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DEMO PANEL & Discussion: Search in Healthcare

Tom Eng, President & Founder, HealiaVenky Harinarayan, CEO, KosmixAlain Rappaport, CEO, Medstory/MicrosoftDean Stephens, President & COO,Healthline NetworksModerator: Jack Barrette, CEO WeGoHealth (ex-Yahoo

Each of the presenters gave a 4 minute demo of their specialized search abilities: gathering together relevant, multi-media information, and then breaking that information down into discrete sub-topics. A key challenge each approach has dealt with in a different way is helping the searcher weight, narrow and make sense of the findings.

Most have developed advanced algorithms that work better with natural language, and that rank results by probabilities and incidence. By identifying searcher characteristics and responding in kind, these tools increasingiy also allow searchers to be aggregated into social groups.

Questions:

How likely is one of these health vertical search players to take meaningful market share from "the major?""Not Very Likely" came in first at 47%, followed by 32% voting "Pretty Likely."

Which search engine gave the most useful results? Praxeon came in first, but the first four were relatively even. Kosmix received the lowest response.

One of the challenges that specialized search engines face is the development of profile in the consciousnesses of consumers who use them relatively infrequently. They must find ways to exist alongside the majors, who have strong search capabilities but cannot, by definition, be nearly as nuanced.

One questioned called the panelists to task for not accessing the growing (and, presumably, increasing valuable) mass of user-generated health care content.

One response said that this was a work in progress, and would undoubtedly increase over time. But another respondent noted that, at this time, the search engines should rightly be focused on identifying evidence-based information first, with commentary secondary.

Superb discussion on a very challenging and increasingly sophisticated topic!

David Brailer

Will Web 2.0 play in health care?

The people who are of the Health 2.0 population do not overlap with the health care user population…yet.

Health 2.0 gives a voice and leverage to the people who need health care. Tech needs to exist inside the context of relationships, but those may be accelerated as patients, providers and the industry more capably relat to one another.

In 2007-8, we’ll see the shakeout in the health tech industry.

A marvelously succinct and insightful presentation!

Opening Panel: The Role of the Consumer Aggregators

Missy Krasner, Product Marketing Manager, GoogleWayne T. Gattinella, CEO, WebMD Health Corp.Peter Neupert, VP Health Solutions Group MicrosoftBonnie Becker, Director, Health Category, Yahoo!    Moderator: Jane Sarasohn-Kahn, THINK-Health

Jane introduced the session, pointing out the 4 panelists firms’ capitalization is somewhere in the neighborhood of a half trillion dollars.

The goal is to first create a highly trusted brand. That’s the predicate to be able to leverage in health care the assets that each of these major firms have accumulated elsewhere.

Defining the business model is one of the problems that must be solved to deliver on the promise of personalized medicine.

How do we make "data liquidity" happen.

People trust themselves to make decisions given a sufficient quantity of trusted information.

People trust well-known, credible organizations as information sources, but they need a coach to sift through the information.

While the panelists have focused primarily on search, the audience wanted to know what else is coming down the pike They panelists responded that search will continue to increase in relevance, but will also drive a lot of the social networking functions.

One audience question asked whether physicians are marginalized by Web-empowered patients. The panelists appear to agree that, in contrast to the early days of Internet-based health information, doctors are increasingly receptive and supportive of that health information. This is part of an ongoing dialectic of the convergence of professional and consumer information and interests.

Esther Dyson (thankfully) asked the panel to describe their business models for Health 2.0.

Missy said that Google does not aspire to be a health care company, but rather extend their reach as a firm that helps people manage information. They use very small project groups. Their goal is always to drive more search, since that’s where they make their money.

Missy commented that "data liquidity" is a great term, but that health care currently has too many standards and that the real goals of data liquidity are at least a couple years away. The other panelists generally agreed. They avoided in-depth discussions of how data might be brought together to create multi-layered patient records and decision support tools for patients, clinicians, vendors and purchasers, and it wasn’t clear whether this was coyness or simply a lack of progress in this direction.

One questioner asked whether "the majors" shouldn’t show the leadership to bring data together and define the standards.

Peter responded that the question is how to bring the source data providers together and use that information to enable decision making for consumers. He believes that technology + information + communication has the promise to impacting behavior.

Introductions to the Health 2.0 Conference – Matthew Holt/Indu Sabaiya

After a spectacular opening video by Scribe Media on the history and current trends in medicine and health care, Matt and Indu made the introductions. They met and conceived the idea of the Health 2.0 meeting just last December. It’s all come together since then.

