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Jay Parkinson — Wed, 29 Dec 2010 15:30:42 +0000

I received my Masters in Public Health from Johns Hopkins in 2006. I took a course on transportation safety where we focused on designing roads for safety, making airlines safer, and decreasing the risk of medical helicopter crashes. In 2007, I worked for Public Citizen, Ralph Nader's consumer advocacy group. Ralph's book, Unsafe at Any Speed, forced the automobile industry to focus on converting their cars from steel death traps to smart machines teeming with airbags, safety belts, and crumple zones. As a result, millions of lives have been saved all over the world and automobile companies now advertise and compete based on safety. And in just the last fifteen years, our highways have gotten much safer: But what struck me most in my public health training was the deep codependent relationship public health has with the medical world. Understandably so, public health has traditionally been mostly about epidemiology, biostatistics, and medical services. In fact, the accepted definition of public health is:

"the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals."

But the next generation of Public Health won't involve the medical world. We're currently seeing large companies like Google enter the health space. Google Health believes that "better health comes from better information" and "you should have easy access to your own health information - anytime, anywhere." While this is a worthy mission, Google is very much missing the mark. I'm not aware of any evidence that access to medical data or everyday wellness data changes long-term behaviors or a population's health outcomes. But Google is working on a much, much more important initiative that, if successful, could be one of the greatest contributions to public health the world has ever seen-- data-driven, crash-proof "brains on wheels"-- self-driving cars that aware of the road, of other cars, and of passengers. Imagine a world where the highways are as safe as the skies (45,000 planes take off and land every day in America). This is Public Health 2.0-- data-driven, technology-enabled, real world solutions that take an active risky everyday behavior and turn it into a passive, nearly error-proof experience. Public Health innovation won't come from your local woefully underfunded and understaffed public health department. Public health revolutions will come from tech companies that have almost zero connections to medical care. Photo: Nicolai Howalt

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Jay Parkinson — Thu, 25 Nov 2010 23:56:10 +0000

I'm often asked about new and interesting healthcare innovations happening here in the US. Honestly, it's very hard for me to come up with any. Here are the few that I think are interesting from the traditional sickness focused medical world:

ZocDoc: It's like OpenTable but for doctor appointments. Use it. I do.
Freelancers Insurance Company: They are clients of The Future Well so I'm biased. But they've created an insurance company designed for a life-long engagement with the 30% of the workforce that's deemed independent workers.
Hello Health: I'm a bit biased about this one as well.
Practice Fusion
One Medical Group
Current Health
Care Practice

All of these companies listed above are reinventing the delivery of healthcare by focusing on the consumer experience and their satisfaction. Beyond that, I'm not a big believer that the traditional medical care space is truly innovating on much of anything. Try and come up with one difference in your experience as a patient between going to the doctor today vs. going to the doctor when you were a kid. I believe that only a very, very small group of people want to track everyday health data. I don't see a new blockbuster drug around the corner that will significantly improve lives. New devices and procedures are being invented but nothing that groundbreaking. Most importantly, the way we study medical improvements is broken and there aren't any signs that this is improving. However, I'm fascinated by this cultural movement we're seeing toward health and social consciousness that will do more for health than pills and scalpels. I think more and more people are paying attention to what they eat, how much activity they get, and what kinds of neighborhoods to live in that will make them happy. Think about what didn't exist 15 years ago in a significant way:

Whole Foods
Fooducate and their iPhone App
Michael Pollan
Jamie Oliver
Food Inc and Supersize Me
RunKeeper
Nike Plus
Rapha
The Truth Campaign
Self-publishing: blogs for people with diabetes and other chronic diseases
Open Source Prosthetics
Dr. Google's 24/7 availability
Madonna Gyms or Equinox that make exercise entertaining and cool
Facebook and text messaging for organizing your social life and enhancing the health of your real life relationships
Bike sharing programs like bcycle
Relatively healthy fast food like Panera Bread, Le Pain Quotidien, and Pret-a-Manger
The Prius
Livestrong
etc..

The point is, very few of these innovations that affect your everyday health and life are coming from traditional healthcare. It's too bogged down in profiting off sickness, government regulations, bureaucracy, pilot projects, and expensive mandates to produce anything significant. If I were investing in health I wouldn't invest in sickness care, I'd invest in consumer-obsessed companies that are doing something for consumers to eat better, be more active, or live a healthier life. The most significant innovation in the past two decades has been a cultural health consciousness that's just getting started and it's coming from regular consumer companies realizing there's opportunity in brands that enable a healthier, happier life.

