Understand New Technology: How a Digital Earth Changes Medical Coordination

In 2025 new levels of fast and effective “medical coordination” have become normal. The new Centers for Health Expansion, America’s strategic healthcare firewall, relies on this to handle the unexpected medical crisis of a new, vaccine-resistant strain of Ebola.


Medicine is an excellent coordination example because its ambition is to serve everyone. One of medicine’s most difficult problems is coordinating care between different providers and medical institutions. From primary care physicians to specialists, from ER’s to psychiatrists, medical coordination has been described as “poor.” These problems reduce quality of care, patient outcomes and provider satisfaction — while raising costs. (1, 2, 3, 4)

Medicine, however, is just one illustration of a Digital Earth whose real-time coordination also includes first responders like the military, homeland security and 911 emergency services. Similarly, all major industries face enormous coordination problems. Complex projects and processes are normal between companies in energy/power, construction, transportation, aviation, telecom, technology and other industries.

Real-time coordination on a Digital Earth includes first responders like the military, homeland security and emergency services. In addition, all major industries constantly need to solve coordination problems with their complex projects and processes.

In this medical example, Shared Spaces and Active Knowledge have been pre-configured by the CHE as “capability packages.” Each Shared Space is a collection of continuously connected people and digital resources in an Inactive state, ready to be made Active as needed. For example, the immediate retrieval delivery and use of “HazMat Packs” included pre-identification and inclusion of the specialists (skilled managers), services (warehousing and same-day delivery), and Active Knowledge (steps to reach a goal) needed to use a Shared Space for a collaborative response to any medical event requiring HazMat suits. The ambulance paramedics were guided by a PPE specialist in putting on the suits properly. That specialist remained with them in a Shared Space while transporting the patient to Chicago, then helped them remove the PPE safely afterward. An infection control specialist guided the ambulance company in disinfecting the ambulance afterward.

Dealing with each single issue is similar:  A Shared Space has the people and resources continuously connected but Inactive, with associated Active Knowledge steps. In this new Ebola event, an CHE “First Responder” Shared Space includes pre-configured capabilities for goals such as patient diagnosis for unexpected infectious diseases, specialists to assist a medical facility like a student health clinic, guided use of Personal Protective Equipment, immediate delivery of HazMat suits, ambulance transport of a highly contagious patient, evacuation and sterilization of the clinic, admission to an appropriate hospital, disinfecting the transport ambulance, and other steps.

The clinic and hospital also use their own, independent Shared Spaces to coordinate their internal activities. Throughout, Active Knowledge protocols provide “best practices” guidance for both normal activities and infrequent events. For example, the hospital administrator Focused the hospital’s Emergency Response Shared Space. This allowed him to Activate all the hospital’s department heads immediately. The Presence System Activated the department heads currently accessible, or their substitutes if not available. The relevant department heads could remain Active in that Shared Space to coordinate instantly as needed to prepare for the Ebola patient, while muting their audio and video connection when the Shared Space was not needed.

A repetitive and adaptable pattern of use could evolve to fit each organization’s culture as continuous connections grow familiar and normal:  In a process based on capturing and re-using Active Knowledge, a situation or problem that is solved collaboratively can be defined as a trigger. Triggers are associated with one or more solutions, each with an Active Knowledge protocol that has been proven to work. The Active Knowledge is made accessible from pre-configured Shared Spaces that include the continuously connected people and digital resources needed to respond to the trigger.

When an event occurs the trigger can display an alert. From that, an appropriate solution can be selected and its Active Knowledge is displayed. A user can run it by Activating its pre-configured group of people and digital resources needed to implement that solution. They can all access the real-time interactive guidance of the Active Knowledge as they collaboratively handle that event.

Continuous tracking with immediate reporting and improvement are part of Active Knowledge, so each event’s experience helps improve its Active Knowledge. When a new solution is developed it can be categorized, named and associated with a trigger such as an issue, event or situation. The use of the Active Knowledge employs one or more Shared Spaces in a “capability package.”

The set of Active Knowledge Solutions works like GPS to guide real-time collaborations that can lead to measurable successes. As more events are solved collaboratively, their solutions turned into Active Knowledge, and improved in subsequent uses, these enable collaborative responses to recurring situations immediately in real-time. These form integrated, increasingly successful cross-organizational abilities to coordinate successfully worldwide. These organizations can operate both pro-actively and responsively to growing ranges of situations and events.

As new people and digital resources are needed, they can be added quickly from one Shared Space to another, or be associated with multiple Shared Spaces quickly. This was done when needed in the “medical coordination” example above, starting by adding the clinic’s Dr. Mayhew and Nurse Sweeney to the CHE’s First Responder Shared Space. The result is the rapid assembly of relevant specialists who can deal with a situation. Since these people can deal with each other individually, not just as a whole group, they can solve different parts of a situation simultaneously.

As more events are solved collaboratively and turned into Active Knowledge, and improved in subsequent uses, these enable pre-planned responses to recurring situations immediately in real-time.

For example, the CHE’s Dermody Activated the ambulance company supervisor and the hospital administrator. He “brought them” to the examination in the Madison, WI clinic so they could see the situation, confirm the Ebola diagnosis with Harvard’s Dr. Chester, and worked with the CHE’s Tom Figuera and Li Min on HazMat protected ambulance transport. They then muted the Madison clinic and kept working together on transporting the patient and treating him in the Chicago hospital.

Related Shared Spaces also complement each other. The hospital’s administrator Focused the hospital’s Emergency Response Shared Space and added the people from the CHE’s First Responder Shared Space. There, they worked directly with the hospital staff to prepare for the patient’s arrival.

Coordination is finer-grained than Shared Spaces, however. Each Active Knowledge solution is a “best practice” set of people, resources and steps to improve a single situation. In medicine, each patient could have their own Shared Space. Their different physicians could each add brief notes or videos that help other specialists and ER doctors treat each person, and simplify collaboration when needed. One example is a person’s use of prescribed medications, as a physician could record:  “Mrs. S is in her late 70’s and uncertain of what to do medically, so she is diligent about taking her prescribed medications. Do not prescribe new medications without knowing everything she is taking. Mrs. S will add and take all the medicines from every doctor she sees, therefore is at risk for overdosing and could need to be rushed to the ER.”

Shared Spaces and Active Knowledge are steps toward a real-time Digital Earth that is better coordinated and connected than today. As our use of devices and screens becomes constant, this offers everyone new opportunities to collaborate and succeed everywhere, instantly. When we turn this on everyone will be able to work together and improve how much we can achieve together.

In medicine, each patient could have his or her own Shared Space. Their different physicians could each add brief notes or videos that help others treat each patient, and simplify collaboration when needed.