This is an international meeting, with representatives from all over the world, and one that has attracted a large of marquis and just emerging sponsors. Not bad, noted Mattthew, for a consultant and a guy who writes a blog while sitting in his pajamas.What the Hell is Health 2.0? – MatthewThe frame for this question is "What the hell is Web 2.0?"

    – Personalized search that finds the right answer for the long tail.

    – Better presentation of integrated data.
   

    – Communities that capture the accumulated knowledge of patients and caregivers; and clinicians

    – Intelligent tools for content delivery.

In health care, transparency and consumerism are important foundations of any effort. In addition, Health 2.0 is a way of linking content with transactions, with more productive results.A Continuum of Health 2.0 – Its Present and PotentialUser generated health care goes toUsers connect to providers, which goes to Partnerships to reform delivery, which goes toData drives discovery.

Finally, Matthew asked the audience who would win the Presidential election.

Hillary Clinton won handily with 35% of the vote.

Welcome To the Health 2.0 Meeting – Brian Klepper

Good morning. I’m here at the SF Hilton, where the Health 2.0 meeting should begin in about a half hour. Last night I wrote my thoughts on the meeting over at The Doctor Weighs In. Throughout the day I’ll do my best to describe the goings-on here at each session. Matthew and Indu are looking just the slightest bit haggard but genuinely energized, and there’s a wonderful spirit of innovation, comradeship and anticipation in the room. It should be a terrific day. Stay tuned.

POLITICS: Liveblogging Hillary, by Amanda Goltz

Hillary Clinton did a live webcast on Tuesday night. Given what’s happening in less than 36 hours I was way too busy to watch it. But luckily for me and for you Amanda Goltz who works for a certain large hospital system in Boston was there to blog it for us. Thanks Amanda! And despite this being her first post Amanda seems to have got the cynical style we like at THCB down very quickly!

8:00 PM:  Right on time, Senator Clinton welcomes us to her webcast, where she will answer questions she has received in the past two days since she announced her plan. She tells me I can submit a question if I like, but somehow I don’t think she’ll be taking the on-the-fly submissions. 

8:12 PM:  Nothing that deviates from what she said when announcing the plan on Monday. She is going after private insurers and pharma, who may not be angels, but are not the only blot on an otherwise perfect healthcare system. She also just said something about putting doctors back in charge of your healthcare, which doesn’t even sound that good, when you think about it. I know she meant “as opposed to payers,” but I don’t want my doctor in charge of my healthcare. *I* want to be in charge of my healthcare. Especially since in the next answer she essentially announces that fat smokers will be required to take better care of themselves. It could be just a cliché or campaign saying, but it would have flown better if she had put the patient (or, “ordinary Americans like you and me”) in the middle of her new plan, not the doctor. 

8:16 PM:  Now she’s talking about the EMR’s magical ability to reduce waste and administrative costs. I wonder how an EMR is going to save $70B a year in administrative costs if no doctor uses it. The latest numbers show that only 25% of physicians in the US use an EMR, even with a number of robust solutions that have been on the market for more than a decade

8:18 PM:  She has gumption, though. She just said "I will inherit two wars: the war in Iraq and the war in Afghanistan." No "if I am elected," no "if I am in office," no "when I am in office."  Oh! And she just said "as soon as I am elected President." Evidently the primary process has already happened and we missed it and Hillary is the nominee. (By the way, she is talking exclusively about the war now.  Evidently, healthcare is so depressingly messed up it is easier to talk about the morass that is Iraq.)

8:22 PM:  Now she is talking about bolstering the VA, which is all very well and good, but it highlights the total disconnect you must sustain when proposing progressive healthcare policies.  You can’t EVER talk about anything that has a whiff of national, public, single-payor care; but you can and should talk all you want about providing exactly that model to specific (very large) populations, like the armed forces and veterans. The VA is huge now and is going to grow a lot in the coming years as the troops return from Iraq and Afghanistan with TBI, mental health issues, and a whole host of other stuff we’re going to need cutting-edge medicine to deal with.

8:25 PM:  She just said the forbidden "universal" word. She was talking about access to mammograms, which is pretty mom-and-apple-pie, but still. I wonder if she struggles not to fall into 1994 speech patterns of talking about healthcare, even though this plan is quite different. Maybe it’s enough that she is preserving the insurance model. I know this has been discussed here as a shortcoming  but it is so obviously a political accommodation I can’t find it in my heart to be surprised. She is making no change to health insurance as a concept, and it will still be administered privately.  She is essentially insuring the 47 million uninsured by pulling them onto the federal employees’ plans, with a range of products.  It’s more or less just a fix to the uninsured issue, so that’s why her use of “universal” struck me as unnecessary strapping on a big bulls-eye and asking someone to take a shot, especially when this isn’t really universal healthcare at all – you still have to buy it.

