Empowering consumers to take the reins in their health decisions through robust technology and ultimately transform our healthcare system is the idea behind Health 2.0—a catchphrase that reflects the fresh influx of entrepreneurs, venture capitalists and established Internet companies into the healthcare fray.
About 400 of these early adopters gathered at the San Francisco Hilton Sept. 20 for the first-ever Health 2.0 conference, whose focus was “user-generated healthcare.”
Hot—and very profitable—Web tools such as targeted search (Google), social media (MySpace), wikis (Wikipedia), and user-generated video (YouTube) are transforming the Internet, and, some argue, will transform healthcare as well. The question is how to engage patients, payers and providers, make these tools relevant in our fragmented healthcare system and, perhaps most important, save money and make money.
“Health 2.0 is just getting beyond the buzzword phase,” said Matthew Holt, a noted healthcare blogger who organized the conference. “The next phase I see coming very rapidly is using tools and technology to connect people with providers.”
The Big 3 search companies are already working on this. Representatives of Google, Yahoo and Microsoft Corp. didn’t reveal much of their plans, but all said health is an important part of their businesses because it’s information customers want.
In 2007, more than 160 million Americans went online in search of medical information. And two-thirds of physicians go on the Internet each day looking for clinical information to make better decisions about their practice, said Wayne Gattinella, president and chief executive officer of WebMD Health Corp.
The question is how to take these already engaged consumers and marry them to technology to transform our massive healthcare system—a system that Gattinella described as a “hairball”—a sentiment repeated throughout the daylong conference.
Missy Krasner, product marketing manager at Google and former adviser to David Brailer when he was the national health IT coordinator, said Google aims to put out a healthcare product that drives more Web searches. But she remained mum on the details of Google’s top-secret electronic health-records initiative.
“Search is where we make our money,” Krasner said. “I don’t think we initially, in health, want to use ads. Right now our business model is brand loyalty.”
In February, Microsoft bought Medstory, a targeted search engine for health and medicine. Peter Neupert, corporate vice president of the Health Solutions Group at Microsoft, said the software giant can leverage its assets to work with providers and employers to create “data liquidity,” such as enhancing Web searches and connecting users with data in new ways.
“The next phase in this evolution is the ability to do in healthcare what we do in the banking industry,” Neupert said. “It’s about how do we connect those source data providers. I think that will be the first form of data liquidity.”
Krasner said the new trend of moving healthcare delivery into the retail space, such as the rise of “minute clinics” in big-box stores, could push interoperability of health records and other data forward. “It’s a huge, huge issue, and I don’t think we should downplay it,” she said.
Some 25 vendors showcased their products at the conference, and many more spoke on panels. These ranged from the established—such as Intuit, presenting its anticipated Health software, which works like Quicken and TurboTax—to fledgling patient community sites such as DailyStrength.org and niche upstarts that aim to help physicians organize their data.
An entrepreneurial can-do spirit permeated the day, and was reminiscent of the irrational exuberance of the dot-com boom when every idea seemed worth trying, and funding, despite the absence of a clear business plan. Connectivity was put into practice, as audience members submitted questions to panelists in real time via personal digital assistants and answered poll questions through the devices, with the results posted within minutes in graph form on the conference screens.
But after a full morning of blue sky, the payers took the stage and brought the room back to the cold, hard reality of the American healthcare system.
“Healthcare is harder than it looks,” warned Joe Gifford, senior medical director of the Regence Group, the biggest Blues plan in the Pacific Northwest. “Right now we’re talking about educated big-city folk who have a natural incentive to go to the Web to solve their problems.”
The biggest consumers of healthcare—the poor, elderly, chronically ill and obese—don’t live in this high-tech world, Gifford said, a sentiment echoed by Brailer in a short keynote address.
“Technology is not the only missing factor,” Brailer said. “Also missing is the social context. The way people relate to their doctor and doctors relate to other doctors.”
Jeff Rideout, managing partner at Ziegler HealthVest Fund, a new investment firm, and former chief medical officer at Blue Shield of California and health IT leader at Cisco Systems, said financing has to be in the equation.
“People do what they get paid for,” Rideout said. “That’s not a bad thing, that’s just the reality.”
Ted von Glahn, director of performance information and consumer engagement at the Pacific Business Group on Health, said Health 2.0 must translate into consumer actions that ultimately save employers money. “From a purchaser perspective, that’s pretty darn high on the list,” von Glahn said. “This is an opportunity to create data that doesn’t exist today.”
Few hospital systems attended the conference. Representatives from the Centers for Disease Control and Prevention were there, as was one consultant from HHS, but no one from the CMS.
Many speakers expressed concern that Health 2.0 would just lead to more fragmentation and confusion.
“What scares me is a lot of people are presenting a fragmented view of our healthcare system,” said Jay Silverstein, chief imagineer of Revolution Health and a former executive at Health Net and UnitedHealthcare. “It would behoove a lot of you to hook up.”
Focusing on, as in the Internet space, monetizing Internet page views and number of “eyeballs” visiting each site in an advertising model won’t work in healthcare, Silverstein said. What matters in healthcare is improving patient outcomes through transparency, quality and performance measures to reduce costs.
“We have to address this,” he said. “Or we will exist in the same silos we already do, only faster.”
Paul Wallace, senior adviser and medical director at Kaiser Permanente, said he was encouraged that Health 2.0 is moving beyond the content discussion to talk about how to personalize care and make everyone more satisfied. For instance, online tools and services can help physicians move away from today’s inflexible patient-visit model in which each patient gets 12 to 15 minutes per visit. With the use of e-mail and online groups, some patient may only need a four-minute in-person visit while others might need 20 minutes, and providers could manage that, he said.
On the physician side, the question was how these tools will make busy doctors’ days easier and improve the care they are giving to their patients, said David Kibbe, founding director of the Center for Health Information Technology of the American Academy of Family Physicians. Kibbe commended the participants on their ambitious ideas, though. “May all your exit strategies come true,” he told the crowd, to big laughs.
Rebecca Vesely, based in San Francisco, covers managed care, disease management and pay-for-performance programs. She can be reached at [email protected]
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