My Talk on "Health 2.0" for the 5th Annual Healthcare M&A and Corporate Development Conference

This is the talk I gave at the 5th Annual Healthcare Mergers and Acquisitions (M&A) and Corporate Development Conference on September 24, 2007. I was part of a panel titled "Healthcare 2.0: Technology & Healthcare Services of the Future," and we were asked to talk about disruptive changes in healthcare.

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Good afternoon.

I'm a bit out of my element here, because I'm a practicing kidney and blood pressure specialist in New York City, but I do have a lot of friends and patients on Wall Street.

I'm going to talk briefly about the disruptive potential of online communities of physicians and patients.

These online communities are an big part of what people have called "Health 2.0." Of course, this is just a buzzword, like "Web 2.0," but it's a buzzword that means something.

Early this month the Economist had an article about Health 2.0, which they defined as "user generated healthcare." In Health 2.0 communities, the content and value is not generated by outside experts, but by the users themselves, by healthcare providers and patients, who interact to share information and insights.

These online communities may be very different from one another -- and I'll give you some examples of them in a minute -- but they all have a couple of things in common: they're all public, collaborative, and simple to use. And this combination can be very powerful and disruptive.

For example, there's a website called Wikipedia which is perhaps the best example of a community that's a major source of health information for a lot of people. If you haven't seen it, Wikipedia is a free online version of an encyclopedia that anyone in the world with an internet connection can read and edit. I'll say that again -- anyone in the world can read it and edit it.

This idea seemed crazy at first and still seems kind of crazy, but it actually seems to work. Wikipedia is now 15 times as large as the entire Encyclopedia Britannica. And partly because of Wikipedia, very few people read the Encyclopedia Britannica anymore.

And what's written on Wikipedia definitely matters. Wikipedia is one of the top ten websites worldwide. Wikipedia is often one of the first places people go if they're diagnosed with a new disease, or if they want to research a person or a corporation. The definitions on Wikipedia are often near the top of any Google search.

But again, it's amazing that Wikipedia works at all, because anyone with an internet connection can change any of the definitions. And that's potentially very scary.

But the system works because it's self policing -- errors are picked up and changed by the users. But of course that still leaves some potential for significant inaccuracies and abuse.

[The author Charles Stross points out that if you extrapolate from current trends in computing, sooner or later everyone in this room will have an entry on Wikipedia. Try to imagine what they might be like.]

I'm going to talk about some other Health 2.0 communities that have the potential to be as disruptive as Wikipedia.

For example, there's an online community for physicians called Sermo. Sermo was founded on the idea of information arbitrage, that there's valuable information locked in the heads of physicians, if you could only figure out a way to get to it.

The way Sermo works is this: physicians ask and answer anonymous questions, but some of the questions are also asked by firms. When physicians answer some of these questions, they get paid, but they don't know which questions will pay them. So the incentive is to answer as many questions as possible. Sermo is basically an experiment in classical conditioning, it mines physicians for information by turning them into compulsive gamblers and taking advantage of their desire to collaborate. And it works very well.

It's only about a year old but Sermo is the largest online network of physicians that's ever existed. Sermo is also partnering with the AMA and the FDA, who are interested in information from Sermo about the safety of medical products. Sermo may actually be a better way to encourage physicians to report problems with drugs and devices than the FDA's own website.

There are also many online communities for patients, including sites with names like Organized Wisdom, Revolution Health, and Patients Like Me. These sites offer a number of services. They function as support groups for people whose physicians may not know enough about their disease or who don't have the time to explain it. They also allow patients to share their collective insights with one another. And they allow them to rate different sources of health information on the web. Some people like to use the phrase that "people are the new algorithm."

And some of these sites also allow patients to rate their doctors, health systems, and health products. And this is potentially disruptive, but not necessarily in a bad way. If people can search on Google for a review of your organization as easily as they can search for a review of a toaster, that can be a powerful incentive to change for the better. But as with Wikipedia, there's obviously a potential for inaccuracy and abuse.

And finally, there's also thriving community of medical blogs, which are online interactive journals written by patients, physicians, and other health care professionals. Many healthcare blogs contain hidden gems of information. And there's a sustained level of discussion on blogs that's hard to find anywhere else.

For example, there's a blog called "Kevin, MD" which collects all the most interesting stories in the media in one place. There's a blog called "Running a Hospital" by the CEO of Beth Israel Deaconess in Boston. And the Wall Street Journal even now has it's own excellent Health Care Blog, which I recommend to anyone interested in the business of healthcare. And the interactive nature of blogs is essential, because sometimes the comments can be more interesting than the original posts themselves.

To summarize: technologies like Wikipedia, blogs, and online communities have the potential to dramatically change and improve communication in the healthcare industry.

Thank you.