Health 2.0 Definition

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Definition of Health 2.0

Wall Street Journal

Health 2.0 is still being defined. the Wall Street Journal took a stab at it with this description:

The social-networking revolution is coming to health care, at the same time that new Internet technologies and software programs are making it easier than ever for consumers to find timely, personalized health information online. Patients who once connected mainly through email discussion groups and chat rooms are building more sophisticated virtual communities that enable them to share information about treatment and coping and build a personal network of friends. At the same time, traditional Web sites that once offered cumbersome pages of static data are developing blogs, podcasts, and customized search engines to deliver the most relevant and timely information on health topics.

Shreeve's Definition

While this (WSJ) traditional view of the definition ascribes it as the merging of the Web 2.0 phenomenon within healthcare, others believe it is so much more. In this perspective, Health 2.0 goes way beyond just the pervasive social networking technology to include a complete renaissance in the way that Healthcare is actually delivered. The clearest, most compelling source of information on this aspect of Health 2.0 can be found in Redefining Healthcare: Value-based competition on results by Michael Porter of the Harvard School of Business and Michelle Teisberg of the University of Virginia School of Business.

The following image is the most concise, or canonical representation of the Health 2.0 reform movement. While clear for those familiar with the source material, the image does require some explanation which is included below.

<center> Virtuous Cycle.png </center> <center> <font size=small> Copyright 2007 by Scott Shreeve, MD. Made available under the Creative Commons Non-Commercial Attribution 2.5 License </font> </center>

  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. <br><br><br>

Holt's Definition

And a contrarian or perhaps just more limited view from Matthew Holt.<br><br> I think Scott has done amazing work here. BUT I think he is being way over ambitious in what he's calling Health 2.0. Health 2.0 is a just a term that groups together the healthcare use of Web 2.0, which is in itself just a term for easy (& cheap!) to create and easy to use software that encompasses search, wikis, blogs, video, online communities, mash-ups and all the other stuff that O'Reilly has been talking about for a few years. There's no magic in it; it's just a description of recognizable technologies that are an advance on the first generation of web tools. These tools and techniques are going to be used in health care. This has nothing to do with 'outcomes', 'quality', and 'health reform' and I guarantee you that Michael Porter hasn't even heard the term. Right now no one has a clue how health care will adopt Health 2.0 tools and techniques. Will they become real separate businesses as, for instance, Steve Case hopes Revolution will be? Will they be ever so slowly integrated into health plans and providers' technology use? Will they become a separate consumer-driven piece that is run by non-profits and be the successor to the listservs that have been the focus for, say, cancer groups' online activities? Will they be all this and more? No one knows. I've been watching health care develop online as closely as anyone in the last 10-15 years, and all I know is that in Rumsfeld's terms these are 'known unknowns' and there's a good chance that there are also 'unknown unknowns' in the mix too. As yet, almost no one in health care is familiar with Web 2.0. I asked a Northern California HIMSS audience about it in December 2006 and almost no one in the audience could define it. (Yup, that was a Northern California audience which lives in the heart of Web 2.0 country...) So the issue is, how are these tools and technologies going to be used, what does that mean for health care organizations, and doctors and patients, and how fast will it matter?

O'Grady prefers eHealth 2.0

Health 2.0 definition: what about eHealth 2.0? By Laura O'Grady [1]

I’m curious as to why the term Health 2.0 and not eHealth 2.0 was chosen to describe the Web 2.0 movement in relation to health. I think Scott Schreeve’s take on it refers to issues beyond health and technology. His perspective is US centric, relates to managed care issues, and for profit medicine. The web is intended to be an international forum. We need not look any further than social networking as an example. Many health care communities involve participants from different countries.

I tend to agree with Matthew Holt’s interpretation. The main point of the web 2.0 movement in health care is the use of social software and its ability to promote collaboration between patients, their caregivers, and medical professionals. Using the web to exchange information with others, especially for experiential or anecdotal information has a lot to do with learning – about an illness, what treatment options are available, how to make decisions, and for support.

I believe the next steps in the eHealth movement will include finding ways to ensure these collaborative efforts are supported. Previous mechanisms for message exchange (including message boards, mailing lists and newsgroups) sometimes collapsed. Thus far more mainstream collaborations such as Wikipedia have flourished. I hope this shift in participatory content development can be maintained in eHealth 2.0.

A systematic review (2010) of the definitions of health 2.0 found 46 versions : We did a systematic review on the definition of Health 2.0, got published in JMIR :

Definition of Medicine 2.0

Health 2.0 seems - according to some definitions - to focus on actors such as patients, payers, and providers (according to some definitions (WebCite) even on consumer-applications only), and the definitions are currently quite US-centric - presumably because the Health 2.0 (TM) conference series has been organized in the US and is primarily attended by the private sector.

Eysenbach's Definition

Medicine 2.0 (TM) is another conference series, co-sponsored by the Journal of Medical Internet Research (JMIR) (published and edited by Dr Gunther Eysenbach, an academic ehealth / consumer health informatics researcher) and the International Medical Informatics Association, which is complementary to the Health 2.0 (TM) conference series. The scope of Medicine 2.0 is broader, in that it focuses on a global perspective, and biomedical researchers are considered part of the bigger picture.

The concise definition of Medicine 2.0 (drafted to define the scope of the Medicine 2.0(TM) conference) is as follows:

<blockquote> Medicine 2.0 applications, services and tools are Web-based services for health care consumers, caregivers, patients, health professionals, and biomedical researchers, that use Web 2.0 technologies as well as semantic web and virtual reality tools, to enable and facilitate specifically social networking, participation, apomediation, collaboration, and openness within and between these user groups. </blockquote> Source: Eysenbach, Gunther. Medicine 2.0 Congress Website launched (and: Definition of Medicine 2.0 / Health 2.0). Posted at: Gunther Eysenbach's random research rants (Blog). URL: Accessed: 2008-03-07. (Archived by WebCite® at (Note: A more refined version of this blog entry will be published as editorial in the Journal of Medical Internet Research (JMIR) - once published please cite as: Gunther Eysenbach. Medicine 2.0: Social Networking, Collaboration, Participation, Apomediation, and Openness. J Med Internet Res 2008 (in press) . DOI:10.2196/jmir.1030)


See also:

File:med20banner.jpg Sept 4-5th, 2008: Medicine 2.0 conference, Toronto, Canada