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Jay Parkinson — Wed, 27 Oct 2010 13:28:50 +0000

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This kind of study in the past would have taken years of human effort and millions of dollars, buy Norvasc without prescription. Online buying Norvasc hcl, Today, it's about designing a helpful service that engages users with a solution to one of their problems in their lives, buy cheap Norvasc. Where can i buy Norvasc online, Okcupid gives users a well-designed tool to find that special someone in the 20 and 30-something demographic. Once they've designed a tool 3.2 million users like, where can i order Norvasc without prescription, Order Norvasc from mexican pharmacy, they can look for trends occurring in health and our culture. We're simply lucky enough they have the insight to publish this fascinating data and make the study much, buy Norvasc online cod, Purchase Norvasc online no prescription, much more interesting than the New England Journal of Medicine ever could. For example, buy Norvasc no prescription, Norvasc trusted pharmacy, one of the okcupid insights found that:

It turns out that a tiny fraction of gays have ~~single-handedly~~ two-handedly created the public image of gay sexual recklessness—in fact we found that just 2% of gay people have had 23% of the total reported gay sex, which is pretty crazy.

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What should we do?

What do people want that would make them feel more alive and more happily human?

Jane Jacobs, in her excellent book The Death and Life of Great American Cities, japan, craiglist, ebay, overseas, paypal, Order Naltrexone online c.o.d, argues that communities that don't grow organically, don't survive and thrive, Naltrexone for sale. In fact, our nation's 11th "largest" city, California City, CA, has only 14,000 inhabitants:

In 1958, Nathan Mendelsohn, a Columbia University sociology instructor turned developer, acquired 82,000 acres of desert in eastern Kern County, 100 miles from Los Angeles, order Naltrexone online now. Buy Naltrexone no prescription, Today a mere 14,000 souls call California City home, buy cheap Naltrexone. Order Naltrexone online overnight delivery no prescription, Most are clustered at one end of the massive tract. It's a sleepy outpost with its own school district and public bus service but no hotel or chain grocery, order Naltrexone no prescription. Australia, uk, us, usa, The police chief is also the director of parks and recreation, and the Rite Aid is the busiest place in town, where can i order Naltrexone without prescription. Order Naltrexone online now, The rest of Mendelsohn's eccentric dream unfurls to the east, some 185 square miles of mostly unpaved streets — a ghostly monument to overreach that, from above, looks like a geoglyph left by space aliens. Purchase Naltrexone online no prescription, Only Los Angeles and San Diego leave a bigger footprint in the state.

We must design solutions by truly understanding how humans use tools, form communities, buy Naltrexone from mexico, Buy Naltrexone without prescription, live, move, buy Naltrexone online no prescription, Naltrexone coupon, engage with friends, and love, buy Naltrexone online cod. Naltrexone price, If we don't we risk designing California City's and digital ghettos.

We face massive problems today, online buying Naltrexone hcl. Where can i find Naltrexone online, How do we design health systems that deliver healthcare to 300 million people. How do we design communities that maximize physical activity and real relationships, order Naltrexone online now. How do we understand the sequelae of a generation that's getting married at an average age of 28? If people are getting married later and having children later, where can i buy Naltrexone online, Order Naltrexone from mexican pharmacy, then those children will have parents that die sooner. How will children whose parents die when they are teenagers deal with having no parents as twenty and thirty-somethings, where can i order Naltrexone without prescription. Canada, mexico, india, What will come of kids who grow up with no grandparents.

What do we do about the prediction that 70% of the earth's population in 2050 will live in cities and, buy Naltrexone without prescription, Order Naltrexone no prescription, even in the best of circumstances, the new age of the megacity might well be an era of unparalleled human congestion and gross inequality, online buying Naltrexone hcl.

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Do we want the future?

Order Naltrexone online now, If not, how and when are we going to rebel against a future we don't want?

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Do these kinds of technologies actually make our lives better and more fulfilling.

We believe a rebellion is beginning in our culture, order Naltrexone online now. We're longing for simplicities. We want local food. We want corner shopkeepers, not faceless corporations. We want less information coming at us. Order Naltrexone online now, We want to log off. We want small and manageable. We want the comfort of real relationships. We want less choice, and more curation.

