Health 2.0 Deserves Careful Watching

by David C. Kibbe, MD MBA

Dear Colleagues:

Thursday I attended a wonderful one day conference, entitled “Health 2.0 — User Generated Health Care.” One of the most interesting events of 2007. Held in San Francisco. I had a chance to talk with Adam Bosworth and Missy Krasner of Google, with Peter Neuport of Microsoft, and with David Brailer, among many others. It was particularly good to see Drs. Walter Lim and Rick Chan, with the Ministry of Health in Singapore, who came all the way from Singapore for the event. I was on the final reactor panel with Esther Dyson, Lee Shapiro of Allscripts, and Jay Silverstein of Revolution Health, representing the American Academy of Family Physicians (AAFP).

How to describe this event?

Imagine it’s 1995, and you spend 8 long hours with 500 other people looking at demonstrations, very brief, of about 40 companies who want to use the Internet and Web for e-commerce and other businesses aimed directly at the consumer. There is lots of enthusiasm, and lots of venture capital attention.

Imagine that in the mix of companies demo’ing their Web-based applications are four tiny firms: Google, Yahoo, Expedia, and Amazon.com . Along with 36 other companies and products. But remember, it’s 1995, and so you have no way to know which company or product will grow and go on to be successful businesses in 2000. (A lot of people in the audience don’t think Google will do very well, by the way.)

That’s what this was, except that the companies and products at Health 2.0 were all aimed at consumer health activities that offer interactive benefits to the user, and in some cases to providers. I saw some amazing products and services, but I have no way of knowing which ones will ultimately succeed and move into the mainstream.

There were several categories of panels for the demonstrations.

• The Role of the Consumer Aggregators, which included Google, Microsoft, WebMD, and Yahoo.
• Search in Healthcare, including Webstory and Kosmix.
• Social Media and Networking for Patients, including PatientsLikeMe and Sophia’s Garden
• Tools for Consumer Health, e.g. Vimo, which offers a way to purchase health care insurance online, and DNA Direct.
• Provider and Social Networks. e.g Sermo and Within3

It will take me some time to digest all of this. Here are some first impressions:

1) What I really, really liked was the way in which so many of these companies and applications helped the patient/consumer help himself/herself — to be better informed, to know their options, to take better actions, to hope and act in their own best interests. This is exciting, and very necessary, as physicians in primary care are already unable to meet the demands upon them for care delivery, and this imbalance/shortage is only going to get worse in the future. And it’s exciting because empowerment is the key to saving the individual out-of-pocket spending. As health costs continue to shift to the individual, Health 2.0 can really be helfpful.

Healing without information is indistinguishable from magic…..And magic in health care today is unsafe and very expensive!

We need an informed (empowered) health nation. Health 2.0 is leading that potential.

I won’t mention any specific examples, but all of the search engines, all of the social media sites, and some of the consumer tools sites are exciting in this regard, and quite real now. The demand for their use will only grow.

2) What disappointed me was how much work the applications require of the patient/consumer with respect to information discovery, data entry, and interpretation of results/advice. Too much work! There are two issues here that I would focus upon:

• We need to help people discover, collect, store, and utilize the relevant health information in digital (computable) format, e.g. the CCR and XML. Until we do that, none of these wonderful applications can be invoked at will without having to type in medications, diagnoses, or family history, etc. And that is going to impact adoption.
• We need to find ways to share the task of personal health data discovery and use — including all the repurposing of that data — between the individual and his/her providers. These applications and networks pose wonderful opportunities for patients and physicians to work together in completely NEW and DIFFERENT ways, some of which we saw yesterday, but for the most part hasn’t yet occurred.

In some respects, the unraveling of the “calcified hairball” (which was the in-conference description of the health care system mess) has to happen one patient-provider encounter at a time.

So, going forward to March 2008, I recommend to the conference organizers that the conference include a panel(s) of demonstrations that show the patients/consumers and providers working together in ways that re-define how health data and information are collected, organized, and used in the therapeutic and healing experience, and particularly how Health 2.0 enables this data and information to be portable and interoperable — as these are preconditions for re-use, re-purposing, and self-activation of the data and information.

Let’s show how these tools, networks, and communities can become mainstream in our society’s health system.

The Health2.0 trend or movement is still very early. But there’s something very real here that deserves to be watched carefully. My sense is that 4-5 years from now a few of these companies will be part of mainstream America and mainstream health care will have adopted their tools and technologies.

Kind regards, DCK