Matthew Holt

Weak analysis about the “demise of Health 2.0”

Everyone’s favorite naysayer Dmitriy Kruglyak is getting very self-satisfied this morning about the failure of Revolution Health to change the world in three years. Normally, I leave Dmitriy’s bizarre wofflings alone, but because he’s directly "pointed the finger" at me and by extension at my partner Indu Subaiya, it’s time to respond.

While there may be a demise in Steve Case’s investment, Dmitriy proves yet again that his background as a software geek with no background in understanding the health care system — and his professional jealousy as the creator of a failed conference about blogging — gets in the way of his limited analytical skills of what he claims I’ve been saying about Health 2.0.

Yes, Indu Subaiya and I founded the Health 2.0 Conference to focus on the use of new participatory software tools in health care. Had Dmitriy paid attention when he attended the conference in 2007 he would have noticed that the audience was asked, what would be the future of the search, social networking, & consumer tools that made up Health 2.0? The response was that 70% felt that these tools would be adopted by mainstream health care companies, rather than become a standalone industry. Which was exactly what I have been saying all along.

Had he paid attention at the end of the dotcom boom and bust he
would have noticed that with the exception of Amazon, E-Bay, Yahoo, and
a few other media business, by far the most impactful adoption of
Internet tools was by mainstream companies, which spent the next five
years changing how they ran their businesses and connected with their
customers. Has Dmitriy not bought an airline ticket or checked his bank
account in the last ten years? While the Pets.com & Webvan bust was
going on, the proportion of Americans (and everyone else) going online
and using Web tools for information and commerce continued to grow
exponentially.

Had Dmitriy been paying attention, he would have noticed that the
proportion of online Americans (and others) using the Internet for
social media/Web 2.0/Health 2.0 purposes has gone from virtually none 3
years ago to over 60% today.

If, as seems unlikely, Dmitriy pays attention in the future, he’ll
see a similar adoption of tools that make up Health 2.0 by all players
in health care, including those which have no interest in profit like
the VA, and the UK national health service, as well as by major
American for-profit health plans and providers. Some media companies
that emerged during this latest wave may or may not survive the coming
consolidation, but if Dmitriy was paying attention this week he’s have
noticed ComScore’s report that visits to health care properties are up
over 20% year on year.

As I have been saying all along, Health 2.0 is about a participatory
change in how consumers/patients/citizens relate to each other, and to
the health care system using new technologies. It’s not just about
anyone including Steve Case trying to get rich without doing anything
worthwhile. Because Dmitriy’s conference wasn’t a success doesn’t mean
that blogging is not important. But because the Health 2.0 Conference has
been a success does not mean it has been hyping the creation of a
standalone industry in which every new venture would be successful.

But then again this analysis would require that Dmitriy pay
attention to large underlying phenomena, not just get overexcited about
Steve Case losing a few bucks.

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24 replies »

  1. Matthew & Dmitriy,
    I know both of you guys. You both are very smart, articulate and bring value to the Health 2.0 debate, however, time to move on from this unproductive “tit for tat”; I’ll pay for the first Ale, Coke, Vodka to make a truce in words.
    Mike

  2. Boys go to your rooms until you can play nice.
    Someone could do a case study on how blogs get hijacked by personal attacks and egos and how this “thread” captures the failure of technology and policy to work towards the common good.

