Back to Volume 13
	Health 2.0 By Yan Shikhvarger

Web 2.0 allows massive empowerment of the Internet community to the information it truly wants. The online community now has access to its top trusted sources. This new access is of particular significance in the online space. Patients can connect to other patients and physicians. Physicians can connect to their colleagues and patients. Technology has also created new opportunities from personal health records management to collaborative disease-monitoring groups. These tools will have huge implications on the healthcare system itself, and shift even more power to the online community.

Until now, researching health topics online was very limiting. Web 1.0 (as it can be called now that Web 2.0 has been coined) did not offer much more than simple text on a subject or disease and often a call to action. Even so, it was one of the most popular activities online because it offered a confidential and accessible way to research health.

Something critical was missing from this. Consumers craved the ability to connect to others in similar situations and find information or emotional support. Collaboration and connectivity offered by Web 2.0 technologies filled this gap with tangible solutions such as wikis, blogs, mashups, and social networks. The new players of this world are sites like CarePages, HopeCube, and DailyStrength, all of which are online support networks where patients and caregivers can find relevant groups with enough users already there to make them valuable. In addition to community sites, other emerging players are creating community information-gathering projects on health topics. Wikipedia is one such example and is incredibly influential just because it has such high visibility on search engines. It is likely that a user searching for any disease will encounter Wikipedia’s entry on that topic within the first few search results. OrganizedWisdom is another site with a similar philosophy but focused strictly on health topics. Additional forms of content such as video, animation, and audio can only help make this content easier to absorb.

Some of these sites, such as HopeCube, attempt to also bring together patients and physicians who until now have been segregated in their own communities. The goal of better-educated consumers seems to be important to physicians, as a recent poll found that a majority of doctors (64%) favored “some sort of moratorium on DTC advertising.” With approximately $5B being spent on DTC (direct-to-consumer) advertising annually, there could be more of a shift to better educating consumers.

Many have questioned whether physicians are even online because of their hectic schedules. Market research shows that not only are physicians online but they see the Internet as essential to their career and practice. Recent research shows that:

• The average physician spends 9.1 hrs per week online

• 50% of physicians say that the Internet helps them be more efficient in their practices

Another recent trend for physicians is the joining of peer online communities. The reasons for joining are similar to what has happened on the consumer side — the functionality has evolved to the point where these communities are simple to use and have the critical mass of membership. Networking and connections have a real value here.

So for example, a physician network like Sermo has a usage base of 60,000 users and they come to post news, ask questions, and even emergency requests for community opinion. This is a quickly growing trend. More numbers by Manhattan Research show that physicians are embracing Web 2.0:

•245,000 physicians in the U.S. can currently be defined as a Web 2.0 physician or “a physician who reports to post professional content online or participate in online communities.”

• 203,000 physicians nationally have posted professional content online

• A core group of 60,000 physicians in the U.S. routinely post professional content online

• 80,000 physicians participate in online communities with other physicians

• Another 111,000 physicians are interested in starting to use online communities with other physicians

A hint as to why this is happening may have been picked by a recent RF Insight physician poll. When asked about trusted sources of information, the most popular answer was “a colleague.” This is the key to physician online communities. It is because physicians simply trust other physicians. Therefore, these communities provide physicians an accessible connection to their most trusted source of information. This phenomenon is still recent: In a physician online community identification research project, RFI Studios found that of the 13 identified major Web properties, 8 were launched in the past 12 months.

Web 2.0 can have a larger impact than connecting patients and physicians to the information they want. The presidential election season is here and all of the candidates have been proposing measures to bring down costs of healthcare by using information technology. Barack Obama mentioned that “One out of every four dollars we spend on health care is swallowed up by administrative costs — on needless paperwork and antiquated record-keeping.” The significance of that was mentioned on Hillary Clinton’s website, which quoted a RAND Study that found “[healthcare system] savings to be $77 billion per year. If IT [information technology] impacted the nation’s healthcare system as much as it impacted the wholesale and retail industry — savings could be as high as $346 billion annually…over 15% of health care spending.” A big part of the solution to this could be the tools being developed by technology giants Google and Microsoft.

Microsoft has been working to develop a system that can securely store patient health information such as prescription medications, health histories, and lab results. The system then allows quick access to variety of helpful features such as obtaining health information, setting up reminders, and enabling connections between patients and health advisors. The communication channels that enable this connectivity can be as diverse as mobile phones, text messaging, instant messaging, virtual chat, e-mail and online conferencing.

Google has a similar approach. Google recently unveiled its prototype, Google Health, which allows a user to have a personal health profile. This would include medications, conditions and connect it to drug interaction and even recommended lifestyle information.

Both of these projects offer better access to health information, in addition to reduced paperwork and administrative costs. Despite the obvious appeal, both must also quell patients’ concerns over the issue of privacy. Both Microsoft and Google acknowledge that transitioning patient health records online will be a challenge, and that building patient trust is a priority.

These projects have just launched in May 2008, and it will be interesting to monitor their usage numbers.

How much more could the Web 2.0 health revolution bring? Well, it can even address some of the most dangerous threats to global public health, such as infectious disease and even pandemic threats. The strategy to this has been communicated by Dr. Larry Brilliant during his 2006 TED Prize acceptance speech. The doctor is quite credible in the field of infectious disease and oversaw WHO’s smallpox eradication program in India, which finally eliminated the disease from the world. Dr. Brilliant’s acceptance speech and his wish focused on creating a collaborative disease detection network online. He pointed out that a key to containing infectious disease is “early detection, early response.” Such a network would consist of two main components:

• Automated blog and media monitoring disease surveillance system; and

• A collaborative space that would allow local residents and NGOs to post local info or even text message symptoms into a repository of information

All of this would provide a clearer picture of what is actually happening and where, and therefore lead to a much faster assessment of the situation and a proper response. An early version of this system actually helped to contain the SARS virus in 2003.

Dr. Brilliant is currently the executive director of Google.org, Google’s powerful philanthropic arm that has a commitment of 1% of Google’s equity and profits. A project development in this area by Google. org is a “Predict and Prevent” network that aims to identify hot spots and enable early response. It is worthwhile to note that similar projects already using Web 2.0 technologies are already live on the Web. One such example is FluWikie.com, which is a collaborative project with the aim of providing credible materials and methodologies to prepare for a possible flu pandemic. Another example is WhoIsSick. org. It is a grassroots site, and the founder came up with the concept while in an emergency room, waiting several hours to find out what a stomach pain could have been. The hospital staff finally revealed that there was stomach flu in the area. The resulting thinking was “if only there were a website that had current and local sickness information, maybe we could have avoided the long wait.” The resulting website is a Google Maps mash-up that makes it possible to quickly figure the status of health in a local area.

What is truly incredible is that the tools and functionality of Web 2.0 can have an impact on everything from a basic health information search to keeping the world safer from infectious disease. It can create communities for information sharing and allow various communities to talk to each other and share knowledge. And of course Web 2.0 has produced technologies that allow anyone from an individual to NGOs, GOs and corporations to connect, participate, and collaborate.