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Age gap, privacy potential Health 2.0 barriers


By: Joseph Conn / HITS staff writer



An example of a potential Web 2.0 winner cited by consultant Matthew Holt—who along with Indu Subaiya, put on their first show, the Health 2.0 User Generated Healthcare Conference, Sept. 20 in San Francisco—and Scott Shreeve, a physician entrepreneur who co-founded the healthcare IT company Medsphere Systems Corp., is PatientsLikeMe.com. Based in Cambridge, Mass., the company was founded in 2004 by three engineers from the Massachusetts Institute of Technology: two brothers, Benjamin and James Heywood, and a college buddy, Jeff Cole, after another Heywood brother, Stephen, was diagnosed in 1988 with amyotrophic lateral sclerosis, or Lou Gehrig's disease. The site encourages the development of communities among patients with ALS (1,461 current members), Parkinson's disease (850 members) and multiple sclerosis (2,132 members), according to recent postings, and is looking to expand to other diseases such as HIV/AIDS.

An official with PatientsLikeMe declined to be interviewed for this story, but according to information on its Web page, the site gathers from its community members basic demographic information as well as date of diagnosis, treatment options and duration, and self-reported outcomes. Some data, such as symptoms and specific drugs in use, are aggregated and tracked. Patients include tales of difficulties in obtaining accurate diagnoses, narratives of their treatment plans and the beneficial or detrimental effects of their drugs and other activities, such as exercise regimes, yoga, etc.

According to the site, "our operating costs will be covered by partnerships with healthcare providers that use anonymized data from and permission-based access to the PatientsLikeMe community to drive treatment research and improve medical care. We only share anonymized data with trusted partners, and all our patient information is kept safe and secure."

Another Web 2.0 example that Shreeve particularly likes is Athenahealth, which started life in 1997 as a physician practice-management company long before the dot-com bubble burst, according to co-founder Todd Park, executive vice president and chief development officer of what is now a publicly traded company based in Watertown, Mass.

"We morphed our business model from an obstetrics PPM to an online billing company" with the valuable core experience of "getting our butts kicked in billing."

Park says their timing fortuitously coincided with the growth of the Internet, making it possible not only to provide the new billing service online, but also to leverage the wisdom of crowds.

"We started to solve doctors' biggest problem," Park says. That was dealing with "tens of millions of insurance rules. We said the only possible way to figure them out, because these rules (were) not published anywhere, is to harness the power of the network of doctors to do that." Using the experiences of multiple physicians, Park says the company used the collective experience of their denied claims to "reverse engineer" a database of insurance rules and build a computer software system, or "rules engine" that could read and apply them to new claims.

David Brailer, the first chief of HHS' Office of the National Coordinator for Health Information Technology, and who now heads Health Evolution Partners, a San Francisco venture capital fund, says he spoke at the Health 2.0 conference and introduced some skepticism to the event. Despite what he described as his "long-term optimism about social networks in healthcare," Brailer says he is "skeptical that there is going to be a short-term, broad application," for Web 2.0 technologies in the healthcare industry, citing "two huge barriers" Health 2.0 companies must overcome.

One is the age gap. "The Web generation is applying it to things the Web generation is interested in, whether it's choosing college dorms or sharing opinions over the latest fashion trends, but the people who consume healthcare are not the Web 2.0 generation," Brailer says. "There are some diseases that affect younger people and some older people are gravitating to Web 2.0, but it has to overcome a huge (age) barrier."

The other issue is privacy. People are willing to post some personal information on social networking sites such as Facebook and MySpace, but when it comes to medical information, that's another matter, Brailer says.

"We're not going to be making a lot of investments in Health 2.0 unless we see a real business there, filling a real business need," Brailer says. "This is a great concept, but it is following the contours of what happened in the dot-com boom." Many of the companies are obsessed with capturing users but not focusing as much on the business model, he adds. "That's why I'm just skeptical about this."

This story initially appeared in this week's edition of Modern Healthcare magazine.

http://www.modernhealthcare.com/apps...02/0/FRONTPAGE