  3. OK. I happen to have insomnia, so as I’m up late I’ll reply, but this is the last time I’m going to write to or about Dmitriy.
    Dmitriy, as I said, your English comprehension sucks.
    When I write ‘You may not remember telling me at the Microsoft Live Launch in late 2007 that I “just print press releases for my clients on THCB”; well I do.’ The trailing phrase clearly refers to me remembering what you told me, which was–as I stated in the prior paragraph in the original comment–a completely false accusation. It does not refer to your quote in the phrase in inverted commas. And if you thought it did, a quick reading of the rest of the text around it would have quickly made you realize the error of your comprehension. The way you have interpreted the sentence does not make any sense.
    To Dmitriy and anyone else who cares, I have no problem with Dmitriy’s interpretation of world events being whatever it is. That’s fine grounds for a rational argument. If the former Revolution Employee wants to share a similar world view, then that’s his/her perogative. I happen to think that it’s wrong, but that is neither here nor there.
    I do though have a serious problem with Dmitriy accusing me of changing my mind to suit my business interests, saying that I print clients’ press releases on my blog, and now apparently claiming that I have been a longtime paid representative of Kaiser Permanente. And now he’s not twisting but completely mis-representing my words. I have literally said that Black is Black and Dmitriy has claimed that I said Black is White.
    It may appear to the outside world that Dmitriy only made a minor dig at me in the original piece that started this whole thread. But that was the straw that broke the camel’s back.
    It was Dmitriy who started these personal attacks several years ago, not I. I have let him directly accused me of these things in public and in private, time and time again, and have always smiled gracefully and not responded. I gave just two examples of him stepping over the line in my earlier comments. I have put up with his self-righteous lecturing about what I should or should not be doing, and his ignorant interpretations of my opinions and business relationships for as long as I can stand while holding my peace. And now that time is up, apparently I’m the bad guy!
    Ironically while I have never worked for Kaiser, Dmitriy has been working for Humana all this time. I have never accused him of bias due to his business relationships, with the exception of my recent comment wondering whether he’s been as diligent at looking at Humana’s considerable warts as he might have been. And that I only said in my earlier comment in this thread after he accused me of bias about Kaiser.
    Instead of Dmitriy holding his hand up and saying that he stepped over the line, and having us return to some level of debate over the issues, he continues to make these slurs and accusations. And now he does it by completely misrepresenting what I say. This most recent example–claiming that I admit to printing press releases–being the most egregious and ridiculous.
    But there are yet more basic errors in his assessment. I have not done any personal consulting for my own account for Kaiser Permanente ever. (I last worked for a firm that had Kaiser as a client in 1997!). I have never spoken at “their conferences”. And apparently interviewing their executives is now a problem! Of course I believe that the interviews I have done with them and the pieces I have written about them have been balanced and deeply critical where warranted. I’ve also personally met and aired very critical views to senior Kaiser officials when warranted (such as with the 2007 kidney transplant debacle). You’re all welcome to search for “Kaiser” on THCB and see what you think. Tell me I’m wrong but don’t tell me I’m on the take and expect me to quietly let it pass.
    If any of you want to take the opinion of a someone who couldn’t pass a junior high school English comprehension test over the cold facts as I’ve presented them, you are totally welcome to do so. But don’t think that I can’t tell the difference between a personal attack and an honest intellectual disagreement.
    As I’ve said the Bush/McCain/Palin campaign is probably looking for a new truthiness-challenged speechwriter, and given his skill at fiction writing Dmitriy would fit the bill well.

  4. @MG: You are asking the right questions. But, Revolution is simply the most visible and egregious example of what is wrong with Health 2.0 companies. They demonstrate the trends in the way “Former Revolution Employee” describes what went wrong AND explains the metrics. The bottom line, “consumerism” is not working not just in Herlzinger’s definition, but in terms of creating most basic kinds of health consumer engagement online – on large enough scale.
    The huge number of 150M+ consumers looking for health stuff online, mostly represents Jane Q. Public typing her health question into Google… She finds the answer, prints it out and be done with it! Look for actual metrics (# of total users, # of daily active users, frequency of return visits and finally revenue per visit) for any deeper interactions that are being hyped… They are not faring too well, the numbers drop to financially immaterial level. So most Health 2.0 companies just generate (not) a lot of junk ad inventory and only a handful, like Sermo found and proven a meaningful way to integrate into industry’s business processes and create engaging interactions of high value. The rest of the scene is mostly fluff.
    There was an extra comment (by anonymous ex-Revolutionary?) on my original post that raised similar questions of whether Revolution is representative of the rest of Health 2.0 gang. You might want to check out his points and my answers.
    @Former Revolution Employee: Thanks for stating the case so well! Given that first I had to respond to personal attacks, the real substance took longer to get to – plus you could speak to their ad spending as insider. I think your quote should have been the headliner of my original post and should be read by everyone:
    Health 2.0, much like Web 2.0, is about 75% to 80% hype. I can’t find a single Health 2.0 company that is busting out in terms of ORGANIC traffic, revenues or a long-term business model. Getting lots of user-generated content + traffic is not, nor has it ever been, a legitimate online business model.
    ORGANIC TRAFFIC: This is traffic you get for free, just for keeping your site up. A gift that keeps on giving. This is how Facebook and MySpace have grown… And now we have consistent data to know that this simply does not happen on large enough scale for online health properties…

