Spring View of Health 2.0, with a Diabetes Twist

It’s a moving target, of course. The whole concept of “Health 2.0” is still being defined, refined, created and recreated. And it was fascinating to be at the epicenter of this creative quake this week in San Diego, at the H2.0 “Spring Fling” event that brought some of the brightest physicians, web developers, entrepreneurs, healthcare consultants and “ePatients” together in one room.

More Patient Community Sites

As you may have noticed, the concept of building ready-made patient communities is on fire as an arrayPatient_communities_2 of new start-ups enter the market. (See my original list from the September H2.0 conference.) Among the new players unveiled on Tuesday were: WEGO Health, a new “purpose-driven community” site that engages highly informed patients to vet out top 15 sources on a variety of ailments, and Trusera, a community site focusing on “the power of story-telling” among patients.

There are also a lot of new players in the find-a-doctor-online search arena. I’ve previously introduced Xoova and Vitals here. Xoova’s newest value-add is the ability to actually use the site to schedule appointments with the doctors you find on their site. Vitals allows you to peruse doctors by specific parameters, such as language skills and gender, etc.

Joining them are:

  • Healthcare.com, which combines provider search with health information search
  • HealthGrades, which lets people rate their experience with individual MDs by actually giving them a grade, and
  • Carol, a flashy-looking new online marketplace
    for health services, where you can actually purchase services like physical exams and medical procedures

Also of note is Health Central Network’s newly launched community site for teens with diabetes, called DiabeTeens. This one is hosted by 23-year-old “happy diabetic” Ginger Vieira, who advises PWD college students on everything from diabulimia to adhesives.

I think all of these companies offer interesting and relevant features, but time will tell whether we, the patients, will equally flock to them all. I think it’s pretty clear that the concept of patient communities and online health services is here to stay –- using them will soon be as common as using your email and therefore nothing revolutionary –- but we’ll see many companies come and go over time.

MDs Going Online

We also heard from several MDs who have incorporated the internet into their day-to-day work. So far nothing diabetes-specific, but interesting nonetheless. For some examples, check out San Francisco On Call, MyCA and Dr. Jay Parkinson, who’s doing some amazing things with online tools and home-based patient visits in Booklyn, NY.

None of these offerings are tailored to diabetes needs yet, but what these guys are doing could be easily extended to endocrinology once it catches on. The efforts of these pioneering doctors are being complemented by technology from start-ups that simplify and improve patients’ interactions via technology:

  • VisionTree Optimal Care, which collects patient information and delivers it to healthcare professionals
  • American Well, which enables video chat sessions between patients and health care professionals
  • Live Wisdom, from Organized Wisdom, which allows you to chat with doctors and other healthcare professionals to get your questions answered and advice on many topics for an average of about $1.99/minute. Would you use this? Conference attendees joked that it sounded a bit like internet porn (talk to a live nude for just $XX/minute! -– which is better for your health, anyway?)

These and all other companies at the event certainly showed many cool features, but I doubt that many of them will actually be used by “sick” people like us. At the moment, it’s almost a tool-and-information overload. But as one panelist noted, all progress it good: bring it on. These tools will live and die by the preferences of the patient community.

Being a Diabetes Company

Finally, the really cool part: Imagine gathering about 350 of the smartest, most plugged-in minds in health and technology, and putting them to the task of brainstorming better diabetes care. Well, not care exactly, but they were tasked with identifying three top problems/unmet needs of people living with Type 1 diabetes and then recommending some new kind of tool or service to fix it.

IDEO, the internationally-know industrial design firm that revamped Kaiser, conducted this fun open-workshop session during lunch. Instead of presenting a typical luncheon keynote, the IDEO folks made everybody work: each of the roughly 50 tables was given the assignment of pretending to be a diabetes-focused Health 2.0 company, and each group had 30 minutes to discuss and develop a concept to solve some problems we face in everyday life.

