Health 2.0: It's Not a Noun, It's a Verb, a Movement

by Jane Sarasohn-Kahn

Sept. 20, 2007, will go forward as the birth date of Health 2.0. A standing-room-only crowd debated the challenges of data liquidity, consumer engagement, provider technology adoption and the value of searching for health information online.

Just a year ago, the concept of Health 2.0 was not as familiar or concrete. In fact, when Matthew Holt, writer of "The Health Care Blog" and co-founder of the Health 2.0 conference, gave a presentation in a small conference room in San Francisco last year on the very idea, he received mostly blank stares. But then someone walked into the room and "got" it. That someone was Dr. Indu Subaiya of Etude Scientific. The two further brainstormed the concept of Health 2.0 and decided to partner up and launch a conference on the subject. I sit on the Health 2.0 conference advisory board and helped with the planning.

In the initial planning stages, Holt and Subaiya thought the conference could attract about 100 attendees. But Holt, a longtime health forecaster, got it wrong, very wrong. By the time the conference was held, buzz about it was so hot that it generated an overflow crowd exceeding 400 venture capitalists, technology developers, health-impassioned bloggers and a very small number of health providers, the bulk of whom paid to attend.

From Web to Health 2.0

To understand what Health 2.0 is, it's useful to consider the term Web 2.0. According to Tim O'Reilly, Internet savant, "Web 2.0 is the network as platform, spanning all connected devices ... creating network effects through an 'architecture of participation.'"

The online tools used in Web 2.0 -- search engines, wikis, blogs, video, online communities and mashups -- are supporting the so-called "architecture of participation" that enable a consumer-generated content. Health 2.0 takes these tools and applies them to health, with the objective of affecting health care for the better. At the September conference, Holt said, "People have better experiences if they understand more about their care, have better relationships with their providers and a sense of community. This is not a brand-new thing, but Health 2.0 tools make it easier."

At this nascent stage in the concept's evolution, there are several definitions of Health 2.0. A particularly broad and provocative definition has been offered by blogger and physician Scott Shreeve. His definition of Health 2.0 is a "new concept of health care wherein all the constituents (patients, physicians, providers, and payers) focus on health care value (outcomes/price) and use competition at the medical condition level over the full cycle of care as the catalyst for improving the safety, efficiency and quality of health care."

Shreeve's definition goes well beyond Holt's. But whichever end of the continuum you choose, it's clear to me that Health 2.0 isn't a thing; it's a verb, a movement.

Driving Interest

Why the interest now?

More consumers are searching online for health information. More than 120 million U.S residents are searching for health information online. Bruce Grant of Digitas Health told us that consumers use six to 12 search sites to determine what's trustworthy.

The more often consumers search for health information, the more expert they become. Many surveys are finding that the Internet is now more trusted as a health information source than a physician. Welcome to the world of user-generated health information, where consumers often trust someone like themselves more than a clinical expert.

Consumers are building communities online. The most passionate health care consumers are turning their personal health expertise to the outside world, creating communities of support and advice. Amy Tenderich, a professional journalist, created the Web site Diabetes Mine in 2004 after she was diagnosed with diabetes. Her site is but one example of consumers advocating for each other.

Another example is Sophia's Garden, a 3-D online community founded by Karen Herzog and Richard Sachs, whose daughter Sophia bravely fought and succumbed to a genetic disease. Sophia's online Garden is what Herzog and Sachs term "a healing community," and it brings together families, clinicians, pharmaceutical companies and all stakeholders who can help in the healing.

A growing demand for transparency. In its latest survey of employer-sponsored health plans, the Kaiser Family Foundation pointed out that insured consumers are bearing more financial responsibility for their health care. As a result, they are becoming health care shoppers -- for insurance plans, prescription and over-the-counter drugs, hospitals and physicians. Shopping requires transparency of price, quality and outcomes.

Consumers are comfortable with IT. We spend a lot of cash, out of pocket, on technologies; MP3 players and iPods, wireless communications and DVD rentals eat an increasingly larger share of our disposable income. Health applications are now starting to be embedded in and/or enabled by these devices. We'll be doing more health-monitoring and communicating -- including e-mailing with our physicians and getting prescription drugs through electronic prescribing -- in the next few years.

Consumers are embracing Web 2.0 tools. Social networking is growing fast, and not just among teens and college students. There are at least 70 million unique visitors to MySpace and Facebook, and consumers are linking up according to their mutual health care interests on both sites. Try searching "health" on YouTube: you'll find countless pages covering every sort of health-related subject from presidential candidates' speeches on health care reform and visual discussions on colonoscopies to health insurance satires and patients' disease-specific videos.

Learning from Health 1.0. Those who were present at the creation of Health 1.0 learned a lot about business models, privacy and rules for engaging with patients/consumers. This time, it's less expensive to build the tools we need.

Mostly, Health 2.0 is about changing relationships among stakeholders in health care. Consumers -- in their many guises as patients, caregivers, advocates and communities -- have already begun to reclaim their stake in U.S. health care. This is the democratization of information, and it goes back to Johannes Gutenberg and Ben Franklin. In 2007, consumers are turning the tables on old school health care, empowering themselves to bring greater balance to information asymmetry in health care.

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