  5. As a former employee at Revolution, I can attest to the reasons why it failed as a business. It lacked clear and decisive management early on (the CEO was the former CEO of Ticketmaster!), and lacked any type of understanding of the current state of healthcare in the U.S. Instead of going out and hiring a few dozen healthcare specialists and policy analysts to help them figure all of this out before they say word one to the world about what they were doing, they launched on hype, a hundred or so former AOL employees (yeah, big surprise there), and press releases. Oh, and money- lots and lots of money!! Buying lots and lots of ads, traffic and other properties and businesses.
    It reminded me a lot like the Wizard of Oz. All the while they were trying to look like they were doing something different, they did what so many startups do — built too fast, bought too much, paid too much, and in the end had nothing of great value to show for it. Except a guy behind the curtain pulling the not-so-revolutionary levers.
    Turn off the ad spigot, and wow, traffic goes down? Who would’ve thunk it?
    Sorry to say it Matt, but you really lost it in this post. I didn’t know anything about the bad blood between you and Dmitriy before this entry, and now I and thousands of others know not only about the bad blood, but about the personal attacks you made on someone just because they called you out on what they saw as a contradictory view. Address the question, leave the personalities out of it. This is a poor reflection on you and your professionalism in this business.
    Health 2.0, much like Web 2.0, is about 75% to 80% hype. I can’t find a single Health 2.0 company that is busting out in terms of ORGANIC traffic, revenues or a long-term business model. Getting lots of user-generated content + traffic is not, nor has it ever been, a legitimate online business model. Investors see a dozen Facebook wannabees every month and turn down all of them because the model works only on a Facebook-like scale (that nobody has shown how to duplicate in any reasonable fashion).
    Health 2.0 is much the same way. Online medical records? A non-starter until they are completely non-proprietary and easy to use/understand/needed by significant proportion of users. Social networking? Hasn’t caught on, though more than a half dozen have tried. Same with specialty search engines. Hasn’t budged the behaviors of the vast majority of people who start off at Google.
    Who knows what the future holds? But let’s take the marketing hype of innovation down a notch or two and recognize most of these sites for what they are — gradual evolutions of existing ideas and technologies.

  6. Meant to say that Revolution was “not really representative of the entire Health 2.0 set of companies.”

  7. Dmitri – Fair enough but Revolution Health is still only one company in the “Health 2.0” space. My sense is that Revolution Health bought into the vision of the world spouted by Herlzinger and others at the end of the 1990s about the role of consumerism and saw a huge opportunity after the MMA Act of 2003 (e.g., HSAs) was passed.
    Basically, the “consumerist” world never really fully materialized in a large way and has taken a lot longer than advocates of it would have liked. Revolution tried to capitalize on this (including set up a service that would help individuals answer insurance-related questions and coordinate care) but Revolution did what a lot of companies with a large amount of cash and a semi-lucid business plan do – over hire and over extend themselves because they had cash in the bank and never were forced to come up with a solid set of products/services that generated sufficient revenues to ensure their basic operations.
    While this may apply to a number of other companies in Health 2.0 that are trying to come up with a business model that relies only upon consumers, I would say that Revolution is really representative of the entire “Health 2.0” set of companies.

  8. Me rewriting Matthew’s comments? This is what he wrote (Sep 18, 2008 9:16:34 AM):
    “You may not remember telling me at the Microsoft Live Launch in late 2007 that I “just print press releases for my clients on THCB”; well I do.”
    The problem with you Matthew is you have short memory, big mouth and little self-awareness of just how conflicted, compromised and unsubstantiated your opinions are. Essentially you are living in a glasshouse and throwing stones, which is a very stupid thing to do. At least you had a good sense to heed my advice to stop and think about how you would look if we bring up the history.
    As for Kaiser, you have done many interviews with them, consulted, spoke at their conferences and really helped them get their message out. On many topics, including Epic project and Justen Deal. There is a long record on the Internets. But I am sure they had valid reasons for sponsoring your conference.
    Funny you should say I crossed the line, when I only mentioned you in passing in my original post. In response, you chose to devote a full post to attacking me personally. I did not think my time was probably worth this fight, but perhaps I should return a favor and do a post about you, your business practices and detailed examples of just how wrong and harmful your calls have been. Let me think about this. Rest assured I made copies of everything in case you decide to rewrite or delete history.
    @Neal Linkon: This is a top-down aggregate that has no practical use.
    @observer: I understand, many people need O’Reilly’s BS-speak translated. You should read this excellent piece by Drama 2.0, who also responds to O’Reilly’s retort in comments:
    http://www.drama20show.com/2008/09/19/tim-oreilly-sees-the-end-of-web-20-tries-to-change-his-stripes/
    @MG: I have numbers on Revolution Health in my original post, including referencing back to earlier post comparing how a one-man nephrologist has more traffic on MacRumors and how much he likely makes. As far as why their traffic dropped, the likeliest reason is they were buying traffic from search engines until they could no longer afford to. This approach is akin to use Viagra and financially usually leads to turning dollars into pennies.
    How come Matthew in his infinite wisdom did not point this out?

