Have Health 2.0 Companies Jumped the Shark?

Health 2.0 companies have jumped the shark, although the health care transformation itself has barely begun. How can this be? It’s easy. The money found the space. Over a billion dollars were invested in mobile health applications so far, and that’s only one part of the space covered by what has now evolved into a meet and greet big enough to commandeer the San Francisco Union Square Hilton– the Health2.0 Conference. However, the industry is complex enough to resist even the big money that is trying to change its entrenched practice habits and money flows,

i started attending Health 2.0 in 2005, when Matthew Holt and Indu Subaiya held the first one in San Francisco. There may only have been two dozen companies there, but they were mind-bending because many of them were crowdsourced patient support groups or online health education sites. No mobile apps, no quantified selves. Most of them required nothing more than willing patients hungry for information. They didn’t take on the established players or the enterprise made up of insurance companies, regulators, or hospital empires. They established “work-arounds.”

Most of those early companies (Wellsphere, PatientsLikeMe, DiabetesMine, iGuard) have been acquired or are established now, and the field has been taken over by a whole new crop of entrepreneurs interested in on-demand virtual doctor visits, payment transparency and reform , continuity of care, and employee wellness. Many of these are taking on the system directly, trying to force changes in price transparency, patient/provider collaboration, reimbursement for virtual consultation, practice work flows, and other sacred cows.

I saw a series of interesting attempts today, including
Ringadoc, an after hours call service for primary care doctors; Sense.ly a remote assessment hub for virtual visits with real care that uses visual triage to set up remote care plans; ConsultADoctor, which makes concierge plans available to patients both directly and through their insurance plans; and SecondMD, an online resource for second opinions.

Most of these startups require the patient to pay, so they’re aimed at the first tier of our two-tiered health system, in which those who can afford to pay increasingly can get access to more convenient, superior care while the bottom of the pyramid is still waiting in the emergency room.

And then there’s the problem of competition. Mayo Clinic, for example has built an iPad app that allows its patients to manage their own recoveries using its proprietary software, and Cleveland Clinic has its own system for marketing its experts for virtual second opinions. The big guns are coming in and forcing the startups out. In the buy-vs-build war, some of these startups are going to be toast, sacrificing themselves to awaken the large systems that will then build their own versions of many services. After all, as one CIO told me, “it’s just software.”

Another problem is that some of the easy-to-enter spaces like wellness, patient information and quantified self are getting pretty crowded. Last year I saw a mobile app by Phillips that used the iPhone camera to measure heart rate and then at the same demo day saw a demo from a startup doing the same thing.

I am still enamored of Health 2.0 and the work of the young entrepreneurs who have committed themselves to such massive social transformation. But I know some of them are going to drink the bitter wine of disappointment in the next few years.


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