Show Notes

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Transcript

[INTRO MUSIC] TOM:
Let me take you into a moment too many of us know all too well. You're in the emergency room. Maybe it’s you. Maybe it’s someone you love. The questions start coming fast: “What medications are you on?”
“Allergies?”
“Surgeries?” You try to remember: Was it your primary care doctor at the Cleveland Clinic? The antidepressant from a Teladoc visit? The statin from CVS MinuteClinic? Or was it your Apple Watch that flagged something odd last week? But no one here sees any of that. It’s all floating in different places—disconnected, siloed.
Your health story is scattered like puzzle pieces from a dozen different boxes.
No one has the full picture. Not even you. This isn’t just inefficient healthcare.
It’s dangerous.
And in some cases, it’s fatal. I’m Tom, and this is Foresight Radio, where we look at what’s coming next—and what we need to do to get ready for it. [ACT ONE – THE BROKEN PROMISE OF EMRs] Today, we’re talking about one of the most obvious—and yet most elusive—changes we need in healthcare:
A single, lifelong, cradle-to-grave, AI-enabled national health record. Now, we’ve been here before. Remember when we were promised that electronic medical records—EMRs—would solve this?
They were supposed to streamline everything. Make care seamless. The result?
A fragmented mess. Hospitals spent billions. Physicians buried themselves in digital paperwork.
And patients? We ended up in even more isolated data silos. Your hospital’s EMR can’t talk to your local pharmacy.
Your insurer’s system can’t read your hospital visit.
Your Fitbit, your Apple Watch, your health apps and wearables? Might as well be invisible. And that disconnection has real consequences—both in cost and in outcomes. A Journal of Patient Safety study showed that 1 in 5 patients experienced delays in care because critical health data was missing. [ACT TWO – MARIA’S STORY] When I was writing Reimagining Healthcare, I spoke with Maria, a woman in Dallas. Her mother’s biopsy results vanished between systems. It took three weeks to locate them.
Three weeks of fear, uncertainty—and a delay that changed her treatment. That’s not just a tech failure.
That’s a human failure. The irony is staggering. We have some of the most advanced medical technologies on the planet—
MRIs that scan down to millimeters, robotic surgeries that reduce recovery time, AI that flags tumors better than radiologists—
but we can’t manage the basics. [ACT THREE – DEATH BY CLIPBOARD] And it’s not just life-and-death emergencies—it’s everyday inefficiency. How many times have you filled out the same clipboard of information over and over?
Because every provider starts from scratch. In a world where our phones know what coffee we’ll order before we do, it’s absurd that healthcare still doesn’t know who we are until we hand over a plastic ID. So why haven’t we fixed this? You already know the answer.
It’s not the technology.
It’s the economics and politics of healthcare. Start with the EMR vendors—the Epics, the Cerners.
They’ve made huge strides, but their systems are fundamentally closed.
They profit from fragmentation. Hospitals? They’re locked in. Switching systems costs millions. So they make do. Insurers? A unified record would expose patterns—of care, and neglect.
It’d be harder to deny claims if the full medical history was available. And what about continuity of care?
We lose it every time data is siloed.
Without the full picture, we can’t track interventions, therapies, or outcomes. A national health record would turn those fragmented episodes into a continuous story. [ACT FOUR – THE FEAR FACTOR] Then there’s the public fear. The phrase “national health record” sparks panic—
surveillance, loss of privacy, government overreach. And to be fair, some fears aren’t unfounded. We’ve seen hospitals hit by ransomware.
We’ve seen breaches.
We’ve seen systems exploited. But here’s the contradiction:
We hand over more intimate health data to app developers—with fewer safeguards—than any public health agency would require. Sleep cycles, heart rates, menstrual tracking, location-based exposures—all stored in the cloud by companies who’ve never met us. This isn’t just about trust.
It’s about leadership. [ACT FIVE – WHO’S GETTING IT RIGHT] Let’s zoom out. Estonia—a country smaller than Manhattan—put every citizen’s health record on the blockchain in 2008.
Fifteen years ago. Doctors there save an average of nine hours a week.
That’s time looking at you, not at a screen. Or look at Saudi Arabia. I was recently in Jeddah, working with their Ministry of Health.
They’re not patching old systems. They’re building a national health platform in the cloud, integrating AI from day one. It’s part of their Vision 2030 initiative.
The goal? Predictive, personalized care from cradle to grave. And yes, risks exist—but they’re governance risks, not technological ones. [ACT SIX – THE ADVOCATE AI] Now, imagine this: An 80-year-old man named Henry arrives in the E.R.
He’s had a stroke. He can’t speak. But his AI-enabled lifelong health record kicks in: • Allergic to penicillin. • Do Not Intubate order on file. • Cognitive baseline was perfect 48 hours ago. • This is not dementia. This is an acute event. No clipboard. No calls. No guessing. Or picture a 40-something breast cancer survivor.
Now she has mild heart symptoms. No one connects the dots—until the system does: • Chemo. • Radiation. • Family history. • Fatigue. The system flags a possible late-stage cardiac complication—before it becomes critical. This is not about AI replacing doctors.
It’s about AI amplifying them.
Giving them the full canvas, not just a sketch. [ACT SEVEN – THE BIG PICTURE] Every year in the U.S., we lose $300 billion to inefficiencies and administrative waste. But this isn’t about dollars.
It’s about people. Maria’s mom.
Henry.
The breast cancer survivor. This is our story. And we need to reclaim it. [ACT EIGHT – THE CROSSROADS] I’m not talking about single-payer healthcare.
This is not about dismantling what we have.
This is about building architecture for interoperability. A national health record accessible to providers and payers—
giving you ownership from cradle to grave. And if we don’t do it? The Googles, Apples, and Amazons of the world will.
They already are. And we’ll end up with a shadow healthcare system—fragmented, inequitable, and opaque. [CLOSING – A CALL TO ACTION] We have the tools.
We have the data. What we need now is the will—political and public—to demand a better future. Share your voice. Push for change. Because the future of care depends on something much bigger than digital files.
It depends on owning your story. [OUTRO MUSIC] I’m Tom Koulopoulos.
This is Foresight Radio.
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Because the best way to navigate the future… is to reimagine it.