  9. Hmm, somehow my own blog is eating my comments.(rewriting ugh) And for my last point on this matter one final pass about Dmitriy’s skills in basic comprehension.
    They suck.
    I explicitly call him out in an earlier comment for accusing me of “printing my clients press releases” in THCB. And tell him that I don’t do it and that I’m very angry with him for suggesting that I do (with of course no proof to back it up).
    What does he say in his last comment? That I admit to doing so!
    He really should join the McCain/Palin team or try getting a job at Lehman brothers. In the Dmitriy world either black is white or positives mean negative.
    And I don’t know what he’s implying about my “long relationship” with Kaiser, but three things are worth pointing out. 1. The Kaiser person responsible for deciding to sponsor Health 2.0 has known me for less than 2 years. 2. That person is no fool and would not spend their employers’ money just to please me. 3. Health 2.0 has a separate sales person who has no control over the content of the program, which Indu & I control, in order to maintain a separation between commercial advertising and conference content.
    But I’m so glad that his insults privately and publicly over the years have been in fact “an invitation to learn”, presumably from his great wisdom.
    Well as MG, and many others have pointed out. Other than sneering and missing the point with crappy analysis, it’s hard for the rest of us to see what the benefits of that wisdom have been.

  10. What I don’t understand about this entire argument is that Revolution Health is just one part of what Steve Case’s Revolution company is doing in several industries.
    Just as with the overall Revolution company, there are components that have worked better (RediClinic to today than others (ExtendHealth) to date.
    You would gather from Dmitri’s comments/analysis that Revolution Health LLC was simply just a consumer-facing website when there are several parts to it. Not to mention that Dmitri provides absolutely no insight as to why Revolution Health’s web numbers hit a free fall in the early summer/have remained in the dumps since then.
    All the more surprising considering that they have steady growth and actually had created a hook last year in the 4th quarter around New Year’s Resolution goals that looks like it was pretty succcessful in driving traffic late last night/early this year.

  11. Actually, O’Reilly wasn’t talking about the demise of the Web 2.0 bubble, he was asking people in the tech community to focus on the many problems the country is currently facing. So, I’m not sure your analysis is sound.

  12. Matthew,
    I never aired contents of our email exchanges and private conversations publicly. Everything I said was simply to educate you on technology concepts and metrics you know little about, but cover as authority. I hoped you’d take my private comments as an encouragement to learn.
    I am sorry if you took the last paragraph of my original post as a direct accusation of “professional malpractice”. That is not what I said or meant, but if that is how you took it, what can I do? I am sure you will be able to demonstrate that this is not the case by your actions, rather than words. I have great faith in you.
    If you want to go into “he-said-she-said”, dredge up email exchanges and turn the whole thing into a circus, consider if that would be good for your brand. I was not even interested in commenting on you personally, till you decided to devote a whole post to my persona of all people. Look, what are you looking to accomplish at this point? What do you want me to do? I have no beef with you.
    To explain what I have always meant by “hype” is the setting of “unrealistic expectations”. Even if a shift is happening (which it certainly does) this does not mean that every claim made is valid and realistic. Manna will not fall from heaven. Seas will not part. Dead will not rise. There is too much in your coverage that loses sight of such limitations and I dare not question why. Alas, to understand what is going on you probably should have listened to my concerns instead of assuming that “serious chops in health care research & business consulting” is all you need to understand the “Internets”. Perhaps the next step in Health 2.0 is a “series of tubes”?
    I am glad that your long-standing relationship with Kaiser led up to a sponsorship. Still what really matters is the ratio of “buyer” vs. “vendor” support. Even Gartner does consulting for vendors (about 30% of revenue or so?), but they would not stoop to “printing press releases for clients” as you admit to doing.
    Finally by some strange coincidence, today is the day on which even Tim O’Reilly after whose Web 2.0 conference your show appears to be modeled on, essentially admitted that Web 2.0 jumped the shark and turned into a “reality bubble”. What is there to add?
    http://news.cnet.com/8301-17939_109-10045321-2.html
    As usual you are too late to notice and understand a technology trend. Why am I not surprised?

