A Hologram Might Be Worth a Million Numbers

I saw a fascinating article about how Fidelity, through their research arm Fidelity Labs, has released a virtual reality tool to portray financial information in a more visual manner -- not even using numbers.  I immediately thought about how this approach could apply to health care.

The Fidelity tool -- which can be viewed using virtual reality goggles or as in simulated 3-D on a browser -- is pretty cool.  Stocks are buildings, the height is their price, the size of the base is the trading volume.  Weather reflects whether markets are up or down, day/night indicates if markets re up or closed, and so on.  You can build your own "city" or neighborhood based on your portfolio or stocks/sectors you are following.

Fidelity got interested in this after Facebook acquired virtual reality company Oculus earlier this year (for a very real $2b), figuring Facebook might have some hint of where consumers were headed.  To date, virtual reality has been mostly thought of in terms of gaming, but Fidelity is thinking out of the proverbial box.

Financial information certainly can be very dry and numbers-laden, but I think health care can make a case for the title of most confusing.  Lots of confusing language, lots of data that sometimes is information and sometimes just adds to the noise.  Think of your medical record (if you've ever been able to see it) or a set of lab results.  Now add all the data that is or is soon going to be added to your information via wearable or remote monitoring devices, and the sum total is certainly a situation that is crying out for better visual representation.

Yes, I know that many of those fitness devices, as well some lab results, may come with charts or graphs, but people who don't like numbers may not like charts and graphs much better.  And that's still just a slice of our health information.

We know understanding health care data is a problem.  In a recent study, The University of Michigan found that people with low literacy and numeracy skills were less than half as likely to understand their lab results -- and even among those with higher such skills, only 77% were able to.

All that health care data is crying out for visualization.  Visualization of Big Data is becoming a hot trend generally.  From an evolutionary standpoint, humans aren't very good at making sense of numbers, but we excel in looking at patterns -- and pictures.

To help address this, University of Michigan has a "Visualizing Health" initiative.  They've created a gallery of of recommended ways to graphically represent health information that they've validated through user testing, and are making them available for free.  It's a great project, but looking through their 54 examples, I think it is just a first step.

GE Healthcare has their own data visualization effort, and I'm sure there are others.  Still, more and better charts and graphs are nice, but Fidelity has raised the bar.

I'm thinking holograms.

To some, holograms are still the stuff of science fiction, but they're becoming more mainstream and they've already started to be used in health care.   Last year, Realview Imaging showed how holographic images could be used to assist surgeons in cardiac surgery, allowing the surgeons to view, touch, even mark the 3-D images generated from ultrasounds and X-rays.  Realview just went through a $10 million investment round and expects to be in the commercial market by 2016.

I want to see a holographic medical record.

Think about it.  The current generation of EHRs isn't wowing anyone.  Health future Joe Flowers recently suggested that they are so flawed that we should just ditch them and start over again.  No wonder, because, as best I can tell, they did for medical records what 1990's websites did for paper: they simply made the content digital, added a few links and a modest amount of interactivity.  We called that "brochureware" then and I'm not sure EHRs have done much more for the old paper records.

No wonder they're so clunky.

On the other hand, imagine if your doctor comes into the exam room and instead of holding a paper chart or tablet with your record, her smartphone projects a holographic image of a human body.  Of your actual body, if preferred.  That scar on your knee, all your X-rays and CAT scans, your balky shoulder, your asthma -- all those are represented in the image.
 
The doctor can view and update a current snapshot of your health, go back to a previous version and contrast, add or listen to verbal notes.  She can zoom in to specific organs or other body parts in order to highlight specific areas of concern.  When she takes your vitals, they automatically get uploaded into the record.  The hologram can take advantage of Fidelity-like symbolism to give a literal picture of your health, down to lab results, Fitbit readings, and even your own subjective comments (e.g., the image gets blue when you are depressed, or degrees of red indicate where and how much pain you are feeling).

Advances in haptic technology may mean that anything your doctor feels when examining you (like a lump) can be uploaded to your holographic image -- and that the image itself has tactile qualities.  The "hands-on" advantages of the exam can be fed directly into your record, with no manual input (pun intended).

Rather than you feeling that the doctor is reading the record when he/she should be paying attention to you, the record would become interactive with the exam, in a way that is both highly visual and available to both of you.  It also would become another tool for the doctor to explain to you any diagnoses or recommended procedures; she can touch and manipulate the image to show you exactly what is going on or will happen.

That's an EHR that could add to, rather than detract from, the clinical experience.  Equally as important, it is an approach that consumers would probably be more willing to use on their own in managing their own health.  That Big Data that everyone expects us to be collecting about ourselves would become not just more numbers or charts but part of an interactive display of...well, us.

One way or another, better visualization of health care data is going to be essential if we don't want to get lost in all the data.  I sure hope health care doesn't come late to the party, like it did to digital information.  Holographic technology isn't the complete answer, but it is here and will soon find applications throughout our daily lives.  It will play a more important role in health care, and I can't think of a better place to start than revamping our idea of what an EHR is.   You can't tell me that the folks at Realview aren't already thinking about health records.

I just wonder if the people at Epic or athenahealth are.