At night, the average heart rate of millions of people slows down as they sleep; parents of newborns feel their hearts race as babies all over a city wake up with a cry. Now add blood pressure and zoom into a neighborhood, like my own in East Harlem. Aside from the natural variation in a day and automatic rise in blood pressure as people get up from sitting on their couch, there are thousands who live in the red zone. I work in a health system that operates in the red zone, waiting for physiological meters to shatter as symptoms like throbbing headaches and catastrophes like strokes send a constant stream of pulses and pressures into the hospital. Without information about what’s actually happening in the community, we work in the dark.
In your mind’s eye, paint the outline of a neighborhood on a black canvas, and color it Tron with a street grid. In 3-D space, assign each person a microscopic white light, so you can see them moving around, stacked in their apartments, or scattered across streets. Now, shade that light orange or red for those people whose blood pressure is nearing or hitting the red zone. You’d see that some fraction of them get to the clinic, and another set heads straight for the emergency department, while others suffer through their symptoms or don’t feel them at all. And tragically, the health system so often first learns about someone in the red zone when the damage is already done. What we need are a thousand wired torches, wielded by people in the community who know their neighbors best, to guide them to the right place at the right time.
At the Earth Institute, I lead a team of technologists, designers and health professionals who are building the next generation of community health systems. We developed our basic approach in the Millennium Villages Project across 10 countries in Sub-Saharan Africa, where nearly a thousand Community Health Workers use mobile phones to help them make decisions, identify sick neighbors in their homes, and visualize hotspots of activity that require further inquiry. Now we’re working with groups like City Health Works! to adapt these systems to places like East Harlem. In the process, we’re going to cheer communities on to build their own ways of meeting personal and community health goals with the help of local peer coaches.
The amazing thing is that for all the investment in electronic medical records, no health system is yet ready for the deluge of data that these systems will produce. Richly meaningful, socially interconnected and owned by the people who generate it, we see communities illuminating the areas that surround hospitals across the country, where people actually live out their lives. We’re on the cusp of a new era in community health systems, and a vibrant approach to health data enables communities to know their own pulse and act before the pressure grows too great.
[Modified based upon We The Data]