  13. What data supports this statement from Matt’s original post:
    “…the proportion of online Americans (and others) using the Internet for social media/Web 2.0/Health 2.0 purposes has gone from virtually none 3 years ago to over 60% today.”
    Thanks!

  14. Dmitriy. There’s no hitting of my nerve & I’m not unhinged. I’ve just decided that after putting up with your bullshit for two years on this topic, you need calling out. If you think my description of your analysis and background is an ad hominem attack, then welcome to the big boys club. Go back to school & work to get some at least half serious chops in health care research & business consulting like I did in the 1990s, and I won’t mention your background & experience.
    But you’ve stepped over the line into your own personal attacks several times. You say in the previous comment “I never said you are “on the take” or questioned your motivations”. That’s such a whopper that I suggest you go work for the McCain/Palin campaign, or go get your memory checked.
    I wont bring up the exact details. You may not remember what you said in a long email exchange with my partner Indu Subaiya about me being on the take (I’m paraphrasing not quoting) in 2007, but I do. I suggest you go check your email inbox. You may not remember telling me at the Microsoft Live Launch in late 2007 that I “just print press releases for my clients on THCB”; well I do. And a quick review of all of your collective comments on the topic on THCB and elsewhere shows a consistent axe that your grinding against those “hyping Health 2.0” — and it’s damn obvious who you mean — and suggesting that my analysis & objectivity is tainted by my business interests.
    Finally your piece the other day directly accused me of changing my analysis because I’m hyping Health 2.0.
    If that’s not ad hominem, then I don’t know why what I’ve written about you is. But worse you’re accusing me not of personal bad behavior but of professional malpractice.
    More importantly I’ve shown many times and again in the comment above this one that your analysis is inconsistent with the facts because you are mistaking investments in a few start-ups for a fundamental shift in how things get done. Of course, the piece I quote from you in my last comment above shows that apparently you do think such a shift is happening. So if it’s happening, why is calling that shift Health 2.0 “hype”? You have no real answer other than to witter on about helping people get the “real story” when you don’t ever mention what that real story is, but instead staying focused on rehashing the tale of eToys & Pets.com as if because they went out of business the Internet went away. If you have some actual analysis of the underlying change in health care, I’m sure people would be happy to hear it.
    Finally, I’m touched that you’re worried about poor decisions made on the “buy side” of the health care business — even if that’s a Wall Street term not commonly used in health care–and very glad that you are going to solve that problem.
    I’m also very grateful for your kind words about the line up at Health 2.0. It is stellar and Indu and I have worked our butts off (with lots of help) to make it so).
    And thanks for your advice on how to run a conference. And yes most sponsors of any conference are vendors, as are most advertisers in any medium. But you may not have noticed that a major sponsor of Health 2.0 is Kaiser Permanente which is probably the biggest single “buyer” of technology in American health care. However, I’m sure that that they’re not sponsoring Health 2.0 to get advice about what or whether to buy — I’m sure they’re getting that straight from you.

  15. P.S. It is much easier to sustain a conference business by targeting “sell-side” with their “whatever-it-takes” marketing budgets. This does not work the same way with “buy-side” since they tend to seek advice privately and be hesitant to spend on sponsorships. Especially early in the game.