8:30 PM: She ends by saying "this is a uniquely American solution to the healthcare problem" (so I guess she is implying that this is not that commie pinko European Canadian healthcare.)  Topics she did not cover: improving quality and preventing medical errors; eliminating unwarranted variation in healthcare practice; bolstering Medicare in the face of the baby boomer retirement wave; price or quality transparency, pay for performance, what happens to Medicaid in her plan.

HEALTH 2.0: Sept 19 pre-ConferenceGet Together(s)

If you’re in San Francisco for Health2.0 Bob Coffield is organizing a Health 2.0: Sept 19 Get Together.

There’s also a speakers/sponsors party (which is different to Bob’s get together) at the same time. If you’ve been invited to that (and you know who you are) the venue has been changed. Please check your email or email *******@***il.com“>Indu Subaiya for information on that.

Meanwhile, expect some special surprises at the post conference wine and cheese party!

Finally, the real party is going on at the Health2.0: User-Generated Healthcare Facebook group. Go there to meet other “Health2ers”. There are over 160 members and counting, and it’s the best way to network before and after the conference.

POLICY: Edwards copies my idea, and a damn good one it is too!

For a very long time I’ve been saying that the quickest way to get effective health care reform would be to kick Congress out of the FEBHP and make them all buy their care in the  individual market. Well in his reaction to Hillary’s plan announced yesterday, John Edwards has stolen my idea.

Mr. Edwards, in remarks earlier today in Chicago, added a new proposal
to his plan: He said that as president he would press legislation that
ends health care coverage for the president, members of Congress and
political appointees on July 20, 2009, until the Congress passes the
Edwards health care plan.

This is the most impressive thing Edwards has ever said. I wonder if we can extend this legislation to include certain Wharton professors and employees of certain right-wing think tanks?

As for Hillary.  She promised to bash insurers, and like the rest of the Democrats she wants to ban underwriting. Well here’s her plan. I’m not sure that there’s much in place in her plan to regulate insurers…although she may prove me wrong. Meanwhile I’m inclined to agree with Michael Cannon. This is pretty similar to Romneycare, although Mitt doesn’t want to admit to what he did in Massachusetts anymore, and Hillary does have the other wrinkle of extending FEBHP to the uninsured, and offering tax credits/subsidies with an individual mandate.

But essentially she’s hoping that this can be pushed through in compromise a la Massachusetts. The sensible moderates will wonder why she wants to strengthen the anachronism of employer-based health insurance, without putting a risk adjusting body in place. The right will say she’s extending FEBHP to all via the  back door (much as Edwards is trying to semi-explicitly do with Medicare), and that eventually the tax credits and subsidies will lead to a government take-over (whatever the hell that means). And the left will wonder why she’s leaving the insurance companies in place at all.

My sense is that unless we convince Congress how bad things are via some innovative technique like mine or Edwards’, not much will happen for a few more years. Any worthwhile health care reform plan is too complex and too easily smeared to pass Congress unless the wolf is not only at the door but eating the children in the living room.

HEALTH2.0: More on the conference, and the Google situation

Health 2.0 is officially sold out. However, if you
still want to come there is a chance that we will be able make room for
you, as cancellations and other changes open up spots. You can still register on our waiting list. We’ll get back to you as soon as possible — although we may not be able to tell you anything until early next week.
This will also (hint, hint) put you on the list to be notified when spots become
available for the next Health 2.0, tentatively scheduled for the first
quarter of 2008. Meanwhile, to receive updates on conference developments please sign up for our newsletter.

Peerclip_logo
Also, a big welcome (cue applause) is due to HEALTH 2.0’s latest charter sponsor. PeerClip hasn’t launched yet, but you can go take a sneak peak at what they are up to on their site. What exactly are they about? The mystery will be answered soon! Stay tuned to THCB for more details.

DVD  boxed set

Meanwhile, if you can’t make it to Health 2.0 but want to catch all the action or share the Health 2.0 experience with your colleagues, we will be making a DVD set available shortly after September 20th. To  reserve your set, please email in**@********on.com with "DVD boxed set" in your subject line. Full details will be provided.

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