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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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Second Order Thinking: The Move(ment) to Health 2.0

Think (thĭngk) v.

  1. To exercise the power of reason, as by conceiving ideas, drawing inferences, and using judgment.
  2. To have or formulate in the mind.
  3. To bring into a given condition by mental preoccupation

I recently attended a meeting where the speaker opened by stating that he was there to make us THINK. He paused on the word, let people rumble it around in their brain, and then proceeded to “bring into being” through the force of articulate evidence, persuasive argument, and thorough reasoning. I was immediately engaged, stay focused as the evidence was carefully laid out, and then sealed the concepts within my own mind as I taught the principles to others in later conversations. This “cementing” function is an interesting property of the learning process. Perhaps, another reason the old medical training adage, “See one, do one, teach one” is so powerful.

Part of bringing something to reality is also the ability to see something, often visually, before others can see it. So while everyone has the same data inputs in front of them, there are individuals who (due to their background, training, upbringing, values, etc) look at the same data in entirely new ways. They are able to “intellectually mashup” disparate ideas into a new whole, often to the chagrin or castigation of those who should support such notion. An interesting property of this type thinking is that it is so obvious after the fact. Google – duh! You Tube – Duh? After advancing the ideas, and winning a few early converts, then the idea begins to take hold and begins a life of its own.

This reminded me of a story regarding Christopher Columbus and the Egg. In the story,Christopher Columbus attends a dinner that a Spanish gentleman is giving in his honor. A jealous courtier tries to diminish his accomplishment, by claiming that anyone could have traveled to the New World. Columbus asks all the gentlemen in attendance to make an egg stand on end. After all the men have tried and failed, they state that it is impossible. Columbus then places the egg’s small end on the table, breaking the shell a bit, so that it can stand upright. Columbus then states that it is “the simplest thing in the world. Anybody can do it, after he has been shown how!”

Organized Wisdom had an nice post referencing John Sharp’s recent Web 2.0 in Healthcare presentation. John correctly outlines some of the prevailing attitudes found in healthcare with the opposite attitude found within Web 2.0 culture. As I am writing a white paper right now on this very subject, I thought I would build upon this them to share some second order thinking being enabled by the current transition to a new Healthcare delivery system:

Health 1.0

Health 2.0

Zero Sum Competition


Positive Sum Competition







Focus on Cost


Focus on Value

Disease Care


Health Care

Physician’s as Ultimate Authority


Physician’s as Trusted Advisor

Pay for Process


Reward for Result

Culture of Denial


Culture of Quality

Physician directed


Patient participation

Professional medical information


Pervasive medical information

This is a representative, but far from comprehensive, list of the characteristics of Health 2.0

Just as with Columbus or similar innovators, who was able to see “around the corners” (literally); todays health care entrepreneurs don’t see the obstacles, they only see opportunity; instead of just eddies and ripcurrents, they see the unexpected and suprising thrill of managing the oncoming wave of uncertainty.

I look forward to further contributions in the thinking, defining, and refining of the movement while continuing to learn from, highlight, and combine innovative technologies to “bring into being” the new health care reality.

3 comments on “Second Order Thinking: The Move(ment) to Health 2.0

  1. Pat Washburn, Editor, OrganizedWisdom says:

    Thanks for the link! I think you did a great job expanding on the original list.

  2. Vince Kuraitis says:


    I really like your second order thinking about Health 2.0.

    Can you explain further what you mean by “opposite attitude found within Web 2.0 culture”. This went over my head.

    Finally, in the spirit of improvement, I’ll offer a wordsmithing suggestion.

    I believe the literal:

    “Integration >> interoperability”

    is potentially confusing.

    I could probably buy it if you meant to say:

    “IT integration >> IT interoperability”

    but it looks like your framework is geared more toward health system change, not just IT change.

    So the longhand version would be:

    “IT islands >> IT interfaces >> IT integration >> IT interoperability >> health system integration (shared workflow)”

    or in shorthand:

    “IT integraton >> health system integration (shared workflow)”


  3. Anonymous says:

    Thanks for the mention. The contrast of Web 2.0 values and current values in health care a striking except for the collaborative basis of medicine which Web 2.0 technologies can support once we get past the fears of risk and liability.

    John Sharp

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