  16. Matthew,
    The motivation of what I do is not to surprise you or hit your nerve. I am sorry that my analysis of what is going on in the marketplace got you so unhinged.
    My own blog is addressed to people who want to understand what is the *real* story with the impact of the latest Internet technology on healthcare and help them make *rational* decisions based on that. To do that you have to peel off the fluff, which saturates the media. The story of Revolution Health is too big to miss and your commentary is definitely a (small) part of it.
    So my concerns are not as much about “widows and orphans losing their shirt in Health 2.0 IPOs”, but about a lot of privately made decisions, which are just as critical. Surprising as this might be, many people responsible for such decisions often get very poor advice. One of my lines of business has to do with solving this problem. Those familiar with tech analyst world know the difference between firms that focus on “buyers” (like Gartner) and “vendors” (like Aberdeen). QED.
    Please do not put words in my mouth. I never said you are “on the take” or questioned your motivations – the way you habitually go “ad hominem” when you run out of arguments. I am not privy to your financials and could not care less. I am not even interested in answering each of your points here – any outside observer should just consider who has “buy-side” vs. “sell-side” perspective.
    For what it is worth, attending your conference might be an educational experience for many people, as long as they put it in perspective. At the very least I am sure the speaker lineup is awesome, the production value is great and the parties are fun. Kudos!
    Returning back to my undisclosed location…

  17. I’m not ashamed to say that I have lost patience with Dmitriy. In public and in private he has stated consistently to me that a) my analysis is inconsistent, and b) that I am on the take–writing not what I think but what I am paid to write without disclosing the same.
    Of course he never has any evidence of any such thing, because it’s not true. I’ve been prepared to humor him over the years–even linking to his cynicism from the FAQ section of the Health 2.0 Conference site. But this mornings post on his site went over the line, and I feel no need not to respond in kind.
    My statements about Revolution have been completely consistent over the years–(a decent effort, but too diffuse and wrongly named). You can see them on Joe Paduda’s blog , in interviews (e.g. in MDNG, and elsewhere). Ditto has my assessment of Health 2.0, which is clearly stated in my post.
    In his comments above Dmitriy apparently agrees with me. He says “Never did I say that new technologies in online health are not going to have huge impact. Or that there will be no new Amazons, eBays and Yahoos. Nor does it mean that new technologies will not be adopted by mainstream healthcare organizations, as it is happening at a rapid clip. There is plenty of evidence that the major changes are here to stay – as I have said time and again.”
    Pretty odd to call “major changes” “being adopted at a rapid clip” a bunch of “hype” and “irrational exuberance”
    Dmitriy has consistently been concerned about the widows and orphans losing their shirt in Health 2.0 IPOs as they did in the dotcom phase (ignoring how much mney was made during that time). This is complete bullshit. All investments in Health 2.0 (and most Web 2.0 for that matter) have come from venture capitalists, and “sophisticated” investors, or companies buying.
    The only Health 2.0 company that comes close to fitting the term which has IPOed is AthenaHealth–which shows good growth and strong profit growth. Completely the opposite of the dotcom boom when companies with no profits and in some cases no revenue went IPO.
    As it happens, my belief continues to be that the biggest impact of health 2.0 will not be financial for individual tech vendors–although plenty will do well as mainstream health care companies integrate it into their business practices, but it will be the positive health and societal impacts that these tools will have as they get dissemenated on a wider scale.
    If Dmitriy doesn’t believe that there are metrics about that he should Google “David Sobel MD”
    Frankly in terms of his own business, like Gary L, I have no idea what Dmitriy is talking about or how he keeps body and soul together. I know from personal experience that writing a blog is unlikely to do it for him. I know he’s done some consulting for Humana’s online reform project–which FD, has advertised on THCB. I don’t know or care if he’s looked into the many issues that Humana and its fellow plans has had with Medicare Part D plans marketing–maybe he has, but I certainly have on THCB–Google AHIP on this blog and you’ll see. And calling me out for not being prepared to ask the tough questions, fine but I want to see his about his client base.
    But if he really decided to turn his back on a great money-spinning conference business in favor of “actively participating in the marketplace” good luck to him. I assume he’s either motivated by other things than money, or he’s really about to surprise us!