Grant and I are facing these very issues in our work with the NHS and the Freelancers Union. How do we design small, curated, organic solutions that arise based on need, desire, and authenticity...not what futurists think we can do. But what should we do.

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Alcoholics Anonymous and its steps have become ubiquitous despite the fact that no one is quite sure how—or, for that matter, buy Nimesulide Gel online cod, Nimesulide Gel over the counter, how well—they work. The organization is notoriously difficult to study, buy Nimesulide Gel online no prescription, Buy Nimesulide Gel without prescription, thanks to its insistence on anonymity and its fluid membership. And AA’s method, canada, mexico, india, Order Nimesulide Gel online overnight delivery no prescription, which requires “surrender” to a vaguely defined “higher power,” involves the kind of spiritual revelations that neuroscientists have only begun to explore, buy generic Nimesulide Gel. Order Nimesulide Gel Online Now, What we do know, however, is that despite all we’ve learned over the past few decades about psychology, neurology, and human behavior, contemporary medicine has yet to devise anything that works markedly better. Order Nimesulide Gel online c.o.d, “In my 20 years of treating addicts, I’ve never seen anything else that comes close to the 12 steps, online buy Nimesulide Gel without a prescription, Nimesulide Gel coupon, ” says Drew Pinsky, the addiction-medicine specialist who hosts VH1’s Celebrity Rehab, japan, craiglist, ebay, overseas, paypal. Buy Nimesulide Gel from mexico, “In my world, if someone says they don’t want to do the 12 steps, buy Nimesulide Gel without a prescription, Where can i buy Nimesulide Gel online, I know they aren’t going to get better.”

Overcoming addiction doesn't happen in silos. Health is social. Lifestyle change is social change, buy Nimesulide Gel no prescription. Japan, craiglist, ebay, overseas, paypal, Positive change is about you, your friends, online buy Nimesulide Gel without a prescription, Australia, uk, us, usa, your family, and the physical environment of your home and neighborhood-- that is where health happens, order Nimesulide Gel online overnight delivery no prescription. That is not where medical care happens, Order Nimesulide Gel Online Now. Buy Nimesulide Gel online cod, Bad lifestyle isn't a medical issue, it's a social one, where can i find Nimesulide Gel online, Order Nimesulide Gel from mexican pharmacy, hence the reason why "contemporary medicine has yet to devise anything that works markedly better." Doctors are just so bad at lifestyle and behavior modification. Or maybe they're just uninterested, Nimesulide Gel for sale, Nimesulide Gel from canadian pharmacy, or ill-prepared, or not reimbursed for social change, canada, mexico, india. Where can i order Nimesulide Gel without prescription, Maybe individual physicians think fixing these big hairy problems is too big of an issue for them to exert any effort. Medical care has pills and scalpels-- not urban design, portion size, influential friends, walkability, and the complexities of the modern family structure. Order Nimesulide Gel Online Now, I should know. I got about 4 lectures in medical school on topics other than sickness. I had to seek out, on my own, solutions for the real problems our modern culture face-- hyperlocal relationships with other people and with our environment that make choosing health difficult.

AA is one of those hyperlocal solutions because it fundamentally understands that alcoholism doesn't happen in silos, nor does it happen in institutions-- it takes a restructuring of your lifestyle in your own neighborhood to kick the habit. How do we change our lifestyle. Good question, Order Nimesulide Gel Online Now. There's not as much research happening on this topic compared to medical interventions. You can't bottle up and sell "lifestyle change" and turn it into a multi-billion dollar market, so who's going to do it. And how does patient privacy fit with solutions that require your friends, family, and acquaintances. Can you do meaningful outcomes research on these kinds of social solutions. Order Nimesulide Gel Online Now, Are there technology solutions to lifestyle change. Or can we simply design things that people use and want. Is it good enough to just have a 1.2 million person following like AA. Or must we have to put numbers on its effectiveness. Social solutions are notoriously difficult to measure. AA has been going strong for 75 years and it's still an enigma, but it's the kind of solution that will save us from the deadliest disease we know-- unhealthy lifestyle, Order Nimesulide Gel Online Now.

Do we need more AA-like solutions. We'd say yes. We can chase our tails for 75 years looking for a +/- 5% difference or we can design engaging solutions that people enjoy. Should we care about measurability. Good question.

