I've been fascinated by Hello Health, a web-based patient communication and management service, ever since I first heard about it a couple of years ago. Since then, the health industry has changed radically, so I thought it would be interesting to speak to Jay Parkinson, the founder of Hello Health, to see what he had to say about the future of health in an increasingly  design-focussed world.

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Hello Health is a service that has impacted the doctor-patient relationship in a very positive way - you founded it when you were an active medical practitioner (editor's note: Dr. Parkinson now increasingly focuses on running his consultancy The Future Well) , to make it easier for your patients to get in touch with you. When was this, and how has the medical landscape changed since then in your opinion?

I started my own practice on September 24, 2007 in Williamsburg, Brooklyn. It was pretty simple. People in my neighborhood would visit my website; see my Google calendar; choose a time, input their symptoms and their address; my iPhone would alert me about a new appointment; I would make a housecall; they'd pay me via PayPal; and we'd follow up via email, IM, or videochat. The blogosphere and the popular press seemed to really like it -- I got 7 million hits on my site in the first month. Many of those hits were from doctors asking me how they could do something similar. I realized that my practice needed to exist in the cloud with a set of more powerful tools so that any doctor anywhere in the US could have a 21st Century practice. I joined up with Nat Findlay at Myca in January of 2008 to start Hello Health. 

Since then, the medical landscape hasn't changed much at all except for the fact that the new healthcare legislation in the US will make innovations like this harder and harder to successfully execute. One very positive change I've noticed is that the medical industry has realized that patients are people now. There seems to be more of an emphasis on "patient-centered" care. That's a wonderful thing, except that nobody likes to be called a patient. So the medical industry still has a lot to understand about customer service. and how to have a conversation with real people.

We love Hello Health's site design - it's friendly and easy to use, which probably goes a long way in motivating medical practices (and patients) to take it up. Could you tell us a bit more about the design process and the rationale behind it: who designed it, how much creative input did you have personally?

I had nothing to do with the current design, except for the fact that early on in the company I placed a huge emphasis on design from both a visual and user experience perspective. If you'd like to see the designs I was involved with you'd have to visit the partners we worked with at the time to see their portfolio (Ghava.comalencacason.combarbariangroup.com). The process was pretty simple, but it was my baby, so I fretted about every little detail. Most importantly, I chose to work with a design team that had a similar philosophy as mine-- keep things beautiful and simple and question every little detail. I would design concepts (both the website and the web application) in Keynote (see Keynote Kung Fu) and then take them to the team at Ghava. We worked side by side at a computer for months to create the initial designs and then we'd fire them off to the development team in Quebec. For me, it was a real game changer to have a physician work full time along with a respected visual agency to create something for healthcare! That simply doesn't happen - hardly ever - in this industry. Most systems doctors use aren't designed by doctors. And don't seem to be designed by anyone who's ever seen anything after Windows 95. I was fortunate enough to have almost total creative input and I was grateful for the freedom the team at Myca gave me.

How many medical practices and doctors currently use the service? What is your relationship with them on an ongoing basis as far as gathering feedback to improve the service is concerned? 

I left the company back in December 2009 and don't stay in the loop about the number of users. 

Tell us a bit about Future Well, your design practice that focuses on health. Your firm's philosophy is to look at health from a medical as well as an emotional perspective, and as a medical professional yourself you have a unique perspective which many design agencies working in healthcare probably don't have. Can you tell us about some of your recent projects/products please, and what gaps they have sought to fill in the market? Also, who do you consider your competitors?

Grant Harrison and I started The Future Well in February 2010 because we know that there are companies out there who actually want to approach the concept of health from a different perspective. We've been fortunate, because our clients have approached us saying they want to do something interesting in the health space. So we work with them to come up with a new product or service, reach out to our network to hire the best team we can imagine to build it, and then build it for the client. We serve as head of product and design and then we launch it together. Since we've only been around for about a year, we're just getting ready to launch two really new services in May. Unfortunately I can't talk much about them at this time, but I'm thrilled.

We've also been working with The Freelancers Union here in NYC to help them design and build a new healthcare delivery experience for their members who have Freelancers Insurance Company health insurance. They're doing absolutely wonderful things in healthcare and I'm happy to be a part of their vision. Again, I unfortunately can't say a lot about this at this time.

But I wouldn't say that we look at health from a medical and emotional perspective. I'd say it's much more than that. The word health has been hijacked by the medical/sickness industry. But it really means the way you live your everyday life through your relationships with friends, family, your neighborhood, your movement, your food, your experiences, your work, and your finances. Health isn't a goal, it's a tool to live your life the way you want. Sometimes being fit isn't the tool you want to use, but having a lovely marriage is. Is the unfit person with a lovely marriage less healthy than a fit person with a horrible relationship with their spouse? Health is obviously complex but it's more about sociology and anthropology than pills and scalpels.

I don't really think there are many competitors out there. I don't think we're competing with IDEO or Frog or Razorfish. Building innovative things is mostly about building the right relationships with your clients and your partners. There's magic in great relationships and that's what we focus on. We're very small and we want to keep it that way. I think what we offer is quite different and something that you can't get from a company, you'd have to get it from a person just as unique as Grant or myself. I'm not aware of any design firms started by a doctor and combines the talents of both the medical perspective and the global consumer perspective. 

The US medical system is very difficult from the UK's National Health Service. How do you think a service like Hello Health can help a country like the UK, given its completely different regulations? Also, I noticed that Future Well is actually working with the NHS - can you tell us more?

