While most of the rest of the country is still struggling with information-age basics in Health 1.0, a small but growing troop of forward-looking entrepreneurs continues to lay the groundwork for what they predict will be the future of Internet-driven health care.
The second Health 2.0 conference last month in San Francisco attracted more than 1,000 participants, twice as many as last year's conference.
"I was stunned there were 500 a year ago," said Health 2.0 co-founder Matthew Holt. "I thought maybe we'd have 50 people. To get a little more than 1,000 this year is clearly a sign there's a place in this information culture for what we're doing."
Defining exactly what Health 2.0 is doing is not an easy task. It's related to Web 2.0 and Medicine 2.0, both of which come with similarly nebulous definitions.
On the Health 2.0 Web site, this is the "traditional" definition:
"The use of social software and light-weight tools to promote collaboration between patients, their caregivers, medical professionals, and other stakeholders in health."
The "expansive" definition:
"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."
Holt says the concept of patient-driven health care is the root.
"Health 2.0 is just a label," Holt said. "In the end, anything that's as complicated as what we're talking about -- and that's moving this fast -- is going to be very hard to nail down with a simple definition."
Holt and co-founder Indu Subaiya divide the Health 2.0 movement into three categories -- search, communities and tools -- all intricately woven into the Internet.
"You're definitely seeing significant numbers of people using the Internet for health-related searches," Holt said. "There's no question that that's a robust growth area."
"And now you're seeing the big players -- Google, Microsoft, Yahoo and others -- are now looking at communities and tools, and they're realizing the best way to service customers in the future is to get the customers to do it themselves, starting with consumers at home online, guiding their own health care decisions," Holt said.
Tools are "definitely the shortest leg on the stool right now," according to Holt. "That's partly because the health care industry hasn't made it easy for them. But I totally think in 10 years' time it will be a growth industry."
'A Lot of Creative Energy'
Andy Levitt, a member of one of 14 panels during the two-day conference, said the "vibe" in San Francisco this year was similar to the dot-com heyday of eight years ago.
"In the early days of rapid Web growth in 1999 and 2000, there was a lot of enthusiasm and a lot of companies showing up with whole new ways of looking at things. I kind of saw that happening in San Francisco last week," Levitt said.
Levitt is founder of HealthTalker, a two-year-old Boston-based marketing firm specializing in Internet exposure for prescription drugs. Funded by the pharmaceutical industry, it probably straddles all three legs of the Health 2.0 stool.
On HealthTalker, patients can find information on medications, as well as communities of other patients who have used or know about a given drug. It fits the third category as a tool for pharmaceutical companies to get exposure for their products.
"There's a lot of creative energy right now," Levitt said. "This is an exciting time to be involved with Web-based health care in just about any way you can imagine. Right now vendors and entrepreneur types are probably the most involved but ultimately the consumer, I think, is going to get the most out of these applications," Levitt said.
Power to the People
Keynote speaker Clay Shirky, author of "Here Comes Everybody," predicted there will be "enormous demand" for the kinds of communities and tools Health 2.0 represents. An expert on the effects of the Internet on society, Shirky said institutions and industry might try to "prevent 2.0 from happening," but he predicts that it won't work.
Shirky recounted a story about a Los Angeles physician who became concerned about a joint manufacturer's hip replacement product. After hearing of problems with several patients, he asked the company to investigate. The company said the product was not the problem and suggested surgeons needed more training, Shirky said.
Unconvinced, the physician took to the Internet and posted a letter about the issue, Shirky said. Patients began spreading the letter, the issue grew into a controversy and the company eventually withdrew the product from the market.
Growth Will Be Consumer Driven
"Just accepting what the health care system dishes out to you is going to begin to fade as people begin to see what kinds of options are available to them," Holt predicted.
Technology holds the promise of delivering new options, Holt said.
"What Indu and I are trying to do is create a forum for the kinds of companies that are working on creating some of those new options," Holt said.
The idea of patient-driven health care still is young, Holt said, but it will mature quickly.
"Most consumers adopt technology at a time when it matters to them -- and most people are not sick, usually. But as technological offerings grow and as the population ages and begins to look for answers, the kinds of tools and communities we're talking about in Health 2.0 are going to become increasingly important."