Health 2.0: Innovation, Obstacles, and Opportunities

We live in an era of great technological innovation and advancement that has pervaded almost every aspect of our lives—except health care. That was the opening message of this morning’s keynote speech at the Health 2.0 conference in San Francisco delivered by Mark Smith, MD, president and CEO of the California Healthcare Foundation. Smith went on to explain, however, that the innovators at the conference have a prime opportunity to help make health care more affordable and accessible, provided that they go about it in the right way.

Over the last few decades, Smith reminded the audience of 1,500, personal banking has gone from tellers to ATMs to online banking, travel from travel agents to online search portals, and research from books and card catalogs to Google. Yet during the same period, medical consultation has remained essentially the same: the doctor and the patient in the doctor’s office. “We don’t do anything the way we did it 15 years ago except go to the doctor,” Smith pointed out.

Many of the innovators at the conference, Smith said, have the opportunity to help bring health care information technology into the 21st century and in the process make health care more accessible and affordable. He added that health care reform has set the stage for the implementation of Health 2.0 innovations, yet a number of obstacles remain.

The main problem, he explained, is that the health care system is not set up to propagate the advances that the Health 2.0 community is making. To illustrate this problem, he pointed to a program in which Kaiser Permanente established EHRs for patients in Hawaii and found that patient satisfaction went up and doctor’s visits were reduced by 21%. An excellent result from a patient perspective, but the typical health care business model involves payment by the doctor’s visit, so reducing the number of visits is seen as a disaster in many quarters.

Another problem with technological innovation in health care is that successful pilot programs often fail to get the support they need to be implemented on a wider scale. To assist in this process, Smith explained that his foundation has launched an innovation fund to help bring these pilot projects to market. “We are interested in trying to stimulate innovations that can get some market traction,” he said. “The graveyard of health care innovation is littered with projects that never got market traction.”

A third problem is that cost-saving measures are often cost-shifting measures and, even when costs are reduced overall, those who have to make an investment to implement them tend not to be the ones who will ultimately save.

For those who aim to successfully implement Health 2.0 innovations, Smith offered four tips. First, keep in mind whose money is going to be saved by them. Second, given how inconvenient the health care system tends to be for patients and their families, if you can make it more convenient for them, you are likely to get better buy in. (As an example, he pointed out that Kaiser Permanente runs ads during Oakland A’s games telling patients that they can e-mail their doctors.) Third, find ways to speed up assimilation of existing data by health care providers. (As an example, he pointed out that it has been over a century since the establishment of the germ theory of disease, yet we still have trouble getting providers to wash their hands.) Fourth, with tens of millions of the uninsured set to become eligible for insurance in 2014, finding a way to make it as easy as possible for them to sign up is a great challenge and opportunity.

Perhaps a bit on the lighter side, the Health 2.0 unofficial kickoff took place last evening, when attendees gathered at the "Doctors 2.0" track to discuss a variety of HIT topics. One of the more entertaining aspects of this track was when moderator Dr. Enoch Choi chose a rather creative way to voice his displeasure with electronic medical records, as seen below.