David Kerr: Gordon Gekko and the NHS

David KerrHere in United States, the latest must have app contains software that blocks any mention of the actor, Charlie Sheen. Until recently, Sheen was the highest paid television star in the world but was fired last week after making caustic comments about his employers in public. Subsequently, he has just been awarded the Guinness World record for having the fastest time to gather more than 1 million followers on Twitter with his devotees presumably awaiting more linguistic utterances such as #biwinning or #tigerblood.  As has been pointed out elsewhere and recently, the Internet can be an unforgiving forum to bare one’s innermost thoughts especially if they contain expletives and unflattering comments about work colleagues. The medical profession seems to be particularly sensitive about this issue and a number of professional organisations have started to publish guidelines for medical students, junior doctors, and other healthcare professionals about how to behave online. It cannot be long before another new app will be created that can vacuum up embarrassing content from Facebook and other social networking sites and destroy the evidence for ever. However, this type of app is likely to be premium priced.

The philosophy of Silicon Valley is clear – any new technology should make money. The well trodden path to fortune seems to be: first come up with a idea that is simple but that no one else has thought of previously, best if it does one thing but one thing very well. Next, give it a one word name that is a neologism and some kind of funky logo then create the front page of the website using funding from friends and family or perhaps Angel investors. After this start knocking on the doors of the Venture Capitalists. If the budding entrepreneur gets this far, then telephone number sums of money are available but usually at the price of handing over 70% of the new company to the VC.  From a business perspective, once things start to happen the founders of any fledgling start up company need to beware of the potential for equity dilution as shown so well in the movie “The Social Network.”

Most of the time making money is not considered to be a bad thing to do. However, some people here in California appear to be bemused with the some of the responses to UK Government’s new proposals for the NHS. Many UK commentators, especially those with medical or nursing backgrounds, are publishing articles in high profile national newspapers and medical journals expressing their concerns about the potential arrival of Gordon (“Greed is Good”) Gekko types, whose aim is to cherry pick the most lucrative aspects of the health service. This seems unlikely given the consequences of the US allowing unbridled capitalism access to healthcare over many years and the monumental problems it now has to deal with.

In contrast, however, some of the more philanthropic US businesses are, in fact, awaiting the arrival of representatives from the new GP consortiums and foundation trusts to discuss innovative ideas for partnerships in health care. These agreements would be based on improving efficiency and quality of patient care and at the same time providing a profit for the company and investors. In the area of environmental science this is already happening – interested venture funds are looking specifically for next big idea that will have a measurable benefit for the community and at the same time provide a return on investment– with any resulting equity split (unequally) between the fund, the relevant University, and the scientist. From the investors perspective the challenge is to bring the science to market without the University and scientists infringing intellectual property rights by putting too much information in the public domain.

Also in the news, major local companies including Apple, eBay, Hewlett Packard, Intuit, Intel, and Oracle have joined together as founding partners to provide $150 million to help support the building of a new 600-bed hospital for Stanford University. The $2 billion project is being touted as “a global model for patient centered and technologically advanced healthcare.” The companies want to do more than just provide the money, they also want to help with the development of new approaches to patient access, providing information, education, and navigation. Whether this type of partnership approach will ever become politically acceptable in the UK remains to be seen but at present, over here at least, few eyebrows have been raised and in general the idea has been given a thumbs-up (Facebook style of course).

David Kerr is the managing editor of the Journal of Diabetes Science and Technology.