Esther Dyson's Population Health Dream

Scott Mace, for HealthLeaders Media , May 14, 2013

During our conversation, I was reminded that Dyson is not alone in her city-as-petri-dish subject focus. The CommonWell Health Alliance, announced at HIMSS, is targeting two cities, as yet unnamed, for its initial rollout of its health record exchange, says Arien Malec, co-founder of the Direct Project, and an executive at RelayHealth. Whether the topic is exercise, healthy eating, or health record exchanges, the city is shaping up to be the essential unit of measure.

Malec also spoke at last week's Health:Refactored conference in the heart of Silicon Valley, and revealed that the big launch of CommonWell's efforts is timed for HIMSS 2014. Details, and cities involved, remain unannounced. Yet when I told Dyson of CommonWell's city-scale plans, she seemed eager to explore possible synergies.

Elsewhere at this conference, I met a doctor who doubted that the current health gadget boom, and even coordinated care itself, could help those costing the system the most: older patients with multiple chronic diseases and co-morbidities, perhaps morbidly obese, who are unlike to strap on Fitbits and Nike FuelBand sensors and make dramatic strides.

Dyson concedes this. Her program is about prevention of these diseases, not cures. HICCUP itself is just one potential part of solving healthcare's problems. That doesn't mean it lacks value.

This experiment won't work in all towns, Dyson says. She's looking for communities where the inhabitants live, work, and go to school locally. Otherwise multiple communities will have to be involved. Towns with several large employers will be easier to test than communities with lots of smaller employers.

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