American Well, an ambitious startup designed to provide virtual health/medical transactions between patients and doctors, has been invited to present its product overview in a thoroughgoing way–a deep dive, in Health 2.0 patois.

In this liveblog, I need to control the depth, of course. I’ll try to boil this into five (5) key points about American Well:

1. Unlike other industries, health so far hasn’t succeeded in doing transactions (Amazon, Expedia, eBay, etc.) on line. Imagine Expedia if, instead of buying a ticket, all you got was a picture of your plane. What’s missing? In health, it’s the real care transaction.

2. American Wellness is essentially a brokerage system for online wellness services–real services, not just information. Connecting consumers with providers and, as important, the money–which is to say insurance reimbursement systems. Patients, docs, money, all tied together.

3. Consumers can access specialists, from anywhere, for a fee. Their calls, e-mails, etc. are aggregated and distributed to the appropriate specialists in real time.

[The liveblogger anticipates the big question: How does this provide continuity of care?

And the answer comes immediately–the AW marketplace delivers only specialists, not a primary care doctor. The tradeoff of getting someone with whom there is no existing relationship to have immediate access to care. ]

4. What’s the transaction like? The demo shows a consumer’s entry into the system. [The interface is very clean–you can tell they usability tested this really well.] First, consumer looks for a doctor. [PowerPoint slide joke: Doctor profile that comes up is an OB whose name is given as Otto Matic.]

Doctors presented with bios, videos, etc. Ratings? Yes, but not clinical ratings. Just consumer satisfaction ratings. [Needless to say, this is one of many services attempting to aggregate patient evaluations of doctors.]

Part of summary is–price transparency! The cost of the anticipated consult is listed. Patients can fill in their health background to let docs understand the situation more fully. Then doctors, in real time, review request and decide if it’s appropriate that they take it on.

Then: When patient and doctor both agree to a clinical encounter online, an interactive console pops up –the interaction can be live video via webcam, live  audio or typing chat, on-screen notes and documents, etc. Lab information, with patient permission, can be added. While it’s a virtual interaction, it’s a rich-media virtual encounter.

5. And the consumer’s regular doctor? Patient can send doctor report of entire transaction.

[The liveblogger’s question: What will the patients’ internists have to say about this?]

Other point: Insurer AIG has developed a new malpractice insurance product–per transaction, not annual. It’s embedded in the service.

Will this save money in healthcare? AW argues that by providing some care in the home, and keeping some transactions at lower cost, insurers, payers and patients can save money. This can keep people out of the ER, maybe.

The AW plan–essentially disconnecting care from a physical location–raises all kinds of questions not dealt with, even in this deep dive: Privacy? Coordination of care? How to deliver service of real value without risking misdiagnosis, etc. How will insurers ultimately reimburse this care? How different/better/worse will this be compared to in-store retail clinics? What conditions or situations is this kind of virtual care best suited to?

And finally, when will this launch? In 2008, CEO Roy Schoenberg, MD assures us.

So Indu is on stage, introducing the Health 2.0 "Unconference"–user-led
discussions around tables, all happening at the same time. Whoever
submitted a topic gets to "hold court" at a table.

So you are reading The Health Care Blog’s liveblog of an Unconference. This is so front-edge, high-wire techno-virtual I think I may get a nosebleed. 

Enoch Choi, a very 2.0 physician and veteran leader of
unconferences, is leading the show. "Very reality TV"–if you’re bored,
pick up and go to a table that’s more interesting. Topics are being
submitted as we speak.

• Enoch is giving out topics
• Social media and pharma!
• Genomics!
• Extending patient-physician relationship!
• The future of alternative sales channels in pharma!
• Increasing patient engagement!

I’m using exclamation points, but we’ll see how exciting these topics
actually turn out to be. People are finding tables now. We’ll see how
many wind up bolting–and what precisely the I’m-leaving-your-table
etiquette is.

***********

The biggest crowd, curiously enough, is at the table discussing "information overload." David Sobel holds court. Interesting point: More information actually "disempowers" people due to confusion and excess. Information is not always power. It’s often annoyance, noise, even harmful.

*********Over at the table of the estimable Esther Dyson, there’s a hand-written sign "The Impact of Genomics Info." This is heady stuff: one discussant talks about the sensitivity of an individual’s genomic information, and that the system isn’t prepared for dealing with that.

"And doctors," it’s pointed out, "are not trained in genetic medicine."

Benjain Heyward of PatientsLikeMe seconds the motion: Doctors aren’t set up to deal with the information that patients often want about their genetic risks, etc.

******

BIG crowd over at the Pharma-and-social-networking table. Great point made: "What would pharma have to gain from trying to create and own their own social network?"

If you’re a patient with Crohn’s, it’s asked, where are you going to go to find support? A forum run by a drug company? Or one with more independence and credibility.

Something called GroupLoop is mentioned. It’s described as a network that has the ability to become a "cross between MySpace and health." We’ll have to check that one out.