Event Horizon: What's Next for Health 2.0

My review of Health 2.0 is a bit of classic Health Management Rx "glass half full, glass half empty."

Having just returned from two days of the whirlwind that was volunteering at the Health 2.0 Spring Fling, I can say the conference was a huge, energizing success, but also a bit like ripping off a Band-Aid a few days too early.

You know there's fresh, promising skin underneath, but it still hurts a bit more than expected if you just can't resist looking at the healing wound too soon.

Figuring out this new healthcare landscape is painful.

Navigating the offerings at H2.0 leaves a bit of a mark and a very slight bitter aftertaste of frustration. Very few firms demoing are viable or really attractive as-is - I was hoping to find more firms ready for the Band-Aid to come off NOW, useful to patients and doctors NOW, not months into future redesigns.

Like most meetings, you get a return that's reciprocal to the effort you put in. But I'm not sure anyone at H2.0 could say there wasn't an energy (albeit a rather unfocused buzz) in the rooms. Here's Dan Kogan's review on the Health 2.0 blog.

I met interesting people with excellent ideas and engaging personalities whom I knew only from blogging, including David Hamilton of VentureBeat and Scott Shreve of Crossover Health (read his March 5th entry for an excellent analysis of the emerging space).

The crowd was youngish, largely male (I'd say about 70% without exact figures), IT dominated, entreprenuerial, and embodied a 'seeking' mentality. Everyone was looking for their space and keeping an eye on developing firms. Some were seeking capital and a few had potential capital to burn.

You know it's a good conference when you have a hard time deciding to listen to the panelists, a VP of Business Development 'selling' why they're engaged in healthcare consumerism, or some very high-octane conversation debating merits of panel offerings at the table next-door.

Health 2.0 meetings are fascinating not because they single-handedly hash out a definition of where we're going in consumer-directed healthcare, but rather because they provide a spectrum of offerings that demonstrate how various entrepreneurs are trying to answer that question.

Their answers to this question help shape our views, and the industry. These are the first-movers, people. 2 or 3 will succeed. Many more will fail. But the failures teach us just as much about what is missing from the healthcare experience as the leading players, if not more.

Health 2.0 is a blast because even coffee chat reiterates businesspeople are passionate about bringing consumers of goods and services (both patients and providers) into the fold.

At an IDEO brainstorm event we all watched a video and then had to QUICKLY design a product or service to pitch to VCs addressing concerns and needs for people living with diabetes. Our group developed a buddy system (based on the sponsor model in AA) to connect newly diagnosed diabetics with 'experienced' and well-seasoned consumers. We called it, tongues-in-cheeks, The Sweet Life. I wish we had more opportunities for this type of on-the-fly innovation that rules out nothing outlandish, and I hope the IDEO participation is a fixture at each Health 2.0 event. The IDEO staff are just as interesting as their methodologies (how're the photos Webster? Can I get some copies?)

And of course, there's a lot of money to be made in becoming a defining H2.0 firm and being at the forefrunt of next-wave development. Entrepreneurs are no dummies; they are successful if/when they enter market spaces filled with potential for change, lots of payors, and weak traditional offerings.

What's the point of H2.0? Is it a movement? Is it well-defined? Is it shaping the industry?

Answers: Yes, no, and yes.

Subjectively, it's a movement allowing firms to coalesce around a need for consumer-directed goods and services, whether the consumers are patients or providers, or both.

Objectively, Health 2.0 as represented at the Spring Fling, is a healthcare industry category, for now largely IT based and entrepreneurial in spirit and size, that connects disparite segments of the hospital/healthcare market.

A very rough list of subsectors includes:

1. Search/seek/find services (find a doc, etc.)

2. Ratings (rate a doc, rate a hospital, etc.)

3. Back office for providers (helping docs take back healthcare mgmt, including online med reconciliation, e-health provision, emailing patients, etc.)

4. Consumer Buys (direct purchases for consumers of 'new' services such as $1.99 generic online chat with a doc)

5. Connectors (translating EHR/PHR data, connecting patients to docs who are in their HMO network, connecting people with newly diagnosed conditions to others who live with the illness, etc.)

Everyone I spoke to is not only actively engaged in 'changing healthcare' into a consumer/service based industry, they're putting their money (and management expertise) where their mouths are.

What's the point of going to future Health 2.0 events?

First, at Health 2.0 we'll see continuing clarification of the space - organizations will use lessons from the conference to differentiate and define subcategories.

Second, it makes business travel and industry learning exciting again. Don't underestimate the power of the status quo on limiting innovation.

Healthcare conferences can be a glut of traditional views, heirarchical assertions of what's working in the market, and talking heads who have burned out - they're no longer passionate about the enterprise or the possibility that their organization will play a role in changing offerings and improving care.

Most often, I learn more about what's working (and what's not) in the healthcare industry from reading the bloggers on my blogroll. Sad, but true. They're telling me, passionately, what's up to date. What's about to change. What their customers want. What they need to do business in the business of making us 'well.'

And perhaps that's the seminal realization of my time at Health 2.0, the lightbulb theorem.

