No Internet? No Problem

Most healthcare thought leaders seem to be at a conference these days, what with StartUp Health Festival, JP Morgan Healthcare Conference, and CES 18.  They're talking about or listening to others talk about the future of healthcare and/or technology. 

Me, I'm just sitting at home thinking about the future.  Specifically, the future of the internet.

The internet has been successful beyond anyone's possible expectations.  It have infiltrated virtually every part of most people's daily lives, to the point where pundits like John Nosta suggest that technology has become almost as important as food, water, and shelter. 

He quotes an Ipsos survey that found 82% of people in India said they couldn't imagine life without the internet.  In India.  The comparable percent in the U.S. was 73%. 

Now we're all excited about the Internet of Things (IoT).  Everything you have or encounter will soon become capable of monitoring and communicating everything you do, and that will include monitors inside us.  The options are limitless. 

But, let's be honest: we've made a mess of things. 

Earlier this year we learned that most of the world's microprocessors have security flaws that leave them vulnerable to hackers stealing essentially anything on them.  The manufacturers and others are rushing to address the problems, but there aren't going to be any easy answers.  We've put an emphasis on ever-faster, and have accomplished miraculous improvements, but the trade-offs are sometimes vulnerabilities like these.   

If your personal information hasn't been hacked yet, well, sorry to tell you, but at least some of your personal information has been hacked.  Moreover, your personal data is currency to an array of companies.  All those "free" services aren't really free, they're just a clever way to find out more things about you, to better target advertising to you or sell your data to some other organization. 

Many thought the internet was going to democratize everything: make more information available to more people -- which it undeniably has -- and move more power to individuals and small organizations -- which it undeniably hasn't.

Think of the concentrated power of Amazon, Apple, Facebook, or Google, any one of which would make John D. Rockefeller envious. 

The underlying problem is that the internet was designed some 40 years ago, the Web over 25 years, and those are ancient in technology years.  We can throw more band-aids on them, but clever people will figure out new vulnerabilities and exploit them -- and us. 

Zeynep Tufekci fears that we're facing a looming digital meltdown.  In her words: "Modern computing security is like a flimsy house that needs to be fundamentally rebuilt."

It's time for something new.   

Some think that blockchain is going to be the next internet, fundamentally changing how we store, use, and ensure the validity of data.  Others caution that it is, perhaps, more like a new Linux.  Blockchain does offer exciting new possibilities, but may not go far enough on its own.

DARPA, which funded the development of the original internet, is looking at something called Dispersed Computing.  It would take advantage of more localized computing resources, such as smartphones, tablets, or autonomous vehicles.  Jonathan Smith, the DARPA program manager, told Fast Company: "Melding computing into communication is a dramatic rethink of the models and architectures we have become accustomed to." 

As Fast Company describes it:

Imagine every cell phone, smart thermostat, fitness tracker, and game console in your house contributing their spare cycles to help process the video you're trying to upload, or educate the machine learning algorithm that runs your AI personal assistant.  When a dispersed computing network wants to borrow your phone, in other words, it's going to be doing a lot more than sending a text.  

Petros Mouchtaris, president one of DARPA's vendors on the project, believes dispersed computing will be "transformational", one that will provide "a much more advanced internet than today."

DARPA is not alone. Wired's  The Internet Is Broken and accompanying article on how to fix it profile several efforts.  For example, Aral Balkan of ind.ie and Tim Berners-Lee are pushing for a more decentralized web.  Mr. Balkan says: "Imagine a world where every citizen owns and controls their own place on the internet." 

Dr. Berners-Lee is leading Solid at MIT, which they hope will decouple data from the applications they produce.  You could choose what data you wanted stored where, and any application that wanted to use it would need your permission. 

Meanwhile, Interdigital's Dirk Trossen is pushing for an "information-centric network," instead of the existing one based on URLs (uniform resource locators).  ICNs would disclose what information is stored, and that information would carry an authentication code that would make anonymity harder, this reducing phishing and fake news. 

Healthcare should be leading these kinds of efforts, not just watching with polite interest.

Healthcare leading the charge to reinvent the internet?  Ridiculous!  This is the industry that still uses faxes!  This is the industry whose providers need to be bribed to install EHRs!  This is the industry that can't connect those EHRs!  This is the industry in which making appointments online, viewing prices, doing virtual visits with providers, or even accessing your records are still viewed skeptically. 

And this is the industry that is already selling your health data to drug companies and others, and this is the industry suffering from data breaches and ransomware attacks. 

All those are reasons healthcare should be pushing for the next internet.

There's no internet-based healthcare colossus.  There's no healthcare organization whose use of internet-technology is the envy of other industries.  Face it: healthcare is only grudgingly accepting the use of computers, and, aside from things like email and organizational websites, is barely taking advantage of what the Internet has to offer. 

Rather than healthcare trying to catch up on internet-based technologies, it should skip to its next iteration.  Instead of a healthcare internet-of-things, let's put those new types of connectivity on a more stable, extendable platform.

Peter Levine of Andreessen Horowitz says: "I'm waiting for the next entrepreneur to come in who blows us away with the idea that there's some next thing that needs to be done relative to [dispersed computing].  I don't know what it is yet, but when I see it I'll let you know,"

Why can't that be someone in healthcare?  After all, it's our lives, and our most personal data, at risk here.