About a year ago, Susannah Fox “penned” another one her thoughtful posts, this one was about health data, “Thinking critically about Big Data and health care” in response to an article in the New York Times, “Sure Big Data is Great. But So is Intuition.” I drafted a View from the CLOUD in reaction. Susannah has a habit of great trend-spotting, as well as provoking the rebellious innovator and “meme-breaker” in me.
Her reflections on Health Data’s Adolesence at the Health Data Consortium and the birth of the Web as we mark the 25th anniversary of Sir Tim Berners-Lee work this year is not only an apt analogy but brings back fond memories of those early days. In the late 1980s, early 1990s, I was a young Account Executive and Account Manager at Apple. Back then, we were still Apple Computer and not Apple, Inc. I was based in the Chicago office and had the privilege of working in our Midwest Higher Education District. I remember the University of Chicago telling me, “hey, that AppleTalk stuff is nice, but how do we hook up our Macs to TCP/IP?” I remember our sales district providing some financial and technical support to the University of Minnesota as they built Gopher as a visual interface to FTP file transfers. I also remember a colleague, account executive and district manager, heading down to Champaign/Urbana to launch Spyglass, a company that later built out an entirely new Mosaic code base, that later was licensed to Microsoft and became the basis of Internet Explorer. In those days, Apple did less than $10B a year in revenue. When I joined in 1987, the company did less revenue in a year than it does in a weekend now as it launches a new iPhone or iPad.
A lot has changed for Apple, but I’m not so sure that much has changed for the Internet and the Web. This is not to say that there hasn’t been much good work done. There have been some really innovative ideas born of the connections of the Internet and the presentation interface known as the Web. In many ways, Facebook is the ultimate progression of the two, however, Facebook is the end of an old paradigm, not the start of a new one. It has definitely connected lots of people, like LinkedIn and others, allowing so many people the opportunity to nurture relationships, share family news, and advocate for causes and change. However, at the end of the day, it is still just a bunch of webpages.
Yes, one can download myriad Facebooks apps from Apple’s App Store or Google’s Play, but those are just different interfaces to the same stuff, a step beyond HTML, but still wrapped around the concept of “chartopomorphism.” Chartopomorphism is a term I coined in my View from the CLOUD a year ago for paper-based thinking. Just like anthropomorphism attributes human characteristics to inanimate objects, chartopomorphism attributes paper characteristics to digital tools. Electronic health records are a prime example of this in the medical field. We’ve spent $20B moving data from papyrus on clipboards to silicon on glass screens but haven’t changed the paradigm. My upcoming book, “The End of Linearity” will unpack this concept in more detail.
Just like Gopher evaporated for file transfers in the advent of the web interface, Blue Button, too, will be one of those important transitions to a new model of sharing data. It is important to remember that Blue Button allows us to download our health records, not our discrete health data. The health data is certainly available within the health record, but even with recent Blue Button updates, we are still moving whole records. It is still linear. The clipboard motif has been updated from fax numbers to Direct addresses, but the whole notion of transmit is still decidedly 2-dimensional and paper-based. Blue Button is the gopher of health data. There is another disruptive moment ahead, like Tim’s with the Web, 25 years ago. As Sherry Turkle once said, “just because we grew up with the Internet doesn’t mean the Internet is all grown up.”
As I spoke about at TEDxAustin in 2011, we must “Reweave the Fabric of the Internet to Transform Humanity.” As I spoke about at TEDxTallaght at the Atelier of Ideas this past October, “we must move to a pull-based world, rather than push.” At the end of the day, it is not about the health data, it is about the 7B human beings connected by that data. Unlike Gutenberg’s printing press, in a world of ME 1.0, we are the moveable type of the next Renaissance.