but perfect for machines. Then humans can concentrate on the important stuff.

All of our data will be captured beautifully, without us knowing it. And when we have to input data, it will be a highly lubricated experience.

The data will be human and machine readable: structured, longitudinal, accessible, accurate and always updating. Unlike our current guesses, the baseline will be the ground truth. It will include all of my data — my life data.

My healthcare will help me understand my health status, needed behavior changes, and personalized care plans. It will also help my entire care team. The treatments that comprise my care plans will dynamically evolve based on my ever-changing health status.

I can my proxy my data to any person, any organization, any service — parts or whole — for today, tomorrow or forever.

I will own, or co-own, my healthcare data. I will see my health advance.
From Data to Algorithm to Measurement to Policy

The distance between home plate and the pitcher's mound is known. The distance between second base and third base is known.

Baseball has a fundamental set of rules that every ballpark and team has to play against. And yet each ballpark has its own quirks and personality.

This is opposite of healthcare wherein no fundamental rules are played on. Unlike in baseball, in healthcare you cannot complete on talent alone.

Health System Ranking of 11 Industrialized Countries

  1. United Kingdom

    Has a Standard Health Record

  2. Switzerland

    Has a Standard Health Record

  3. Sweden

    Has a Standard Health Record

  4. Australia

    Has a Standard Health Record

  5. Germany

    National identified but not SHR

  6. Netherlands

    Creating a Standard Health Record

  7. New Zealand

    Creating a Standard Health Record

  8. Norway

    Has a Standard Health Record

  9. France

    Has a Standard Health Record

  10. Canada

    Has a Standard Health Record

  11. United States

    Does not have a SHR

  1. New Zealand

    Creating a Standard Health Record

  2. Norway

    Has a Standard Health Record

  3. France

    Has a Standard Health Record

  4. Canada

    Has a Standard Health Record

  5. United States

    Does not have a SHR
Standard Health Record changes the game

  • Standardize the data

    Focusing on exchange standards alone has been ineffective because vendors and providers have not been pushed hard enough to standardize health data.

    Providing a clear target in the form of a well designed, computable, digital standard health record will cause a 10x acceleration in health data interoperability in the US.

  • Standardize the measurement

    Standard health data requires that data collection at all entry-points to the healthcare system systematically capture aspects of the patients' health. While visits to the emergency room necessitate focus on the ongoing medical issue, primary care appointments can function as points for synthesizing a more-holistic picture of the patient's health.

  • Standardize the algorithms

    Healthcare is only a small fraction of the overall experience of health. The determinants of health can be influenced by medical attention, but the socioeconomic determinants of health play a far greater role. Means the healthcare system uses to evaluate outcomes must consider this reality.

  • Standardize primary care

    Primary care is simultaneously the entry-point and catch-all to the healthcare system. Its central and therefore universal role underscores the mandate to standardize the primary care experience so that all may receive a high standard of care.

    To err is to be human and variability in the primary care experience provides fodder for possible error.

Primary Care Manifesto

  1. Help the patient own, control, and understand their complete, merged, accurate, timely, digital standard health record.

    This helps the patient own their health.

  2. Help the patient understand their health status, any needed behavior changes, and their personalized care plan

    This helps the patient to manage their health.

  3. Help the patient access health services via text, email, voicemail, telephone, app, walk-in, drive thru, by appointment, and EMS.

    Make health easier.

  4. Help the primary care clinician to accurately diagnose, explain, educate, and work with the patient on a consensus standard of care plan.

    Empower patients in their own care.

  5. Standardize Primary Care digital health data in the United States and in the world by 2018

    Begin to achieve #1, #2, #3, and #4 on any standard smartphone.

100% Primary Healthcare =
70% Virtual Primary Care +
30% In-Person Primary Care
My Robot Doctor

No one should be denied healthcare.

To accomplish this goal, healthcare must be made accessible at scale. Three quarters of humans on the planet have an internet-connected cell phone.

We need to leverage this expanding, global reach to ensure that healthcare is a human right. Primary care for all.

We are the most underutilized resource in healthcare.

  • Juhan Sonin

    Author

  • Eric Bai

    Web Developer

Many thanks to

  • Sarah Kaiser
  • Edwin Choi
  • Eric Benoit
  • Jen Patel
  • Craig McGinley
  • Sharon Lee
  • Jon Follett
  • Xinyu Liu
  • Mark Kramer
  • Andre Quina
  • Eric Topol
  • Harry Sleeper