Disruptive technology or technology fad?

Defining Health 2.0, similar to describing any emerging trend or movement, remains a work in progress. Health 2.0 builds off of the concept of Web 2.0, a term originally coined by O’Reilly Media in 2003. Established companies and start-ups alike are incorporating Web 2.0 tools such as specialized searches, social networking and online communities as well as blogs, wikis, podcasts, and videos that enable users to create their own healthcare content.

Health Industry Insights defines Health 2.0 as the application of Web 2.0 technologies to the health care industry to be used by the various stakeholders (e.g. consumers, providers, payers, employers) to improve collaboration among them:

• Communities form around areas of interest
• Participants freely exchange information about their experiences – both good and bad
• Web discovery via search is the natural first step for consumers (and increasingly providers)
• The Internet as the primary source of knowledge
• Internal knowledge management and process improvement initiatives depend on collaboration and web 2.0 technologies
• Provision of highly interactive real-time transactions, services and care

Given the proliferation of Web 2.0 technologies in mainstream use, it is not surprising to see healthcare-focused Web sites adopt these technologies. After all, consumers who have grown accustomed to reading online reviews of consumer goods and services, and then purchasing them based on these recommendations will want that same experience when selecting and interacting with their physicians, other healthcare providers and health plans.

User-generated content
Health 2.0 enables consumers to find and create their own user-generated healthcare content more effectively via:

• Multimedia delivery channels for content
• Healthcare-savvy search engines
• Social networking opportunities

At the crux of consumer empowerment is information. Historically, clinicians were the oracles of medical information. Only the most motivated and ambitious of patients could search out information from medical journals and other resources in medical libraries that are traditionally the purview of trained professionals. Today, with the coming of age of the Internet, Web 2.0 and, more recently, Health 2.0 capabilities, consumers can readily find health information online from the comfort of their own homes and exchange health information with their peers. According to nationwide Harris Poll conducted in 2006, 80 percent of online adults (up from 72 percent in 2005) use the Internet to search for health-related information.

In an attempt to manage healthcare costs, especially the costs of treating chronic conditions, payers, employers and providers are focusing on healthy lifestyles and disease self-management. Increasing consumer awareness regarding the importance of taking a more proactive role in managing one’s own health ideally should lead to more positive patient outcomes. Consequently, there will be opportunities to use Heath 2.0 technologies in the areas of healthcare coaching and education where supportive communities will enhance the likelihood of success.

Challenges
For health information to be useful and not harmful, it must be from a trusted source, accurate and taken in context. Otherwise, consumers risk falling prey to ‘cyberchondria’. A set of symptoms consistent with a simple cold could be misconstrued as something more serious. Conversely, consumers with more serious conditions might present with seemingly innocuous symptoms (e.g. is the fever caused by the flu, mononucleosis or meningitis, which can be fatal?).

Patients with reams of printouts from various Web sites, some of which could contain inaccurate or out-of-date information, will place additional burdens on already pressed-for-time physicians. Physicians can either choose to be defensive and reject such information out of hand, and thereby risk losing that patient, or see themselves playing the role of interpreter or guide. Providers and payers should be prepared to counter misinformation consumers find online by providing links to sites that they trust and make patient education materials readily accessible on their Web sites.

Privacy and security are also a concern. HIPAA regulates covered entities. Social networking sites and other sites that offer personal health records are not regulated under HIPAA privacy and security laws that govern how payers, providers and clearinghouses use and disclose protected health information. Consumers are advised to review sites’ privacy and security policies before providing personal health information. An important consideration is whether the consumer can permanently delete his online health record or profile from the site. This is especially important for social networking sites, which might have more public pages where anyone can view the musings of the participants which could include potentially sensitive health information.

Health 2.0 runs the risk of expanding the digital divide for some consumer populations, especially the segments most at risk – the elderly and the poor. There is an inverse correlation between Internet usage and age, socioeconomic status and health status. Older, poorer Americans, who typically have more chronic diseases, tend not to have access to computers and the Internet from their homes. Providers and payers will still need to incorporate multi-channel strategies, including telephonic and mail, to reach these at-risk populations.

Technology Fad?
Many of the capabilities that define Health 2.0 have been around for a decade or more. After all, list serves and bulletin boards provide the ability to communicate and create community among online users much like blogs do today. Social networking sites, such as MySpace and Facebook, are essentially personal Web pages, but with more gadgetry to connect participants together. Broadband has greatly improved the output of video that was at one time disjointed with audio lagging the video display.

Health 2.0 is reminiscent of the early Internet days before the bubble burst. There are hundreds of start-up and established companies with a grand vision, seeking to transform the healthcare industry through their clever deployment of Web 2.0 technologies. Some vendors serve a specific niche, such as specialized search or healthcare communities, while others offer a variety of Health 2.0 capabilities and are therefore challenging to categorize neatly. And with the explosive rate of innovation, some organizations will simply defy categorization. Like any nascent, highly fragmented market, there will likely be more losers than winners as companies struggle to balance developing the next “cool technology” with establishing a sustainable business model.

Disruptive Technology
Health 2.0 will have a profound effect on how consumers interact with the US health system, and has the potential to be a disruptive technology, as it creates a new market place for health services that did not exist before. A decade ago, ecommerce enabled consumers to buy medical goods, such as prescriptions and medical devices, online. Today, more prevalent broadband access and better real-time communication technologies (e.g. instant messaging, Web cameras, voice over IP) make it possible for consumers to obtain actual health care from clinicians over the Internet.

More consumers are already going online to search for health information. Specialized searches that help to organize comprehensive search results or filter out questionable search results will improve consumers’ ability to find appropriate, medically relevant information. Online communities will provide additional resources for consumers, including suggestions for alternative treatments, validation of health information, and tips for daily living with a life-changing condition.

The healthcare industry should anticipate more innovative use of Web 2.0 technologies in healthcare by mainstream healthcare technology vendors and niche companies over the next 12-24 months. Some of the major provider and payer organizations are already adding these capabilities to enhance their current Web sites and consumer portals. Provider organizations, payers and purchasers should evaluate and incorporate these capabilities into their own patient and member portals to enhance the ‘stickiness’ of their sites with their respective constituents and to make their sites more competitive with third-party mainstream and healthcare-focused sites.

Factoid
80% of online adults use the Internet to search for health-related information.

Lynne Dunbrack is a nationally recognized thought leader in the application of information technology (IT) to the business problems of the health industry. As program director for Health Industry Insights, she provides research-based advisory and consulting services that enable health provider and payer executives to maximize the business value of their technology investments and minimize technology risk through accurate planning.