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Scott Shreeve, MD

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I'm the CEO of Crossover Health, a patient-centered, membership-based medical group that is redesigning the practice, delivery, and experience of health care. We offer urgent, primary, and online care to our members who can access our technology platform, practice model, and provider network from anywhere and anytime to optimize their health. Email Me



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The Canonical Health 2.0 Representation

Canonical (kə-nŏn’ĭ-kəl) adj.

  1. Of, relating to, or required by a canon of law.
  2. Adhering to beliefs or practices approved by authority or tradition
  3. Conforming to orthodox or well-established rules or patterns, as of procedure.

As I mentioned at the conclusion of a previous post, I believe strongly in the power of imagery to symbolically represent complex ideas. Symbolism can become a powerful means of communication, both by its parabolic method of conveying layered meaning depending on context, and its ability to inspire the passion or madness that fuels entire movements. As a result, I am always drawn to reducing the complexity in my everyday professional life to simple images or symbols that capture the essence and literally replace the thousand words with a single image that “says it all“.

Another term for this reductionism, or attempts to capture the inherent essence of something, is “Canonical“. The word Canon most often describes a body of works in a given field (e.g., works of literature, or of art, or of music) deemed worthwhile for student to study and for scholars to investigate. The word “canon” is derived from the Greek (akin to the English ‘cane’) referring to a reed. Reeds were used anciently for measurement, and later became associated with a rule or standard by which things were measured, or judged. We see this in the establishment of religious canons, or the instances where a representative, definitive, and accepted body of work becomes the measure by which all other related works are judged.

In that vein, I have attempted to capture, the quintessential characteristics of the emerging movement and body of companies that make up the Health 2.0 movement. I have already developed the definition, described a few of the companies, and as promised, have now attempted to capture this definition in the following graphic:

The canonical representation of Health 2.0
Conceived by Scott Shreeve MD, illustrated by Hemeon Design, and Copyright © 2007 by Crossover Consulting.
Distributed under the Creative Commons Attribution, Non-Commercial, Share Alike 2.5 License.Updated on 5/30/07.

The graphic is self-explanatory, but the narrative is helpful to see how the pieces build on each other and work together to bring the concept of Health 2.0 into focus. Here goes:

  1. Begin by defining Health 2.0
  2. Realize that Health 2.0 is all about Patient Empowered (not the misnomer “Consumer Directed”) Healthcare whereby patients have the information they need to be able to make rational healthcare decisions (transparency of information) based on value (outcomes over price). In the Health 2.0 paradigm, everyone in the healthcare process is focused on increasing value for the patient.
  3. Realize that Health 2.0 is absolutely reliant on interoperability of health information. Everything from the Personal Health Record (PHR), to the Clinic Health Record (CHR), to the Enterprise Health Record (EHR), to the National Health Record (NHR) must be based on standards, be seamlessly transitioned between environments per standardized security and privacy protocols, and be accessible anytime from anywhere.
  4. Undergirding this foundation of information, the Four Cornerstones (Connectivity, Price, Quality, and Incentives) of the Value Driven Healthcare movement begin to create a virtuous cycle of innovation and reform. Transparency serves as a key catalyst in this process by creating positive sum competition that can deliver better outcomes at a lower cost.
  5. As more information becomes available as a result of increased transparency, there will be a wave of innovation at all points along the full cycle of care (see slide 8-12), which includes phases where health care service providers Educate, Prevent, Diagnose, Prepare, Intervene, Recover, Monitor, and Manage the various disease states. Measuring someone’s HgA1c or Ejection Fraction does not tell you how effective their diabetic or cardiovascular treatments have been. You need to factor in the care provided over the full cycle of care to appropriately determine value.
  6. An increased amount of personal health and outcomes information will create an ongoing role for infomediaries and related services providers to add value at each stage of the full cycle of care. These value added Health Advisory Services (more later) will offered by hundreds of companies, in thousands of forms, to millions of people who are can benefit from the remixing of medically related information. It is easy to see how the new Web 2.0 framework, with its inherent social networking and collaboration tools, will make this “long tail” of medicine a “value”able venture.

These concepts are worthy of further discussion and debate, particularly since we are blazing new territory without any established rules, patterns, or procedures. Shooting my canonical representation of Heath 2.0 out into the ether is the proverbial “shot out of the canon” to stimulate the conversation.

7 comments on “The Canonical Health 2.0 Representation

  1. Idetrorce says:

    very interesting, but I don’t agree with you

  2. scottshreeve says:


    I appreciate differing perspectives, but without further description about what you “don’t agree with” I have no opportunity to convince you.

    More description please.

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