[MUSIC] Hello again, this is Bruce Darrow and I want to return to a topic we discussed earlier which is factors that make information technology easy to adapt and hard to adapt. And we'll apply that to the topic of digital medicine more specifically. So if we think about the industries that have adopted information technology easier, some of the enabling or driving forces include the fact that information standards exist. So think about the world of money, we know the value of a dollar, we've agreed that one dollar equals one dollar wherever it is. The scenarios for using the technology, where possible, are limited or constrained. There are only so many things that you can do with that dollar, for example. There are limited interdependencies within that organization or within that sector. You don't have to depend on outside factors so much and be able to handle them with your technology strategies. And lastly, where possible, there is a strong return on investment. So investing in information technology helps your business be more efficient, more productive, more profitable. So, when we think about how digital medicine works, there are some key factors that digital medicine will leverage that make it easier. So, first of all, digital medicine uses mobile tools that people use in their everyday lives. They use their computers, their desktops, their laptops, their tablets and their mobile phones. And more and more, people are able to do things on their smartphones that they weren't able to do without either physically changing their location or sitting down at their desktop previously. And there's an expectation as they do this, with more things like reserving plane tickets or seats at a restaurant, they start to wonder why they can't do this in the other parts of their lives, like going to see their doctor or getting their test results. So, the technology is not one that has to be deployed by the health care enterprise, it's one the patient already has in his or her hand. So the devices exist. And then there is the ability to bring in newer devices like fitness trackers, wireless scales, blood pressure cuffs, things that are Bluetooth enabled. And to use the infrastructure in cabling from our existing WiFi, our existing cable, our existing telecom and the standards for handling the transmission of electronic signals, things like Bluetooth and WiFi. When we think about where the friction is in the system, here are some of the factors involved. First of all, most core IT systems including electronic medical records, were initially designed to do all of those things that we've talked about previously that doctors need to be able to do. To be able to write their notes, to be able to prescribe medications, to be able to handle lab results, to be able to interact with other components of health care IT. Mobile has been a sort of late development, and a lot of the court EMRs, and leading software companies, have been somewhat slow to get into the mobile arena. Another complicating factor is the fact that not all patients have all their data in one place. If you are optimizing one particular system that has a subset of patient data for mobile, the patient will be grateful to have mobile access to that data, but will wonder, probably, where is the rest of my data? Where is the rest of my information? Why do I have to go into multiple mobile systems to get all of the totality of my data? Next, not all patient data is discrete. So, anything that is written in a text-based form will be harder to cram into a small screen on a mobile device for a patient, it's much easier for the things that are already discreet. If I want the result of my blood test, I can pull that in, because that is a discreet value. But if I want to know what my doctor thought about me, or what my condition was like, or what they told another physician. That's a big hank of text, and pulling that out from an electronic medical record into a mobile device is going to mean much more complicated. And to the point of the form factor of the screen. As we become more mobile and we enable digital health the real state that any patients looking at, at any given time is much more limited. So, if you think about the totality of healthcare information, use of information, blood test results, radiology results, doctor's notes, medications, allergies, all the things that go into healthcare. Getting the right piece of information or the combination of pieces of information that all should be on a single small screen in somebody's hand, is going to be sort of the equivalent of trying to put together a Mercator projection of a map of the earth. You are trying to take something that is big and complicated and flatten it down and you get some distortion in the process. And then two other factors that are important from the provider side of things, many people nowadays have a 24/7 availability expectation. If you are carrying your phone and your phone has an email program on it, you are always able to look at your email, you may choose not to. But, it comes in whether you've chosen to or not. If you are a doctor and you're used to practicing with a certain set of office hours or if you're any professional you are used to being able to potentially stop working at some point and be off duty. Not all physicians or clinicians want to be available 24/7. And one of the challenges in digital medicine, is figuring out how we take people with devices that are always on, and we allow them to be off. And then finally, there is this question of why a person who is providing health care, a doctor, or nurse, or coordinator, is doing something for which they are not necessarily getting paid. There is not great alignment at this point between the things that clinicians get paid to do, which are usually things like seeing a patient in the office, giving a specific treatment, doing an operation, taking care of them in a hospital or emergency department setting. And things like returning phone calls, email, or interacting digitally, which are sometimes reimbursed either very poorly, or not at all. This does not mean that doctors and clinicians are unwilling to do these things. It means that they have a healthy suspicion of providing a majority of their time professionally for something for which they are not going to be paid. [MUSIC]
