This article in Government Health IT by Brian Robertson is a reasonably good description of the basics behind Health care 2.0. It doesn’t really feature much in the way of actual Health2.0 players other than Revolutions, but it does interview the guy who runs the Health2.0 wiki, Johannes Ernst, who is a leader in the Health2.0 movement (even though he’s more of a general techie than a health care guy).

Oh and I just noticed that Tony Chen has a rather better rundown of Health2.0 companies on his site —Hospital
impact – Consumer’s Guide to the top Healthcare 2.0 websites.

The AHRQ’s report on its monitored eRx pilots is out. Here are the findings that I’ve extracted from their slightly longer list in the exec sum. 

In addition to testing the functionality of e-prescribing standards, pilot sites tracked various outcomes of e-prescribing in their pilots. The following observations were made by the evaluation team:§ Prescriber uptake and satisfaction. Adoption and retention of e-prescribing among providers was generally good. In order to facilitate prescriber adoption, the evaluation team recommends institutions implementing e-prescribing take into account the role of their organizational culture and prepare for possible “surrogate prescribing” (see below).§ Prescriber and pharmacy workflow changes. One finding that was consistent across all sites was that prescribers’ staff played a much more important role in the e-prescribing process than most pilot sites had anticipated. The evaluation team recommends that future e-prescribing efforts take the role of these staff, or “surrogate prescribers” into account in their planning. Another finding was that e-prescribing almost never replaced the need for paper-based prescribing, leading to highly variable use of e-prescribing features. In addition, implementation of e-prescribing can create dramatic “paradigm shifts” in pharmacy workflow. Pharmacies implementing e-prescribing, therefore, must allocate sufficient resources to deal with substantial change management. Finally, preliminary findings suggest that e-prescribing tools may decrease reliance on verbal orders and generate certain efficiencies for small physician offices. Proof of such efficiencies is still relatively preliminary, however.§ Changes in number of callbacks from pharmacy to prescribers. Findings reported by some pilots suggest that e-prescribing reduces the number of phone time for physician practices while potentially decreasing efficiency on (Sic—I assume they mean “in”) the pharmacy through an increase in the number of callbacks required to complete a prescription. Yet other pilots found a decrease in callbacks related specifically to drug coverage issues. Given these inconsistencies, the evaluation team recommends that further study is required to acquire a more complete understanding of this potentially “cost-shifting” phenomenon. § Use of Medication History functions. Overall, the pilots’ findings demonstrated poor adoption of this functionality. We recommend further research to determine better ways for displaying and maintaining up-to-date medication histories to providers.§ Changes in prescription renewal and new prescription rates. The long term care site reported a reduction in new prescription rates, indicating the possibility that e-prescribing may reduce the tendency for such patients to accumulate unnecessary active medications.§ Use of on-formulary medications and generics. Clinicians surveyed by the pilots were concerned about the accuracy of formulary information provided by e-prescribing systems. Further studies will need to assess the perceived and actual quality of this information. In addition, generic prescribing that automatically allow for generic substitution may increase the rate of generic prescribing.§ Change in fill status rates. Fill status use was extremely limited due to the difficult implementation of this standard.

More comment later, but the issue of pharmacy workflow is clearly a major problem—especially if call backs from the pharmacy increased after eRx was implemented.

Sermo, the physician community site, seems to really be on a roll. I can now tell you what CEO Daniel Palestrand told me a few weeks back.

1) They’ve got 10,000 physicians registered–and there’s a lot of use on the site. Consider that there are only 600K active physicians in the US, and the average physician survey done by market research tends to have fewer than 100 doctors in it.

2) They’re taking aim squarely at Gerson Lehman and the other physician introduction “dating-agencies” which service Wall Street.  Essentially they’re allowing their customers to get a view about what physicians are seeing and discussing, and the physicians seem to like it—and don’t seem to want much if any money for their time.

Part of the reason the physician users like it, is that the UI and web tools they’ve put together are really neat. I would love it if Six Apart could knock those off and then my blog users could see things like where they’d commented, who’d commented on their comments. what the most active posts are, etc, etc. Perhaps Sermo should go into the blog hosting business?

Just kidding—I think they have bigger fish to fry.

What really surprises me is that although there are patient social networking sites popping up daily, I see no one else seriously going after physicians. Given how valuable physicians are, and the huge amounts dropped on researching into what they think by pharma, investors, health plans, et al, I cannot imagine why there aren’t more competitors.

The prospect of Revolution Health’s official launch (it’s actually up already but is relaunching this Thursday) has generated favorable press in the NY Times for Steve Case and crew. Milt Freudenheim’s done his homework, mostly. He essentially says that the pack of contenders includes Revolution, WebMD, Google (although nothing official announced from them yet–stay tuned), Yahoo, About.com (a sop I think to the NYTimes corporate sister) and the big health plans. He talks a bit about the limited use thus far of PHRs (no surprise there other than not mentioning why they might grow). The only surprising thing is that there’s another potential competitor of Google, Revolution et al that has plenty of money, a decent track record in software, a significant online network, and has just bought a health care search engine—But Milt never mentions the boys (and girls) from Redmond. Methinks that there’ll be some shouting from them before the large lady chants.

My only complaint is that Revolution’s board is made up of a bunch of rich people who haven’t exactly covered themselves in glory in their recent business (or political) ventures including it must be said Steve Case himself—(other than the brilliant move of selling AOL at a hugely inflated price to the buffoons at Time Warner). But it doesn’t mention their management team which is pretty steeped in health care and technology and pretty smart. If I was interested in gauging Revolution’s success I’d think that they’re more important than what, say, Carly Fiorina thinks. But she’s got $21m more than most of us…