Since December 2006, when Matthew Holt and Indu Subiya almost single-handedly began the Health 2.0 movement with Matthew's blog and their first conference, the entire world of health care has begun to change. And that's not a simple thing to achieve. Health care is steeped in tradition, regulation, disparate moving parts, and territorial entities (witness the issues involved in health insurance reform). But Matthew and Indu did not shift the system the way President Obama and Congress tried to do, through "push marketing." Rather, they decided to harness the grass roots "pull" brought about by patients and the Web to force movement of the inertial forces.
They took what was already happening—patient empowerment through online communities and early health information sites such as Medscape for physicians and WebMD for patients, and accelerated it by evangelizing patient engagement and empowerment, the prototyping of new technologies, and the shift of responsibility from the doctor to the doctor-patient partnership.
I've been to all the Health 2.0 San Francisco conferences, and I can see the changes. In the early days, it was all about sites like DiabetesMine, a blog started by a woman living with diabetes, and PatientsLikeMe, a home for people with life-changing conditions like ALS. These were founded by patients, to fill their own need to talk to other people with similar conditions.
These developed into patient communities so successful that they formed partnerships with the pharmaceutical industry, which was the first segment of the industry to come aboard, seeing an opportunity to market drugs to patients. Ironically, the pharmaceutical industry now takes the aggregated information from patients and uses it in drug discovery and development as well: a site like Iguard.org, a service that alerts patients to drug safety information, new research about interactions, and recalls, is now a pharmaceutical industry reference for information on what the "user experience" actually is for drugs that have already been approved.
This year's conference, which I attended last week, told me just how fast the ground is shifting. Practice Fusion, a free electronic health record for physicians that took off slowly because of physician distrust of data stored in the cloud, formed an alliance with Salesforce.com last year. That alliance provided scalability and data security. But at the conference, Practice Fusion announced that it has opened its API and is going to become a platform. In other words, developers can take the information in the EHR the physician sees and develop applications that do everything from analyzing trends to providing information back to the patients. This is one of the most exciting game-changers I could imagine.
Even more exciting, the physicians have jumped on board! In the early days, there were a few, Dr. Kevin Pho, who writes the KevinMD blog, and Dr. Enoch Choi from the Palo Alto Family Medical Center, who saw the potential. But now real shifts are happening: in the MIT Media Lab, Dr. John Moore is testing an application called Collaborythm, which he thinks can re-define the doctor-patient relationship by using technology for online real time doctor patient discussions that don't involve and appointment. This is the 21st century version of the house call.
In fact, at the urging of both doctors and patients (do you think doctors like to be trapped in their offices all day?), health care is moving out of the office and the hospital to where the patients are. A new series of startups are enabling a far different doctor patient relationship, free of the traditional physical and emotional distance between the participants.
One startup, Mytrus, brings participation in clinical trials to the patient's home. Another, WeCareTLC, brings the family practice to the employee workplace. As an incentive to use the service, if employees use the WeCare on-premises clinic, they get all their tests and labs free, which lowers their out of pocket expenses. Still a third, Univita, connects the elderly to neighborhood-based consumer-rated home health services through an alliance with Angie's List—after providing an assessment tool for what services the elder needs to live independently.
The last of the categories that interested me were the ones that created transparency around what medical services cost, and included a startup that shed light on what different physicians in a given geographical area charged for similar procedures, allowing a patient to comparison shop for doctors according to whatever criteria are most important to that patient (cost, convenience, credentials).
These new companies are looking ahead to health care reform. You will be seeing more of them.