  18. Matt throws a fast ball at Dimitriy and Dimitriy hits it out of the park!!!!
    Running a conference has nothing to do with a measure of how well or how poorly health 2.0 is doing.
    Dimitriy works in an undisclosed location….Matt seems to do his work in public….Two different styles.
    I happen to agree with D.K. about Rev. Health…Case probably will get some or most of his money back.
    He’s done with it, move on to the next money making scheme.
    Matt, I am disappointed in your personal attack on D.K.
    D.K. is not just a “geek” he also is articulate.
    I have never figured out what he ‘really’ does to put bacon on the table.
    GML

  19. Thank you for the ad hominem argument, Matthew.
    While the purpose of my original post was not to point at you specifically, I thought the reference to your assessment of Steve Case three years ago and your subsequent flip-flops on the role of technology in healthcare were very relevant. I apologize if I hit your nerve.
    Way easier to dismiss my argument as “bizarre wofflings”, instead of looking at the facts and metrics to figure out what really works and what does not for these new ventures. What is really new and what is not. You do not have much interest in looking at how things really are, instead of how you want them to be? I have not seen much interest on your part to ask any hard questions. Your coverage of Health 2.0 always reminded me of Lake Wobegon – every project is above average.
    Never did I say that new technologies in online health are not going to have huge impact. Or that there will be no new Amazons, eBays and Yahoos. Nor does it mean that new technologies will not be adopted by mainstream healthcare organizations, as it is happening at a rapid clip. There is plenty of evidence that the major changes are here to stay – as I have said time and again.
    What I have said consistently is that there is a lot “irrational exuberance” around this innovation and by some “coincidence” the least substantiated claims tend to come bundled with the “Health 2.0” term. I understand not everyone remembers “1.0” business cycle, but back then the similar buzzword was “dotcom”. The term became symbol of excesses and created a lot of confusion, distraction and ultimately financial losses for most marketplace participants. While the underlying technology trends were as solid then as they are now, I think there is the same pattern of setting expectations a bit too high – bound to disappoint.
    Since everyone gets to put forward their own definition of Health 2.0, I did that too in my post. My point is that true Internet health innovations, do not need a “buzzword crutch” and should be able to prove themselves on their own. There are quite a few companies, including startups, that are doing just that. Lumping them in the same pile with those that are relying on hype is a disservice to true innovators.
    Funny that you question my background as a software geek as irrelevant when we are talking about changes in healthcare, brought about by technology. What you should ask yourself is if you need to get some basic education to understand the metrics involved in creating Internet driven businesses. While there are many interesting and unique approaches specific to healthcare, everything still comes down to how many people are engaging with your service, how often they do it and how well are you monetizing these interactions to return on your investment. Not much of this sort of analysis has appeared in your productions. The exception is your frequent referencing of highly summarized data (e.g. ComScore’s +20%) which often masks the truly important trends that happen on micro level. What is the top pet peeve of venture capitalists? Entrepreneurs who say “the market is $10 billion and we only need to get 1%”. Most of such “analysis” is completely out of touch with real specifics of what it takes to succeed. The only metrics that count are built bottom-up. Where are they for “Health 2.0”?
    Finally, I am kind of getting a kick out of your references to my “failed conference” and “professional jealousy”. Indeed, my conference has not drawn as large crowds as yours, but they had a lot of differences, including different subject matter, different timing and different standards. While I pulled the plug on the Healthcare Blogging Summits, I also passed on several new opportunities to do more conferences. Why? Because conference production is not a line of business where technology and Internet are central. Producing conferences is very different from actually participating in the marketplace. So I made the decision where to focus. Most of my new projects, by the way are not for public announcement.
    As to the final tally of who is right and who is wrong, let’s wait for the marketplace to sort everything out. Revolution Health outcome is just one of the datapoints. Surely enough we will have more soon – The Good, The Bad and The Ugly. The wheat and the chaff will get separated as people start asking questions.
    And if you are a 3rd party without a horse in the race, consider that early warnings can save a lot of pain later. Just ask Lehman shareholders.

  20. So much venom … don’t beat up on poor Dmitriy. Whoever he is (and I did not hear of this feud before), his post was not as personal as this one.

  21. For many of us, Revolution Health was doomed from the beginning since it never paid attention to the needs of patients and health seekers.
    Using its demise as a proof that Health 2.0 companies are all fluff seems like the regular method of the person refuting the reality of the wisdom of crowds.
    Dinosaurs Unite!

  22. As many bloggers know, it is much easier to write provocatively about failure than success. A) There is lots to pick from B) They lend themselves to catchy phrases and sarcasm…not to mention the natural tendency of news to be “bad news”.

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