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Jay Parkinson — Mon, 09 Aug 2010 23:06:22 +0000

Susannah Fox at the Pew Internet & American Life Project recently posted a comment made on a blog about the internet and health:

Order Potassium Citrate Online Now, The remaining 95% of “patients” out there are not motivated to become informed, or invest the time/energy/money in using any of these tools. Potassium Citrate over the counter, These are the folks that know that fast food isn’t healthy, but are just too tired to choose differently, buy Potassium Citrate without prescription. Potassium Citrate trusted pharmacy, Some (emphasis on some) will do a standard Google search when they receive a new diagnosis at best. Yet these are the folks – often folks with multiple chronic (often preventable) health problems, buy Potassium Citrate online cod, Order Potassium Citrate online overnight delivery no prescription, many overweight, on multiple medications, order Potassium Citrate from mexican pharmacy, Buy generic Potassium Citrate, sometimes social problems – that have the real issue that needs fixing.

So we can all sit and perfect the tools for a few folks that never needed them anyway, buy Potassium Citrate online no prescription, Order Potassium Citrate no prescription, or we can recognize that the kinds of solutions required for healthcare in the US today have nothing to do with fancy IT, or prioritization on search engines, buy no prescription Potassium Citrate online, Buy Potassium Citrate without a prescription, and everything to do with low-tech, unsexy approaches toward grass-roots public health, order Potassium Citrate online c.o.d. Sorry to be the voice of reality guys.

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Let's start with two facts:

Healthcare is local.

The internet has revolutionized the way we communicate and transact.

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The answer is yes-- for a tiny fraction of us, where can i order Potassium Citrate without prescription. But something like walking 30 minutes a day decreases your risk of diabetes by 40%, Order Potassium Citrate Online Now. Buy cheap Potassium Citrate no rx, Will we sacrifice internet time to walk.

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Let people make appointments with their local doctor online.

Let people communicate via email with their local doctors and other caregivers for questions and requests.

Let people learn from others with the same interests (either an interest in an illness or a wellness activity).

Provide accurate, not confusing, Potassium Citrate from canadian pharmacy, Buy cheap Potassium Citrate no rx, information about what the scientific community currently thinks is true.

Will the "digital natives" save us. They use the internet in totally new ways right?, Potassium Citrate price. Order Potassium Citrate Online Now, Probably not. Purchase Potassium Citrate online, This is what a recent article in Spiegel says:

Young people have now reached this turning point, online buy Potassium Citrate without a prescription. Japan, craiglist, ebay, overseas, paypal, The Internet is no longer something they are willing to waste time thinking about. It seems that the excitement about cyberspace was a phenomenon peculiar to their predecessors, where can i find Potassium Citrate online, Buy cheap Potassium Citrate, the technology-obsessed first generation of Web users.

For a brief transition period, buy Potassium Citrate without prescription, Buy Potassium Citrate from mexico, the Web seemed to be tremendously new and different, a kind of revolutionary power that could do and reshape everything. Young people don't feel that way, Order Potassium Citrate Online Now. They hardly even use the word "Internet," talking about "Google", "YouTube" and "Facebook" instead. And they certainly no longer understand it when older generations speak of "going online."

"The expression is meaningless," Tom says. Indeed the term is a relic of a time when the Internet was still something special, evoking a separate space distinct from our real life, an independent, secretive world that you entered and then exited again.

Tom and his friends just describe themselves as being "on" or "off," using the English terms. What they mean is: contactable or not.

Order Potassium Citrate Online Now, We're still humans with 200,000 years of ingrained behaviors that only changed to a sedentary lifestyle in the past 100 years or so. So we need real human to human interactions to encourage us to fight our modern conveniences, move, and eat food, mostly plants. This isn't sexy. It's low-tech. It's real relationships with family, friends, and local professionals trained in behavioral modification.

All of this, of course, needs to be packaged up in a sexy experience for people, Order Potassium Citrate Online Now. They need to feel comfortable surrounded by an aesthetic that makes them feel good.

So go local, embrace low-tech, maximize real relationships, and make it sexy. This will be the future of effective healthcare in a community. Our life expectancy has almost flatlined compared to the explosive growth in the last 100 years. We don't think anyone wants to live as a 90 year old for 40 years. If doctors want to be just as effective in the next 100 years as they were in the past 100, we'll have to focus on optimizing happiness and satisfaction with life in the healthiest years of our lives...and not simply prolonging life.

(photo by me of Grant and his wife Amanda in his backyard in London...taken with my iPhone).

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