Looking into the Future

by francine Hardaway on September 20, 2007

At the end of an entire day of Health 2.0, a panel of experts looked ahead based on what they had heard. They spoke from several perspectives.

Providers know that the incentives are wrong. Health insurance pays only for discrete units of care right now, not for longitudinal outcomes. And in fact, it pays better for crises than for prevention. The physicians on the panel know very well that a change is needed, but they aren’t going to change until the reimbursement changes. Most providers have reimbursement as their business model.

Doctors would love to contribute to clinical decision support for patients: help them figure out where am I, where am I going, and what will it cost me?

Lee Shapiro, Allscripts: Allscripts was health BC (before connectivity). Their models isn’t superseded yet. Electronic health records are now used only as a subsititute for paper charts. But the transformation only comes through connectivity. What we are now seeing is the ability in which individuals, patients, practitioners are becoming connected to share information. Must have connectivity at the beginning of the process where the patients are being seen so the data can be generated.

Health search is generating $1b in revenue already, and that’s without connected electronic health records. So there’s a great incentive for Microsoft, Yahoo, and Google to solve this problem. What happens when interconnected health information and records are the new context? Innovation flourishes when context is in place. We are at the brink of the change in context.

Jay Silverstein: Revolution Health. Lots of imagination and creativity going into building community. The power of community replaces the randomness of health. Community can lead to accuracy of diagnosis and uniformity of practice patterns. Right now, outcomes differ greatly depending on who the doctor is and what the location is. What about Eastern medicine, what about diabetics in waiting, what about the half-sick?

Esther Dyson: There’s still a solid rock of calcified matter surrounding health care. What we have heard today is sniffing around the edges, but not really connected. We need to get to something like the mobile phone, which didn’t replace the landline, but supplanted it. But in health care, some of the problems need to be fixed by collective action: paying for wellness, rather than for service, and measuring what is saved, rather than what is spent. We also have to let the data flow, and that’s a matter of standards, micro-formats, and other tech terms.

And then we struggle with the BIGGEST hairball: how do we get people to change behavior? Web 2.0 lets us measure behavior, which could lead to change. Someone suggested a FICO score for your health, in which you get paid for a higher score. And if your doctor doesn’t help you get your score up, you change doctors.
The early version of that is RealAge.

Consumers: stand up and demand your data. Demand the ability to communicate around that data with your trusted advisors — physicians, pharmacists, and friends.

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