You should check out the decades worth of work that Dr. Larry Weed has created at UVM Medical School. The Boston Globe did a good article back in 2002 entitled “What your doctor doesn’t know could kill you” http://www.boston.com/news/globe/reprints/071402_whenyourdoc/

Plenty of good physicians and geeks are working on this in Boston, so I’m glad you are forging alliances out here in Beantown, too. Best of luck!

The 2008 Health 2.0 conference is around the corner. Some of last year’s participants and attendees have gone under or changed strategies. Few have traction and fewer generate any meaningful revenue. The handful of funded companies will burn their last few dollars unless they can make a case (to their investors, employees) that there is a real business model.

One of the fundamental issues is that healthcare companies are challenged before getting out the gate: developing a solid revenue model for a “consumer healthcare play” is limited by federal and state regulations which then limit what and how you can offer healthcare services to consumers.

Doctors are too busy to fill out profiles and are not keen on being rated by websites. Some have sued. Few will post their (reasonable/real) prices as they lose bargaining power with insurance plans and may be violating their insurance plan contracts (insurance plans consider prices with doctors their confidential negotiated rates).

Consumer adoption of healthcare services like an “Opentable for Doctors” or a “Expedia for Healthcare” is still a long way off. It’s not technology. It’s trust. The majority of us have few interactions with healthcare. When we need information we will go to trusted, although imperfect sources: our family, friends, and a handful of websites (WebMD, Mayo Clinic, etc). Trust takes time, having lots of money or cutting edge technology doesn’t necessarily accelerate the process.

The industry still relies on a non-market based model of healthcare delivery and would like for it to stay that way. Vested interests (and revenue) are a powerful force that will probably relegate today’s Health 2.0 startups as interesting experiments.

Bleak outlook for Health 2.0 companies. But we saw this in 2000 during the dotcom era when many B2C and B2B healthcare startups failed. Perhaps a few lessons learned then seem to have been forgotten.

Someone pointed me to this blog posting and when I read the last paragraph of your post I nearly fell off my chair! The product that you describe already does exist, and its called FreeMD.

You can see it at http://www.freemd.com

The product is 100% physician created and runs off an Expert System that has successfully triaged millions of people over the past 15 years. FreeMD represents the firm’s (DSHI is the creator of the product) first attempt to create a product of this kind exclusivley for the consumer health market (FYI, I am a former 7 year WebMD executive who now has his own online health firm, Q. Wild & Co. I have been working closely with DSHI for several years.)

I would love to get your thoughts on the product. It might have some interesting synergy with Medpedia.

Cheers,
Josh Wildstein

PS: If interested, you can read my latest “Health 2.0″ thoughts as published here: http://seekingalpha.com/article/79615-failure-to-deliver-meaningful-roi-online-for-pharma

You hit the problem on the head in that the money isn’t well aligned with the ethical goals of the sector. Also, I think you hinted at, but didn’t explicitly state, that sick people will always want more until they are “better”– and our current system is based on throwing as much hope at them that money can buy.

I think the foundations are wrong and we won’t really be able to address the disconnects until we realign the money with bottom-up engagement in good health.

To paraphrase Jennifer Aniston in the “Break-up”, I don’t want you to just exercise and eat your vegetables, I want you to want to exercise and eat your vegetables.

My take is the emphasis of bottom-up wellness and optimization of health will provide a counterbalance to the top-down insurance model of “managed” health. My soon to be launched startup is one of the few looking to change the economics, painful though that process may be. Glad to see a fellow contrarian doing something interesting and well needed.

–Vijay

http://www.archimedesmodel.com

The ‘2.0′ part was established within computer programming – as a new edition of a an application is released, it is common practice for the programmers to add an incrementing number at the end of a program’s name, to label the new version.

Web 2.0 implies the ‘2nd release’ of the Internet, which of course is not based on anything concrete. The Internet being made up of millions upon millions of interconnecting computers running lots of various programs, but is more of a concept to describe the type of programs/applications/functionality one can now locate on the Internet.

The Internet was initially complied of mainly static pages of data. Soon to follow was email, web forums and chat rooms where discussions could take place. Web 2.0 refers to a trend on the Internet that saw a step forward in the way users conduct communicate over the Internet, which includes the use of blogs, videos, podcasts, wikis and online communities where people with common interests get together to share ideas, media, code and all types of information.

Web 2.0 technologies such as social networking, blogs, patient communities and online tools for search and self-care management look as though they will permanently alter the healthcare landscape indefinitely.

As with Web 2.0, there is a lot of debate about the meaning of the term ‘health 2.0′. The Wall Street Journal recently attempted to define Health 2.0 as:

“The social-networking revolution is coming to health care, at the same time that new Internet technologies and software programs are making it easier than ever for consumers to find timely, personalized health information online. Patients who once connected mainly through email discussion groups and chat rooms are building more sophisticated virtual communities that enable them to share information about treatment and coping and build a personal network of friends. At the same time, traditional Web sites that once offered cumbersome pages of static data are developing blogs, podcasts, and customized search engines to deliver the most relevant and timely information on health topics.”

While this traditional view of the definition imputes it as the merging of the Web 2.0 phenomenon within healthcare. I personally believe it’s so much more. In my opinion, Health 2.0 goes way beyond just the permeant social networking technology to include a complete renaissance in the way that Healthcare is actually delivered and conveyed.

Source – http://www.rxpop.com

One way that hasn’t been approached (I think) is to develop an electronic medical record that is secure so that only designated physicians and healthcare professionals and the patient themselves have access to it. By keeping it online anyone who is given access can get at it. Being able to contact a physician with a correction to clinic visit or past medical history entry would greatly advance the health care delivery system and provide a more accurate and “higher level” of care. What do you think? Sound like somethink ooga should be working on???
One could even provide this free or charge to patient and physicians by using patient and physician specific advertising (a group hard to get any face time with!!!)

Let me know if you want a hand with this…

toodles,

Bijal Mehta, MD, MPH
Dept. of Neurology
SUNY Buffalo
Resident (pgy-3)

p.s. Discovered your blog through your viral video.

p.p.s. yo.

Cheers,
Mike

I’d love to hear more about the ideas from the woman you spoke with. I think she’s on the right track in trying to address basic issues at the ground level. The core problem with trying to replicate Web 2.0 concepts for healthcare is that healthcare relies on multiple intermediaries who are the gatekeepers, rather than the patient/consumer. Doctors provide the choices and insurance companies decide the “budget”. This is completely different from say an Amazon.com-type concept where the consumer does their own research, makes their own decisions, and purchases the product directly. The woman you spoke with hit on the right idea – substitute the choice-providing intermediary (doctor) with a machine-based algorithm because at some level, doctors act as human experience/intuition algorithms for deciding treatment!