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Scott Shreeve, MD

Hey there!

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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Health Fool Point Oh!

Disintegrate (dĭs-ĭn‘tĭ-grāt‘) v.

  1. To become reduced to components, fragments, or particles.
  2. To lose cohesion or unity
  3. To decompose, decay, or undergo a nuclear transformation.


I remember attending a high school football game as a wide-eyed sixth grader. Not only did I get to hang with the big kids, but I got to see big kid things like my first girl fight. It was right after the half-time crowds had headed back to the stadium, and these two high school girls with big hair, big earwings, and even bigger four letter word vocabularies circled up for the battle. I remember jostling for positioning and the bizarre fascination of watching these girls reduced to primal visciousness, hair pulling, clawing (literally), and ultimately a whirling mass of confusion rolling on the ground until the stadium security blew in to scatter the crowd and break apart the cat fight. It was visceral, raw, and a reminder that things can go non-linear pretty quickly (ala, the current financial meltdown).

I was surprised to tune in to the near nuclear meltdown by two people that I respect for different reasons. It was also a reminder to me that the internet is a highly ineffective medium for the nuances of human communications – not that there was much nuance about these communications – other than how things escalate much more rapidly on line than in person. Much like the cat fight (or every fight I have ever seen), it is usually one or two swings and alot of rolling around in the dust without any clear winners.

Since I have been around from the beginning of Health 2.0, I actually know both of the players very well. I have a personal association and friendship with Matthew, and always enjoy his perspective and insights. I also know Dimitri, having sparred with him myself over the evolution of Health 2.0 as a concept, and am familiar with the perception of smugness he assumes as the authoritative critic. Unfortunately, that last element appears to have clouded his otherwise very appropriate challenges and turned professional philosophical differences into deeply personal attacks.

Its too bad because it gets in the way of some healthy conversations. My take away is that both have elements of truth in their argument – Matthew for recognizing an emerging trend that will have long term impact (adoption of more socially engaging technology to improve health) and Dimitri for trying to put that trend in perspective (having lived through the bust). While the noise around Health 2.0 has grown louder and more rambunctious, I believe that the pitch and tone of the criticism has grown as well. Unfortunately, looks like we had a couple of swings and some rolling around last week with no clear winner (but lots of people embarrassed by the bizarre fascination in watching).

I would like to serve the roll of the stadium security to clear the tussle while also trying to figure out if there is any substantive root cause that is worth your reading time. I would like to thank Fard and VJ, both of whom I know personally, for their insights and comments that help us focus on some things worth talking about – like – what is the actual business case, the business metrics, that can help show us that Health 2.0 is doing something/anything meaningful within health care. I think Dimitri’s undisclosed location must be in Missouri because in the end all he is just saying “show me”:

But I would like to caution them and everyone else that the ideas for new structures in healthcare value chains are well, just ideas until proven. This does not mean experimentation should not continue. It is just that we should all learn from past mistakes, stop the hype and prove something by doing and turning in the numbers on organic traffic and monetization/value. But once you have done it, what is the point of keeping Health 2.0 label, that is getting tarnished by less successful ventures?

The little dig at the end is unnecessary and distracts from a fair point Dimitri is trying to make – continue the experimentation but show me something along the way. I can’t agree more with you. However, you realize that experimentation is difficult, fraught with failures, quite messy, and is mostly boring misadventures until you hit the one or two discoveries that matter. However, I am all for it, and enjoy the process of discovery, and if people get a little enthusiastic about it consider that the optimism required for push past the repeated failures in the search of the cure.

What you will find, most of the time, is you end up somewhere different than you thought but it might be a great place to be (aka, athenahealth: premier birthing centers to collective intelligence network). So it will be with Health 2.0 – lots of fits/starts, acquisitions instead of IPO’s (does anyone consider a failure?), and promoters/naysayers in equal abundance. Now that we are in season 2 however, it is time to start putting some meat on the table in terms of businesses that have models, revenues that are sustainable, communities that can influence, and outcomes that improve quality of life.

I will be fortunate to lead one of those sessions at Health 2.0 conference: The Business Case for Health 2.0. We are going to be talking with several large companies who are evaluating Health 2.0 technologies on a daily basis to determine its practical application when real dollars and real sense (intentional) are on the line. I hope to dig into a couple of business models of some of the companies who are out there as well. Further ideas you are interested in exploring are welcome so we can get the most out of the session.

We hope you find it fascinating, but not bizarrely so!

3 comments on “Health Fool Point Oh!

  1. We should talk.



  2. Jesse Shantz says:

    I’m sorry that I can’t come to your session at Health 2.0. I’m a medical trainee and was denied permission, but I thought that I would add in my 2 cents for the time being.

    It’s becoming more and more clear to me that one has to think about current users of Health 2.0 to appreciate the impact it can have. Although there are people from all age groups I think that we can all admit that more sophisticated users are from a younger demographic. These are not your typical chronic disease sufferers…Yet!

    So, can the Health 2.0 revolution lead to disease prevention? It depends what tools evolve to get users hooked. I think that there is a public health opportunity; integrate prevention and improved health into current and future tools.

    How do you get someone to pay you for that? That’s the hard sell. The medical system (I have Canadian expertise) is geared to treatment of acute problems. We’re still figuring out the model to deal with the massive chronic problems of diabetes, hyperlipidemia, et al. That seems to be a good point to focus on developing a business case.

    I hope that there’s a podcast of your session so I can hear your thoughts too!

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