Apr 6, 2009


Yet another story of electronic medical records this morning in the New York Times. What intrigues me most about this one is the accompanying photo. It shows a doctor and patient reviewing her data on screen side by side.

Side by side. That is a huge shift in the relationship.

I don’t know how your doctor deals with you but mine walks into the examining room with a paper file folder of records he keeps on me and scans his notes. Sometimes he tells me what he’s reading, sometimes he doesn’t. Either way, it’s privileged information – privileged to him. He would never think of showing me what he’s written, and I would never think of asking for it. It’s his.

Pretty soon, his records will be mine. And not only his but the case histories on me compiled by all my doctors, hospitals, and (hopefully this is pretty far out) my nursing home, pacemaker, motion sensors, and other smart devices. I’ll have a password and some sort of editing powers. Sure, I won’t be a doctor but I won’t be just the subject of his investigation either. I’ll be the chief administrative officer. Doctors will be coming to me, to my database, for the most complete – the best – information on me.

Which reminds me of something I heard from web guru Andreas Weigend. Andreas was chief scientist at Amazon when Amazon was putting in place the amazing business/technology model that has captured the high ground in retailing. In the past, Andreas said, consumers came, hat in hand, to companies. They searched for what they needed then snuck a peek at the price tag.
In the future that will change, dramatically. And not just for medical records, but for all kinds of business transaction. “Make me an offer,” Andreas says, is going to be the consumer’s opening gambit. “I need a 46-inch plasma HDTV that turns itself off at night,” the consumer posts. Companies submit their bids. Search work shifts to the provider. Power shifts toward the consumer.

That’s huge change, basic to any business. If you’re an executive, take another look at the guy in the scrubs above. Imagine he’s you. I need to think more about this but here are some implications. In a customer-centered business world, companies that offer the most complete, most narrowly targeted package will win.

This will require unprecedented levels of cooperation between providers in the end-to-end distribution system. And the provider in the best position to take charge and design that customer-specific solution will no longer be the retailer. It will be the manufacturer.

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