Getting Real: Can Health 2.0 Stay Relevant?

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Relevant (rĕl’ə-vənt)

1. Having to do with the matter at hand; to the point

I read with amusement Susanna Fox’s redux review about the relevance of Health 2.0 in general and in changing patient’s behavior specifically.  Here questions reveals her bias in a very limited definition of Health 2.0 that I attempted to abolish originally in some of my bantering with Matthew Holt. I always saw Health 2.0 as a “movement” that would not be defined so much by its technology but rather enabled by it. As an “enabler”, the technology can help people do new things in new ways but I never believed technology in and of itself  had the power to truly change health, health behaviors, or health care delivery in and of itself.

That is why my definition of health 2.0 was always more expansive and contemplated an entire “movement” to the next generation health care “system”. This new system must include new delivery models, new financing mechanism, and the new tools and technology that bring all of this together in a simple, efficient, and affordable way.  Clearly this next generation of care would include technology, the new tools, but until we had a new delivery system that is financed in a new way we are going to continue to have the same behaviors across the patient, physician, provider, and payor continuum.

So Susanna, I don’t think your version of Health 2.0 (Tools and Technology) do much to get us to the behavior change you seek. In fact, getting to the root of behavior change requires almost a religious experience. Interestingly enough, the health care industry provides plenty of “religious” experiences including passing close to death, unbelievably poor customer experiences that invoke deep passions (ie, the birth of ePatient Dave), and promise of a far better world than we currently enjoy. So while the tools and technology show us what is possible, health care delivery and health finance are the catechismal doctrines we must reform first that actually incent the behavioral change we all seek.

So is Health 2.0 Relevant?  I think it depends on your definition!

8 Responses to Getting Real: Can Health 2.0 Stay Relevant?

e-Patient Dave says: November 25, 2010 at 9:09 pm

Hi Scott!

What’s your version of my birth myth :) that involves unbelievably poor customer experiences?? I thought Beth Israel Deaconess did pretty well at saving my life. Good room service 24/7, too. Yeah, the guest bed for my wife was crap, but I didn’t rename myself e-patient because of poor customer service – I just read the white paper and said “Yo, that’s me!”

Re Health 2.0 – I thought Matt & Indu’s definition was “user generated healthcare,” in the same way web 2.0 was user-generated content (e.g. blogs) compared to packaged-and-published content. No?

I certainly agree about behavior change.

D. Erasmus says: November 26, 2010 at 5:24 am

Health2.0 will be relevant when we stop kidding ourselves that technology is going to answer basic questions about quality of life. Tech can solve production problems, but the humanities are essential for more important stuff.

What Adam Smith referenced as the diamonds and water paradox is the conundrum of the health business in the USA. Who have you ever met who would bargain for health? Do you want a 25% discount to get 80% of the health care you need? “Health microeconomics” is an oxymoron because marginal values are mirages with quantum services or goods, but this issue has been obfusticated by vested interests.

I’ll believe we are on a healthier course when such trash as “medical loss ratios” gets tossed where it belongs. Paying an industry whose core skill is discrimination (aka risk assessment) to skim 15-20% off the top from health is worthy of a new chapter in “Extraordinary Popular Delusions and the Madness of Crowds, but MLR really is a sign of a sick mythology. The USA pusues this model because our politicians are afraid of taking on the insurance industry.

Markets do work when conditions like two willing participants able to negotiate on the own behalf. This implies each has the ability to walk away from the negotiations, but both are compelled to honor both the letter and spirit of deals made. How many patients are really in that posiiton when they need medical services?

Susannah Fox says: November 26, 2010 at 2:46 pm

Hi Scott,
I love your definition of Health 2.0 as a movement, not just a set of tools, and would only defend “my” redux definition by pointing out that it’s not really mine – it was DarthMed’s (an erstwhile commenter on e-patients.net who has since disappeared).
I think that original “What’s the point” post back in January touched a nerve because it voiced what many people think/fear other people think about our little corner of the health care space: it’s about technology, not people. My research provides evidence that Health 2.0 (or another term: participatory medicine) is very much about people – they just happen to often use technology to connect with each other or to their own data in new ways.
Here’s a speech that sums up what I’ve found over the last 10 years of research:
The Power of Mobile
http://www.pewinternet.org/Commentary/2010/September/The-Power-of-Mobile.aspx
Here’s a key point:
What will happen when the untapped knowledge of every patient, of every caregiver, of everyone who has something of value to share actually has the opportunity to share it?
That’s the next frontier. It is no longer about access. It’s about uploads. It’s about inputs. It’s about learning from each other.
Thanks again for the comment on e-patients.net and this response post. I was afraid that by posting during a holiday week we wouldn’t get any attention. How wrong I was!

Health says: July 4, 2011 at 5:18 pm

Health 2.0 services surely are for the next generation and these are based on technology but what about the technology used today as it is the best use of technology and I think the best of all definition is “user generated”

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