HEALTH2.0: David Kibbe on Health 2.0

David Kibbe, the doc behind the continuity of care record (CCR), and the spearhead of the AAFP’s effort to get family practitioners using EMRs, gave some great comments on the final "looking ahead" panel at Health2.0.  You can see more of David when he keynotes the Center for Information Therapy conference on October 8th in Park City Utah. Indu and I will be running a mini-Health2.0 panel at that same conference (with Revolution, Daily Strength & Organized Wisdom) on Weds 10th. But David didn’t get to say everything in San Francisco, and this is what he wanted to add:

1) What I really, really liked was the way in which so many of these
applications helped the patient/consumer help himself/herself — to be
better informed, to know their options, to take better actions, to hope
and act in their own best interests. This is exciting, and very
necessary, as physicians in primary care are already unable to meet the
demands upon them for care delivery, and this imbalance/shortage is
only going to get worse in the future. And it’s exciting because
empowerment is the key to saving the individual out-of-pocket
spending.  As health costs continue to shift to the individual, Health
2.0 can really be helpful.

Healing without information is indistinguishable from magic…..And magic in health care today is unsafe and very expensive!

We need an informed (& empowered) health nation. Health 2.0 is leading that potential.
I won’t mention any specific examples, but all of the search engines,
all of the social media sites, and some of the consumer tools sites are
exciting in this regard, and quite real now. The demand for their use
will only grow.

2) What disappointed me was how much work the applications require of
the patient/consumer with respect to information discovery, data entry,
and interpretation of results/advice. There are two issues here that
I would focus upon:

– We need to help people discover, collect, store, and utilize the
relevant health information in digital (computable) format, e.g. the
CCR and XML. Until we do that, none of these wonderful applications
can be invoked at will without having to type in medications,
diagnoses, or family history, etc.  And that is going to impact

– We need to find ways to share the task of personal health data
discovery and use — including all the repurposing of that data —
between the individual and his/her providers. These applications and
networks pose wonderful opportunities for patients and physicians to
work together in completely NEW and DIFFERENT ways, some of which we
saw yesterday, but for the most part hasn’t yet occurred.

In some respects, the unraveling of the "hairball" has to happen one patient-provider encounter at a time.

So, going forward to March 2008, I would recommend that the conference
include a panel(s) of demonstrations that show the patients/consumers
and providers working together in ways that re-define how health data
and information are collected, organized, and used in the therapeutic
and healing experience, and particularly how Health 2.0 enables this
data and information to be portable and interoperable — as these are
preconditions for re-use, re-purposing, and self-activation of the data
and information. Let’s show how these tools, networks, and communities can become mainstream in our society’s health system.

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4 replies »

  1. Major health care issues can be discussed on blogs more extensively than they could ever be discussed in academic articles. The interactive format allows rapid responses to medical and health care issues which frequently intertwine moral, ethical and legal concerns, and provides valuable feedback and commentary not available through traditional media.
    Blogs are increasing the visibility of laypeople medical experts, who share tips about treatment and care giving from personal experience, and others have relied on them for straight talk about their health issues and bloggers often provide links to other blogs they favor.
    As always, some cautiousness is needed on them because some bloggers can have a hidden agenda, like some of the main line medical and health care associations can have. But overall, independent thought (not to be confused with lack of evidence) can be cheerished on sites like this.
    Perhaps different practices develop evidence-based guidelines for their own individual practices or modify guidelines based on evidence which they use as their defined evidence-based standards for their practices. The self-educated physician doesn’t “submit” to the status-quo. They can think for themselves.

  2. Tools that help the individual learn more about his or her condition and make it possible to ask the doctor more pointed and intelligent questions about treatment options and the prognosis are undoubtedly good things at the patient level. However, I had knowledgeable medical people tell me that so-called engaged patients are actually more expensive to treat at the healthcare system level than passive patients are. Presumably, this is because they take up more of the doctor’s time and may insist on tests that the doctor may think are of dubious value or may push for a prescription for a brand name drug that they saw advertised on TV when a generic, an alternative brand, or even no drug at all may be better from a cost-effectiveness standpoint. So, while I do as much Internet searching as the next person about my various medical issues, I would not count on these tools to reduce healthcare or health insurance costs anytime soon.

  3. Something that bothered me throughout the Health 2.0 conference is how do consumers/patients know which information is trusted? And what does trusted mean? You can ask “experts” from two leading institutions the same question and get different answers. There is such a focus on search but then what is the individual meant to do with that? Healthcare has always been an industry where decisions are made by everyone (e.g. providers, payers, pharma, etc.) for the patient/consumer except the patient/consumer. And now we are thrusting massive amounts of information on them and saying this is the best thing for you!!!! There is no doubt that the question of value and “individual” value is going to have to be addressed.