Section II: Defining the Ethereal with the Illusory

Ethereal (ĭ-thîr‘ē-əl) adj.

1. Characterized by lightness and insubstantiality; intangible.
2. Highly refined; delicate.
3. Not of this world; of the celestial spheres; heavenly.

II. Defining Health 2.0

Some preliminary brainstorming around the term Health 2.0 shows that the concept of “healthcare” and “healthcare delivery” are dramatically changing in the United States:

The Transition to Health 2.0. This is a representative, but far from comprehensive, list of the characteristics of Health 2.0

While some have challenged the need to define the term Health 2.0, or questioned the validity of the concept, the clear shift in underlying values, outcomes expectations, and fundamental assumptions of this transition as captured not only demand our acknowledgement, but beg for further definition in order to support further dissemination. I maintain that the definitions are important; particularly so when trying to effectively communicate the ideas that will inspire the next generation of healthcare innovators to create a new healthcare delivery mechanism, financing system, and consumer experience. This semantic work sets the stage for the seminal work required at the hands of the innovators and entrepreneurs to bring the vision into reality.

As such, a trim definition of Health 2.0 has been propounded by some to be a term that “groups together the healthcare use of Web 2.0”[1] This definition identifies the enabling technologies that have made user generated content both possible and relevant (ie, social networking (Daily Strength), blogs (HISTalk), mash-ups (Whoissick?), digital publishing, wiki’s (Health 2.0), etc) in the computing world, and how they have begun to infiltrate into the healthcare industry. The healthcare variations on this internet theme have been both impressive and profound. New applications that create new ways for healthcare players to interact, have not only changed the momentum in the game, but are beginning to change the game altogether. Examples of these new relationships enabled by new technologies include: Patient-Patient (Organized Wisdom), Patient-Providers (Medem PHR), Provider-Provider (Sermo), Patient-Payor (Blues Member Access), and Provider-Payer (Athena Health PayerView).

However, limiting the definition of Health 2.0 to “just a description of recognizable technologies that are an advance on the first generation of web tools”[2] misses the point of what is sparking the creation of the enabling technologies in the first place. The enabling technologies of Health 2.0 make it possible to catalyze the creation of a culture of transparency, a refocusing on health care value, the publication of risk adjusted outcomes regarding measures that matter, and the advance toward next generation healthcare. The Health 2.0 technologies, become an underlying philosophy powering a growing healthcare delivery reform movement. I believe the enabling technology and the underlying reform movement are most effectively and efficiently communicated by the term “Health 2.0”:

“HEALTH 2.0: New concept of healthcare wherein all constituents (patients, physicians, providers, and payers) focus on healthcare value (outcomes/price) and use competition at the medical condition level over the full cycle of care as the catalyst for improving the safety, efficiency, and quality of health care.” [3]^, [4]

Whether you prefer a more understated (realistic?) view or perhaps an overstated (futuristic?) one, the argument could be made that both are right. In the end, attempts to define the ethereal with the illusory may prove a Tantalus-like torment, or characterized as more “thermal noise”, and perhaps our efforts could be more productively spent identifying the themes that define what we are observing in the health care market. O’Reilly identified seven themes that succinctly descriptive yet convincingly effective in capturing the essence of the Web 2.0 movement. Attempting a similar feat, I have identified seven inaugural principles of Health 2.0 that illuminate the depth, breadth, and scope of both the technology and reform concepts of the Health 2.0 movement:

While some attempt has been made to align reasonably similar concepts, this paper will not attempt to unnaturally stretch the analogy by attempting a concept by concept comparison. The balance of this white paper will introduce these themes.