By JOHN MOORE

Another year, another Health 2.0 under the belt. This being the fourth time attending it is interesting to see how this event and its participants have evolved. Like many things in life, some things at Health 2.0 have changed, some have not, most for the better, but there remain some troubling aspects to this event that cannot be ignored.

When thinking back on the demos of countless vendors of years’ past, this year’s Health 2.0 had two distinguishing characteristics:

Demos are cleaner, with better user interfaces (UI).

The companies demoing at Health 2.0 are spending a lot more time and resources on creating inviting, clean and engaging interfaces that are a welcome change from the cluttered messes of demos past.

As with Mark Twain’s famous quote: “I would have written you a shorter letter if I had the time.” reducing an application to its core elements takes time. Clearly, the majority of Health 2.0 vendors this year have spent the time and resources necessary to create a simple and engaging environment for the end user.

Business models are more sophisticated.

At the first Health 2.0 event, just about every single vendor there stated that their business model was going to be based on some mix of Freemium and advertising revenue. Needless to say, just about every Health 2.0 start-up from that conference has either gone out of business, is among the walking dead (takes a lot to completely kill a company – trust me, I’ve been there) or has changed their model to survive. This year, the business models presented are more creative and for some, likely to see success in the market.

The contributing factor to these two changes is the amount of money now flowing into the health IT sector. Investors smell opportunity and are placing some pretty big bets as represented by the investments in Castlight (~$80M), ZocDoc ($50M) and CareCloud, who announced a $20M round at the event. That’s some serious cash and with all the investors that were present at this event, quite sure there are more investments in the wings.

Snap-shot impressions of demos:

• Mobile remains hot but no one seems to have figured out a way to rise above the noise.
• Big data is the new hot phrase but few understand its implications. Most demos simply demonstrated even more fractionation of data into distinct silos with no clear path towards aggregation.
• Many see the key to success as becoming the facebook of healthcare with a Zynga Farmville thrown in for good measure. By the end of two days, just about ready to strangle the next demo that started with some reference to facebook and/or gamification.
• Pricing transparency is a big area of focus for many but seriously doubt most will get past their first round of angel funding as this is already a competitive market. Speaking of which, almost as frustrating as short vacuous demos is the lack of clear arguments by those giving these demos as to why they’ll succeed.
• Demos never get into details, thus rarely instructive.
• Many platform plays, ala PaaS, but like big data, few truly understand what that means and how to get there.

While Health 2.0 can get overwhelming with the number of rapid fire, albeit  shallow demos from the multitudes of vendors who are all trying to make their mark in a market that has experienced a significant amount of churn, the event is invigorating for the passion that is shown. Sure, everyone is hoping to make a living on their next greatest innovation, but unlike virtually any other health IT related conference, those at Health 2.0 have passion. They are on a mission. They want to truly change healthcare. They want to make a difference. That passion is contagious. Unfortunately, that passion appears to be confined to the digerati.

Looking around at the Health 2.0 audience one sees a sea of almost exclusively upper, middle class professionals that are tapping away on their iPad, smartphone or laptop. When one sits back and thinks about the many demos seen, virtually all of them seem to be designed for this audience. Maybe the most disturbing part of the event was the on-stage interview with a mother of eight kids (she was white, middle age and clearly upper middle class) showing how her family is tapped into the quantified self movement with the various Apps they use to track their health and fitness. This is not representative of the broad swath of the American populace who are the ones that will drive our healthcare system off the proverbial cliff. It is that grandmother in Indiana who is caring for her diabetic, overweight husband, two grandchildren, a daughter suffering from an addiction and a son-in-law who is unemployed and has no health insurance that we need to talk to, have up on stage to tell us what they need to better manage their health and interaction with the healthcare system. And we need not go to that extreme, how about just having someone from a safety-net clinic talk about their needs? Sadly, no such representatives were to be found at Health 2.0.

It is this detachment that has Chilmark most concern with this passionate movement. Yes, virtually all Health 2.0 participants are passionate about helping all healthcare stakeholders but if we do not start talking to a broader cross-section of the populace, this movement may be much like the barricade scene in Les Miserables wherein the students leading the call for a revolution end up dead and with little to show for they had not engaged the populace-at-large. Some may argue that like this technology will indeed trickle down to the masses in much the same way that smartphones are now replacing feature phones in the mobile market. This “trickle-down theory may indeed come to pass but then again, we could just as easily end up with something very similar toPresident Reagan’s trickle-down theory for wealth distribution and we all know what the end result of that has been.