In an admittedly self-selecting audience (all attendees and presenters actively believe consumers must be engaged and directing the forward momentum of healthcare), we all buy in to the idea that customers are the decision-makers (a central tenet in any other sector - I'm still not sure how we miss the boat so badly in healthcare), and will have increasingly vocal input as to how we should change healthcare.

Of course, if we really want the Health 2.0 debate to shape forthcoming wellness management offerings, we'll have to work much harder to get dissenters to attend and present.

We need some speakers present who believe consumer-directed healthcare is just crap. Let's electrify the debate a bit to accelerate development.

We also need more press, bloggers, editors, and authors who will be critical of the space and ask the tough questions (including "how on earth will that business model pay for itself?")

We're moving towards an idealistic, but also necessary, view of reframing healthcare offerings as wellness management, rather than merely disease treatment.

Of course our ills will still be encapsulated with goods and services, treated in an episodic fashion. Of course. But we'll also see an increasing numbers of providers (docs like Jay Parkinson and Enoch Choi) talking to us about how to focus on being WELL.

Here's an open question to Health 2.0 firms that should be at the heart of a root qualitative analysis: How do you help the system treat me as a person, rather than a pulse?

And of course, how will you monetize the data, format, and methodology that helps me navigate the system along my personal care continuum?

The most interesting firms at Health 2.0 provided ways for docs and consumers to communicate about how to live WELL.

The best firms, regrettably only a handful in my opinion, combined deep management benches with sound business models and also provided a real 'wow' moment when demoing services.

They include Myca, Phreesia, Vitals.com, American Well, Diabetes Mine (although technically a blog not a commercial H2.0 biz, Amy Tenderich's site represents the best of patient-centric, consumer-directed peer-peer info services and community), and a few others.

So here's what I think we'll see in the Health 2.0 sphere in the next 1-2 years (an eternity in any tech niche...):

1. Functional Gut Checks: Firms present at Health 2.0, Connecting Consumers and Providers, will be asking themselves tough questions in the coming weeks. Does my business model work? How will I be sustainable, or not? Do I want to be bought? Is my mgmt team strong enough to seek VC competitively? Does my offering encourage translation and transmission of data across formats and sources (i.e. does it encourage interoperbility?) Does my name, branding, image, and format work for the space and is it successful in attracting press, search results, buyers, etc.?

2. The M&A Wave: Several of the presenting firms (who demoed during H2.0 and then answered questions by a panel in what turned out to be an excellent format for rapid learning) provided similar offerings with a weak differentiating factor. And the presenting firms are the creme-de-la-creme of their segment. For each firm that presented, there are 5 to 50 more doing the same thing with less value who weren't invited to show their stuff onstage. This will result in mergers, acquisitions, and continuing buy outs by bigger, more traditional industry players trying to squeeze into the H2.0 space.

3. "Me Too" Development: Some of the firms at Health 2.0 were seriously checking out the competition. There will be a race to add functionalities so firms can compete (the "we do that too" mentality).

4. Paint a Pretty Picture: We'll also see design innovations as many of these firms move past beta - many sites were crowded, a few glutted with overly obvious advertisements that are turnoffs to savvy consumers. Some took a page from other industries we already trust for online commerce and designed their interfaces accordingly (to look like my online banking entry page, for example).

5. Job Hopping/Management Musical Chairs: The social aspects of Health 2.0 conference-going are valuable for both those examining employment in the space and those needing a fresh injection of engaged employees. Most of the startups are moving at a frenetic developmental pace. These execs will want to look to fellow attendees for potential hires. Here's a plug for my fellow volunteers, an impressive, international bunch with great attitudes and even greater skill sets. Many of us are in grad programs and volunteered our time for Matthew and Indu because our radar tells us "there's just something going on here." In addition, some execs are heading blah firms and some companies had green benches but great business models. I think we'll see some exec. switches in the coming months, or at the very least additions to advisory boards.

6. Shop Til We Drop: Consumers want into the space. Badly. We'll use online versions of word-of mouth referral (blogs, communities, social networks), print reviews (major news and online media), and search offerings/services provided by trusted firms and practitioners to access our health information and shape personal wellness goals.

To traditional healthcare providers using old-fashioned methods - you've underestimated us. Badly. 60% want online access to records and testing, according to this Deloitte survey (at EHR Decisions, the CCHIT blog). If we can't get them online, we'll demand access, as did Dorothy Tillman, who was arrested for not submitting her request in writing (read the unbelievable story on A Scanner Brightly, by Jaz-Michael King, here). Continue to do so at your peril - and ours.

It's no surprise that the realization of consumer-directed healthcare's growing importance was the big 'aha' moment at HIMSS 2008 (Thanks to John Sharp at eHealth for the post). I'm stunned more HIMSS attendees didn't pick up on Health 2.0 and attend the Spring Fling.

Bet I'll see many more of you in 6 mos. at the next Health 2.0 show in San Francisco.

Attendees were challenged to think of a 7 word description for the next generation of Health 2.0. Mine would be almost idiotically simplistic: Listen to my concerns. Help me live - WELL.