Health 2.0: High Wow Factor, High Hopes for the Future of Health Care

I just spent the past two days at the 2011 Health 2.0 conference in San Francisco being wowed and a bit overwhelmed, in a whole different universe than either the community-based organization or public policy environments I am used to.  From the opening video, a fast-paced, high beats-per-minute overview of how far health-related technology has evolved in the four years of this “Health 2.0” movement, to the over forty 3 to 4 minute “demos” of websites, apps, devices, and almost magical sci-fi gadget wizardry I saw (and I missed seeing 10 additional demos when I took an extended lunch break to go into my office), this was a conference experience like no other I have been to in a long time (and I go to, speak at, and plan, LOTS of conferences).

In many ways, it was a cross-cultural experience for me, with an entirely different vocabulary of technology and entrepreneurism, with discussions of “being in this space”, deep dives, the cloud, form factor, native apps, content and search, data utility layer, unplatforms, use cases, eSampling, big data, data as self-expression, monetizing, value propositions,  private labeling, market intelligence, gamification, avatars (not the movie), emoticons 🙂 (and, of course, another whole set of acronyms – how many do you know?):  API, OS, IDE, PaaS, CEM, UX, IVR, M2M, VC, HDI, QS, DIY.

There was a pace, an energy, a feel, that was propelled by innovation and creativity, along with deal-making and instant sales pitches, a re-mix of passion from those who both want to do good AND make lots of money (a “sh*tload” of money, as described by the National Coordinator for HIT Dr. Farzad Mostashari at the closing plenary – yes, he really said that).  Speaker bios were more about how many start-ups, acquisitions, and sales to bigger companies each speaker had been involved in rather than their latest position or job title.  It was fascinating to see companies and products for free, to be given away, shared, or invisibly subsumed, exhibiting or demo-ed next to big-name and start-up companies building their brands, selling their licenses.  It was propriety vs. open-source technology existing side-by-side, developed with both convergent and divergent business and marketing models.  There seemed to be room for everyone; diversity and diversification was essential, not an afterthought.

There was an andrenaline-fueled pace throughout the conference, always a sense of “wait, there is more…”   No talking heads but lots of talk-show style conversations with movers and shakers and only one (really good) keynote talk by Dr. Mark Smith of the California HealthCare Foundation (more on his talk below).   For those of us who often struggle to make our advocacy points succinctly, the developers, founders, CEOs, and sales VPs who only had 3 ½ minutes to show their products (4 minutes if they were lucky enough to be invited to be on the main stage for a plenary session), had to make their case quickly, efficiently, effectively (and pray that the internet connection was stable, or the cameras showing their products live were focusing properly).  Wow, what if we all could make our pitches and points so well in 4 minutes!

Dr. Mark Smith from the California HealthCare Foundation gave another of his usual thoughtful, provocative, and memorable talks that kept being referenced throughout the conference.  With humor and humility, he cheered on the progress he has witnessed (and funded generously through his leadership at the foundation) but his key point was a sober warning: in a largely fee-for-service health care system dependent on billing for visits or number of days in a hospital, why would physicians and hospitals embrace all these health technologies that are intended to reduce the number of office visits or length of hospital stays (and actually improve health so you don’t need to go to the doctor or hospital)?  In other words, all this health technology is about to do nothing less than turn U.S. health care on its head, spinning it around to search for literally new ways of doing its “business” in America.

However, Dr. Smith mitigated his sternness with hope: with the HITECH Act and national health care reform, at least there are tens of billions of federal dollars – and game-changing national public policy changes – that will support and catalyze this coming revolution of how health care is delivered in this country.  These conference participants well-understand that the future envisioned by the Health 2.0 movement just got a one-time, multi-billion dollars infusion of venture capital from the federal government.  It’s like the initial public offering that won’t come around again.  And led by the infectious enthusiasm of U.S. Department of Health and Human Services Chief Technology Officer Todd Park (U.S. health care now has a national CTO!), some of those dollars have become available as real venture capital through developer challenges and prizes.  Dr. Smith’s foundation has joined that movement with the launch of its own $10 million innovation fund, and other foundations are likely to follow.

And so the conference featured lots of tools for those physicians, hospitals, and other health care providers to join the coming change with technology that is easy to use, is cool (yes, I still say “cool”), and just darn looks (or feels) good.  Accessing patient records, lab results, and images on mobile devices; communicating with patients both in real-time and asynchronously through multiple channels; monitoring dashboards with quality measures to identify patients who need more attention and support, are all at the literal fingertips (and some thumb typing) of physicians and other health care providers.  Some seemed like great ideas or first attempts not quite ready for prime time, others had a “wow” factor that means they will be coming soon to your physician’s iPad and to your Android smartphone.

But this coming revolution in health care is multi-dimensional and multi-directional: there also was lots of technologies to put power and control of health information and “taking care” of one’s own health directly into the hands of health care consumers and patients, their families, and their caregivers.  Many are seeking to be the ubiquitous Facebook for health care consumers, leveraging social media and social networking to largely bypass the health care system altogether by creating the highly personalized, customized information, social support, and incentives we need to change our behaviors (managing our diseases and medical conditions, how we exercise and stay active, what we eat, how we sleep, how we stabilize our moods).  Other technologies will drive transparency in pricing and magnify consumer feedback (if physicians and hospitals are now both afraid of and bewildered by the influence of Yelp ratings, watch out for what is coming!).  None of these technologies have yet to seize the imagination or market share to be the “killer app” or iPhone-type device for health care applications but something on the horizon is inevitable, as demonstrated by the range of major companies that are looking at, and investing in, consumer-driven and consumer-directed health technologies, including GE, Microsoft, Adobe, WalMart, Hallmark Cards (for real!), Sprint, and Aetna.

And then there was the reprise of last year’s wildly popular plenary session about the “unmentionables” – money, relationships, sex, spirituality…the parts of our lives that really matter to each of us – and have a disproportionate influence on our health and well-being – but are rarely even talked about, let alone addressed, by our health care providers.   Again, wow, what a different but equally direct approach to addressing what public health folks are describing as the social determinants of health.   The “context” of how we live our lives – and our sense of control and ability to change that context – matters.  The woman who started this conversation, Eliza’s Alex Drane, presented data showing we are desperate for help on these issues – from our employers, from our health care providers, from each other.  Health technologies will have a huge role in supporting our search for control and meaning in our lives.  So it’s both a huge challenge…and for a conference full of entrepreneurs, huge opportunities.

In the conference plenary sessions, exhibit hall conversations, and the tweet-stream, I heard a lot of hope and optimism about the future of this health 2.0 movement, quite a contrast to the hand-wringing about rising premiums, spiraling costs (and the stubborn inability to “bend the cost curve”), decreasing reimbursements and payments, continued medical errors, poor quality and outcomes, patient dissatisfaction, and increasing alienation, burnout, and even a sense of defeatism among health care providers.

It still seems all a bit surreal (how many times have I used “wow” in this posting?), as if I really did step into a parallel universe for a few days.  I just hope the ideas, the vision, the dreams, that I glimpsed the past two days really do become a reality for all of us.