e-CareManagement blog

Chronic Disease Management • Technology • Strategy • Issues and Trends

« List of Top 10 Health Plan Issues — Out of Whack! | Main

Could Facebook Be Your Platform for Care Coordination?

Posted by Vince Kuraitis on April 9, 2011 · Filed in Information & Communication Technologies (ICT) · Comments

My guess is you’ve probably never asked yourself this question. A quick preview:

1. Technical barriers aren’t the limiting factors to Facebook becoming a care coordination platform.
2. Facebook’s company DNA won’t play well in health care.
3. Could Facebook become the care coordination platform of the future? If not Facebook, then what?

1) Technical barriers aren’t the limiting factors to Facebook as a care coordination platform.

Can you imagine Facebook as a care coordination platform? I don’t think it’s much of a stretch. Facebook already has 650 million people on its network with a myriad of tools that allow for one-to-one or group interactions.

What would it take to make Facebook a viable care coordination platform?

• More servers to handle the volume — not a problem
• Specialized applications suited for health care conditions — not a problem
• Privacy settings that made people comfortable — more on this later
• A mechanism to identify and connect the members of YOUR care team — really tough, BUT this is NOT a technological problem, but a health system one

Suppose you are a 55–year-old woman who is a brittle diabetic. Your care team might include a family physician, an endocrinologist, a registered dietitian, a diabetic nurse, a ophthalmologist, a podiatrist, a psychologist, and others. Ideally you’d have one care plan that coordinates the care among members of the team, including you.

What’s the reality of today’s health care non-system?

• There is no formal designation of “your team.”
• There is no mechanism to designate one “plan” that coordinates the plays among your team members.
• It’s possible that multiple quarterbacks are calling the plays for your care.
• It’s possible that members of your team have no knowledge THAT you are being treated by others and HOW you are being treated by others.

Care coordination today is in the stone ages — there is no system for care coordination.

Supplying a modern Facebook-type technology platform doesn’t change this. The major limiting factors in Facebook’s becoming a care coordination platform aren’t technological.

Let’s look a bit deeper.

2) Facebook’s company DNA won’t play well in health care.

Facebook CEO Mark Zuckerberg’s definition of an open social graphdoesn’t fit well with people’s expectations of privacy in health care. Here’s how Zuckerberg described his views:

“You have one identity,” he emphasized three times in a single interview with David Kirkpatrick in his book, ‘The Facebook Effect.’ “The days of you having a different image for your work friends or co-workers and for the other people you know are probably coming to an end pretty quickly.” He adds: “Having two identities for yourself is an example of a lack of integrity.”

IMHO, Zuckerberg’s notion of a single identity isn’t going to fly with people’s private health care information. Sharing everything about yourself might be an idealistic goal for a 26 year old gazillionaire, but when it comes to most medical information, people will want to share information with their care team, not with the world. Zuckerberg doesn’t recognize that the default for medical information for almost everyone is “don’t share,” not “share”.

In contrast, LinkedIn is a platform built for business networking. It assumes that people will want to share different types of information with business colleagues than with their friends. This strikes me as a much more realistic notion of identity, but you can certainly disagree.

Here’s another example of how Facebook’s company DNA would violate trust. Facebook has a reputation for pushing privacy boundaries, and then falling back only if/when people complain (and they must complain loudly).

Since its founding, Facebook has done a 180 degree turn on its business model. The company started with the premise that default for your information was “private” unless you specified otherwise. By May 2010, the default had become “public” unless you specifically modified privacy settings. Why? …because they realized that the valuation of the company was driven by the quantity and quality of data about YOU.

So how would this work in health care? “Oops, we changed privacy settings on you and revealed your HIV status…won’t happen again, sorry.” Disaster!

3) Could Facebook become the care coordination platform of the future? If not Facebook, then what?

Let’s circle back to the original question “Could Facebook be a platform for care coordination?”

My answer is NO!

What are alternatives?

Its pretty much wide open. Here are some possibilities:

• A new specialized company will become a dominant player in care coordination
• The market could fragment — companies might specialize based on patient conditions, geographic concentration, other factors.
• Existing healthcare technology companies, e.g. EHR (electronic health record) companies, could extend their care coordination functionality
• Your local ACO or integrated delivery system could position itself as YOUR platform for care coordination
• An existing social platform (e.g., Facebook, LinkedIn) MIGHT turn the corner and add care coordination functionality
• or ??

Hope you’ve enjoyed going through the thought process. Let’s continue the conversation.