All countries all over the world are struggling with the same process of healthcare delivery. Think about it, what's the difference between going to the doctor now vs. going to the doctor when you were a kid. You still called up the doctor, waited forever amongst a bunch of sick people in a room that looks like it hasn't been renovated for decades, and then met with a doctor only to forget 85% of what she says, with no access to your medical records to refresh your memory. It's the same antiquated process. My first practice was a service design case study about the process of visiting your neighborhood doctor. I sat down and drew a user experience map based on the traditional doctor visit. For every step, I asked myself, can we do things differently here? Can we use an online tool to schedule? Can this visit be handled over email or Skype? How can I get this person their test results as easily as possible? How can my job as a doctor be made easier? But most importantly, how can I optimize the experience this person will have around their health?

Literally every country in the world has the same process and the same kind of leaders who are straddling a major generational divide. Healthcare leaders are still boomers who have trouble understanding anything different than what's always been done, the internet, customer service, and what people want out of healthcare. This new world is threatening, especially because of the politics of healthcare. 

Hello Health was intended to be the ideal healthcare delivery experience-- essentially the killer app of healthcare. But fixing healthcare has very, very little to do with technology and everything to do with the political vision of our leaders. 

We worked with the NHS on a project in Kensington this year. The St. Charles Hospital was shut down because it was no longer needed in the community. They had this massive, absolutely beautiful campus with such an amazing history built in the 1870s under the direction of Florence Nightingale and they didn't know what to do with it. So they hired us to work with this space and create "the future of urban health" that optimized the health of the local neighborhood. As you can imagine, we designed something that had no medical component to it at all, but focused more on optimizing your everyday life in a space that enabled you to live well, form close relationships, be active, eat well, move well, and learn. Then Cameron dissolved the PCT we were working with as part of the Big Society and now the space is sitting empty with nobody and no resources to drive development forward. It was quite a bummer for the space, the neighborhood, and us.

Do you work with partners, either in the US or globally, to expand the reach of your products and services? How do those relationships work, if so? I can see something like Hello Health being very useful in developing countries, for example, where the pressure on medical practitioners is often much more than it is in the US. If you haven't considered expanding, why not?

Health is local and political. Delivering high quality medical care has very little to do with online platforms. While efficiencies enabled by the internet would improve the customer experience, it won't do much to improve the health of a population. Medical care influences only about 10% of the total health of a population. The rest is nature and nurture. Although the internet has revolutionized how we all communicate, the real issue is that the vast majority of leaders in healthcare don't want any revolutions. They want to be politically successful. Although I've spoken with healthcare leaders all over the world, innovation is actively stifled in every country. I have hopes though. I speak to medical students on a regular basis. The youngest medical student today was born in 1990. They're going to be leaders soon. And then things will change. It will change because they can't imagine dealing with inefficiencies that the internet has solved for them since birth. The only way things will change today is the one-off inspirational older leader/innovator in healthcare. They're very, very rare.

Broadly, the companies doing interesting things in healthcare today can be categorized as those who are targeting medical professionals, such as DocCom, which many people are calling the Facebook for doctors, and those that are targeting patients, such as Patients Like Me and Patient Opinion. Where does Hello Health sit on this spectrum?

A Facebook for doctors sounds about as exciting as a Facebook for electricians. Sermo is a social network for doctors here in the US and I visit it about every 6 months just to see what's going on with it. I could see old school forums being occasionally useful, but a social network for doctors? I'm not aware of any successful social network around a profession, besides the creative portfolio networks.

I'm not a big believer in the power of today's version of social networks. I really don't like Facebook, it's way too general and doesn't give me tools that make my life easier. It's entertaining at times, and that's why it's popular, but that's about it. 

I do strongly believe in creating tools that have a social component. But what are those tools that would make a doctor's life easier and have a social component to it? For example, shouldn't a doctor have a Basecamp project for each one of his patients? They can upload files, start conversations, invite other caregivers in on the project, keep things organized all in one place in the cloud, and have milestones and timelines. That's what Hello Health is. Doctors need tools to do their jobs well, not forums to waste all that extra time they have. But the challenge is doctors don't get paid for communication, delivering quality care, or organizing a team to optimize a patient's health. And that's a political problem, not something technology can solve.

As far as the patient sites go, I don't think people want to call themselves patients and then go online and chat about how medical their life is. Bob looks at himself as a person who happens to have this annoying thing called diabetes. He doesn't look in the mirror and see a patient. So why would you create a company and online platform for them that from the get go, calls them something nobody wants to be called. These conversations are already springing up all over the internet in communities started by the people themselves. For example, there are diabetics and all kinds of other health communities on Tumblr talking about these issues. Turning those conversations into a business is a bit dodgy and just doesn't sit right with me.

So, what next for Jay Parkinson, doctor and now design professional?

I'm just going to continue publishing thoughts about health and our society. If this resonates with leaders who can make things that matter happen, well, I am going to give it my all to design meaningful products and services that bring health and medical care into the 21st Century.

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Excellent thoughts, Jay. Thanks very much for sharing them with us.  

Anjali Ramachandran

Anjali Ramachandran

Anjali couldn't shake off the habit of calling herself a 'citizen of the world' for the last decade, having lived in 5 countries so far, but has now amended that to 'citizen of the internetz'. She is a strong believer in technology as an agent of social change and likes exploring the relationship between digital services and physical objects. Robots and transmedia storytelling projects intrigue her.

@anjali28