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Health 2.0 Thoughts

I went to the Health 2.0 conference September 20th, and I’ve been mulling what I saw there.

There were health information aggregators like Google, Yahoo, Microsoft, and WebMD. I think we all agree that these players are doing a mediocre job. As you would expect from public companies with a lot of pressure on quarterly financial results, WebMD, Yahoo and Microsoft pages seem optimized for revenues, not optimized for answering people’s questions. Also, the language on these sites is inconsistent, so you never know if what you’re going to get on the next click is what you want or not. Google is the one that is trying interesting things, as this link shows and as we’ve mentioned before on this blog.

There were lots of social networks for patients at Health 2.0, the best being Patients Like Me, covering conditions like ALS, MS, Parkinson’s, and HIV. They said they’ll soon be expanding from those four conditions which is good news. In general, social networks for patients seem to exhibit a tendency to become whining sessions. Don’t get me wrong, when I’m sick, I like to bitch too. But the long-term, hard-core members of these sites — the ones who end up shaping the tone of the content — tend to be the personalities that never get enough of bitching, it seems.

There were a bunch of doctor rating sites, like Xoova.com, Careseek, HealthGrades, and RevolutionHealth. I think this is an admirable thing to do, but rather than rating doctors as bad or good, I’d like to see people rated on their expertise in relation to particular topics and diseases. Who are the experts in the world? Which are the expert organizations or hospitals in a particular condition? Of the professionals within driving distance of me, who is the most expert in the specific thing I’m interested in?

And there were some social networks for doctors, like Sermo, Medical Alliances and Within3. These sites are a bit like LinkedIn for MD’s — professional networking. Cool, but do these guys really have time to get online and chat away? I suppose if it furthers their research, but man, are those MD’s busy. Sermo has a unique and suprising business model — pharmaceutical companies pay them to listen in on doctors’ email and bulliten board conversations on Sermo to hear first what they are saying about conditions and drugs etc. It’s market research for pharma companies. Interesting.

Vimo was a thinly disguised healthcare-insurance-lead-generation site. Smart to go for the money, but tough for Chini Krishnan to pretend he’s trying to help consumers. It’s like LendingTree, where “when banks compete, you win,” but in this case “when health insurance companies compete, you win.” The fact is they are just selling your contact info for $8 or $16 or $22 to these carriers so they can pester you. Ouch.

There were lots of search engines, all optimized for something different. Kosmix’s RightHealth, in particular, appears optimized for revenues. Healthline seems comprehensive, but I’m still not sure what they do that’s different from Google, other than reduce search spam (and Google is working on that as well).

Then there were various insurance companies, content publishers, and associations who were locked in the past and locked in to how they make money today. There is so much money, the systems are so complex, the number of people and organizations that are affected by any change so numerous, and the moral imperative so strong to “do no harm,” that it’s clear why our system feels at once screwed up and at once impossible to change.

There was a lot of discussion about the future and helping people, but the smell of money in the room was palpable. Most of the people on the stage were stuck in this painful tension, talking about all the good they were doing for people, while their faces and voices revealed a desperateness to punch across some invisible line into a place where the cash flows like rain, as it does for many companies in the health industry. It was a common tension in the presenters, and one I came to believe is endemic to this industry, not just in Health 2.0 companies.

The health industry has a dual mission: help people who are often very desperate for you help — and also make money. In this way, being in the health business is not like the auto industry, or the movie industry, or the finance industry, or the electronics industry, or almost any industry, really. There is a moral imperative that comes to bear, but the reality is that we want to have the most talented people in the world working on saving lives, right? And those people could go become investment bankers or real estate developers and make millions, so we need to pay them a lot to focus on improving health. Thus, businesses in the health area need to make quite a bit of money to support the talent and the R&D required to keep pushing the edge. It’s a powerful tension.

As a final note, I had an interesting conversation with a woman who had been trying to change the system from the top down for 30 years, and was finally giving up. She was starting to pin her hopes on some bottoms-up ideas, and she felt the biggest thing we could do to change the system from the bottoms up would be to create a “computer program to diagnose people.” So a person could type in their symptoms and some other personal data (anonymously) and the system would pop out probabilities for various diseases and conditions you might have and what further tests you could do to refine the probabilities. Does anyone know of any efforts to do something like that? I’d love to talk with them.

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