What about patient portals and personal health records? When Google Health went under, a lot of people said it was the death knell for PHRs. I hope it was the death knell for first-generation PHRs. I gave one of the first talks on PHRs, almost a decade ago. And even then we said the first-generation PHRs were going to be these ugly databases. Where they start to get interested is where the move into social media. I think there will be a lot of uptake with that. Full-disclosure, I sit on the board of Dossia, the PHR company we spun out of Intel, focused on employers. We're about to roll out the second PHR Dossia has created. I don't think PHRs are dead. We had to kill the first wave and start the second wave and say 'Stop focusing on the databases, and [instead] what are the verbs?'

It's not enough to engage patient with their health, to do that first they have to engage with the technology – and they have to want to do that.

And the way to do that is through social [media], right? Someone with a chronic disease, or some form of cancer, sign them up and immediately there are five or six people that fit a similar profile, that are six months ahead in this disease, and they're there to help pull me along. There you have the incentive: OK, I'll track some of my vital signs, and open up a secure folder and let my doctor see that.

So wave one of PHRs sort of missed social. Wave two is getting it. I think the other thing is to look at it globally. You've got Australia making a PHR available to every citizen in Australia by June of this year. Looking outside the U.S., the world is still moving toward the hockey puck for PHRs. We still haven't quite figured out the relationship and the financial model in the U.S. But it's time to reinvent what we've thought of as PHRs.

People do like going online to learn about their health. WebMD is one of the top 200 most-trafficked sites in the country. I think we're just at the point now where you can really personalize the experience to different needs people have. Somebody who's twenty-something and still feels like they're immortal, they're coming to a PHR because they and their wife are pregnant for the first time – it's a whole different set of needs than somebody who's 65 and as four different chronic conditions, it's a very different ballgame. So that same infrastructure needs to be customized for a lot of different services. That's the approach that Care Innovations, our spin-off company is taking, and that's the approach that Dossia is taking.

What are you most excited about in the near future? The 20th anniversary of the Rio Conference in Brazil [United Nations Conference on Environment and Development] is this summer. You see now, whole industries and whole nations competing to see who can be at the forefront of these [green] technologies.

I spoke at the pre-Rio Conference of the United Nations last week, to ministers from about 80 countries. Introduced the idea of what we call age-friendly cities. And said look, if Rio 20 years ago was about global warming, we want Rio this year to be about global aging. And if that was about sustainable energy, we want this to be about sustainable health.

I'm worried about the United States' global competitiveness on this issue. Countries are looking at how they invest in a 21st Century healthcare grid from the ground up. You can either retrofit a community or city or build a whole new one from scratch in places like China, where the health IT grid isn't going to connect a network of hospitals, but they're going to build the capacity into the workforce and into the home from the beginning. And there will be a smaller-footprint hospital that's cheaper, and an entirely different approach to care.

So now in many ways the emerging markets may be on the forefront of what I'm calling gray technologies for global aging – sort of the moral equivalent of green technologies for global warming. And they're going to bypass a lot of the U.S. and Western Europe, because they don't have to defend this install-base and fee-for-service model that's so hospital centric. They'll dive right into consumer engagement models because it makes economic sense for them to do so. And then they can build a broadband infrastructure and HIE – this is why Australia is making a personal health record available to every citizen this summer, because they see they need to build this 21st grid – have to be age-friendly given worldwide demographics. Getting the UN on the bandwagon with that. Working with the WHO. Taking a lot of our learning that we did in all 20 companies and scaling that message out.

It's an interesting conundrum, though, when it comes to engagement. Most people over age 65 aren't using social networks or smartphones. Isn't it a challenge to engage them? Convincing those older people's children that they're capable of doing it is one of the challenges. We've found, in our studies in these countries is that older people who are trained how to use the technologies – and there's a clear value proposition for them to do so – then they can and will learn it.

We've taken mid-80s-year-olds with some form of dementia and taught them how to use PC-based technologies and social networking. But the value has to be clear to the senior, and you have to take the time to train them.

The challenge from a global perspective is to look at both ends of the age continuum. By 2050 we're going to have 7 billion people on the planet, 2 billion of them are going to be over the age of 60. No matter what, over the next three or four decades, we have a legacy of chronic care that's going to bankrupt nations if we don't find a new model.

At the same time, we've got to start now, building the same prevention mentality and the behavioral economic training of the younger generation, not to end up with the same epidemic of chronic disease that they have.

Are you ultimately optimistic? Yes. While there's lots of confusion and fear and uncertainty and doubt right now in the U.S. about how these financial reforms are going to play out. Everyone needs to remember that this is the beginning of the transformation and not the end. But without some radical changes, the innovations that are more focused on prevention and early detection and wellness and consumer engagement are never going to happen.

The good news to me, we at Intel, were less focused on the U.S. until the health reform bill passed. When it did, we said, 'alright, we need to start looking at building an R&D infrastructure in the U.S. again. Now it's getting interesting.' So as long as we stay the course and don't start building ridiculous expectations and realize it's not going to change overnight … we're starting to head in the right direction.