Where we are
We are not there now. That is the reason for the work.
The oath has not changed. The day around it has. In one widely cited study, researchers followed 57 physicians in four specialties through their office day. The doctors spent 27 percent of that day face to face with patients, and 49 percent on the electronic record and desk work.
Source: Sinsky and colleagues, Annals of Internal Medicine, 2016
Nobody chose that on purpose. It accumulated, one form and one click at a time. The question for this decade is whether the technology that helped bury the visit can be made to give it back.
Into whatever houses I enter, I will go into them for the benefit of the sick.
The moonshot
Heal all the children. All the sick.
That is the direction. It is not a claim, and no one organization, technology or decade will get there alone. People heal people. The work is to clear away everything that stands between them.
01
Give back the time
What would it take to return to every clinician the hours that forms and screens now take, and to show that those hours went back to patients?
02
Bring the knowledge into the room
How does everything medicine has learned reach the moment one child is being cared for, safely, with a person answerable for every decision?
03
Leave no child out of reach
How does that visit reach the family who lives far from a specialist, or who cannot wait months for an answer?
Our part is one drop.
Ecofy does not treat patients and does not build the technology. We convene. Each month the Executive Forum is designed to bring the people who run healthcare into one room with the people at the frontier, to examine what is real, what is safe and what should be tried next. A drop is small. Ripples are what happen when twenty organizations decide to move together.
A day in 2035
One day. Seven moments. Seven open questions.
Follow a single day through a health system that has had time to get this right. Each moment is imagined. Each question under it is real, and is the kind the Executive Forum is convened to examine.
05:40
Before anyone arrives
The building gets ready.
Overnight, the supply rooms were restocked and the first rooms of the day prepared. The people who used to do that at dawn are with patients now. Nobody remarks on it. It is simply how the morning starts.
The question for the room · Robotics
Which physical work is ready for machines, and who decides when it is safe?
07:10
A nurse starts her shift
Handover takes four minutes.
The summary of the night is waiting for her in plain language, with what changed listed first. She reads it, asks the night nurse the one thing it could not tell her, and goes to meet her patients.
The question for the room · AI-powered operations
What would it take for a shift to begin with patients and not with paperwork?
09:30
A family arrives
Nobody hands them a clipboard.
The child's history, the family's coverage and the reason they came are already where they need to be. The first person they meet looks up, says the child's name and walks them through.
The question for the room · AI-powered operations
Which parts of arriving should disappear, and which should always stay human?
10:05
The visit
Fifteen minutes of attention.
A children's doctor kneels down to a child's eye level with nothing in her hands. The conversation is the whole appointment. The record of it is written, checked and filed without anyone turning to a screen.
The question for the room · AI and medicine
How far can a clinician trust a note no one typed, and how is it checked?
13:20
The network
Something tries the door.
An intrusion attempt is noticed and contained. The person on duty gets one sentence she can act on, not a wall of alerts. Upstairs, care carries on and no one in a gown ever knows.
The question for the room · Cybersecurity and trust
As systems do more, what must never go down, and who answers when something does?
16:45
The leadership table
Someone asks, should we?
A new capability is on the agenda. The evidence is laid out, including what is still unknown and who would carry the risk. A person weighs it, decides and puts their name to the decision.
The question for the room · Governance and responsible innovation
Which decisions stay with people, always?
19:30
Home
The nurse is home for dinner.
There is no charting waiting for her tonight. Across town, the family from this morning reads a short note about what happens next, written so they understand it, from people who had time to write it.
The question for the room · Longevity and prevention
What does the evidence support today, and what is still only a hope?
Back to today
None of this is promised. All of it is worth examining.
Pieces of this day are being tried in real organizations now. Some will hold up and some will not. The work for leaders is telling the difference, with the people doing it in the room and the evidence on the table.