First they aired a quick video of four patients (including myself and Manny) talking about what’s hard about diabetes. Um, what isn’t? Which is why this was a near-impossible task, with so little information to go on. They saw an insulin pump briefly in the video, for example, but didn’t get the details on the insulin reserviore vs. controller unit, or how an infusion site sticks to your body or for how long. Nevertheless, these sharp minds did pretty well grasping some of our most pressing issues in just half-an-hour, I’d say. See them here at work:

Rethinking_diabetes

They certainly “got it”:

Support_phobia_etc

This group swore they hadn’t heard know about the Charmr, but just came up with this concept on their own:

Ipod_of_insulin_pumps

Some of the other ideas that emerged were:

  • a Buddy System for the newly diagnosed
  • an insulin “patch” that changes color when it’s running low on contents
  • a skin tattoo that glows when your BG is going too low or too high
  • a Zazzle-like site where patients could design their own fun and colorful pump skins
  • and my personal (most outlandish) favorite – the idea for a Bare Necessities-style body pump, which is made of gel and can be worn adhered to your belly or even as a “form bra” patch for the ladies, as you choose (!)

Mostly pipe dreams? Yes, at the moment, of course. But that’s the power of Health 2.0. Dream big. There’s plenty of evidence that some iteration of all these new ideas and innovations will become reality sooner than you think.

14 Responses

  1. Kevin
    Kevin March 6, 2008 at 7:31 am | | Reply

    You should talk to Steve Ponder (a pediatric endo and CDE in Texas who also has type 1) and offers his patients a remote visitation option that leverages all sorts of technology to make it safe, efficient and a high quality experience for both the patient and his practice of pediatric diabetes care. His practice of medicine is one thing and of course the technology that makes this possible is another. Diabetech.net provides the tools.

    You can get more info on how he does this at his website:

    http://diabeteshousecall.com

    He has also written an open letter to his peers describing this in their terms as well.
    http://diabetech.net/pdf/Diabetech.GlucoMON.ADMS.Letter.To.Peers.Ponder.MD.CDE.02.2008.pdf

  2. AmyT
    AmyT March 6, 2008 at 9:13 am | | Reply

    Cool, thanks Kevin. Actually CDE and author Gary Scheiner does some things along the same lines, come to think of it.

  3. Kevin
    Kevin March 6, 2008 at 11:50 am | | Reply

    I’d really like to read more articles about things that already exist and are helping other people with diabetes today. In addition to Dr Ponder’s high tech practice (aka Health2.0 if you have to label it as such) and Gary Scheiner’s, how many other things out there could you help make us aware of on diabetesmine.com?

    It seems lately too much time is being spent talking about stuff that doesn’t exist and may never make it into a pwd’s hands? As the parent of a child with diabetes diagnosed almost 7 years ago, I’m numb to the promises of things yet to come.

    I wonder if I am alone in this or if most of the regular visitors to dmine would appreciate finding out more about stuff they could actually get their hands on vs. promises from corporate shells about the future?

  4. Kevin
    Kevin March 6, 2008 at 7:17 pm | | Reply

    How funny. David Mendosa, just published his review of the GlucoMON-RT service over at HealthCentral.com ( http://tinyurl.com/2jx99g ) a few minutes ago.

    “But the GlucoMON software isn’t even on your computer. It works in a similar way to Google’s ‘cloud computing’ applications like Gmail and Google Docs that I completely rely on nowadays.

    GlucoMON even does Google one better. To use it you don’t need an Internet connection. Or even a computer. Or a phone line. And soon you won’t even need electricity for it” says David.

    David sums it up as a highly sophisticated and easy to use new automated diabetes technology that he says will simplify your life with D.

    …and I don’t mind the comparison to Google, either ;)

  5. Lauren
    Lauren March 6, 2008 at 8:18 pm | | Reply

    All these virtual doctor consultation sites make me wonder. My experiences working as a medical assistant have taught me that there is no substitute for a face-to-face doctor visit.

    To cite a personal example, my brother was diagnosed with type 1 as a child. He was very, very sick for days and my mom was communicating with his pediatrician over the phone. My brother had no fever but he was lethargic, nauseated, and listless (no doubt because my mom kept giving him juice and Gatorade, skyrocketing his BG). The pediatrician wasn’t alarmed. Once we dragged my brother to the doctor (he was barely conscious), the medical personnel knew within five seconds what was wrong with him. The fruity breath was a giveaway for DKA. There’s just no substitute for an in-person visit, even for routine care. (And I say this as someone who HATES going to doctors myself. I saw an endo once to have my T1 diagnosis confirmed, and didn’t go back for 8 months.)

    I know there are underserved areas where telemedicine is useful, but I think the focus has to be on serving those areas by getting more doctors and specialists out there, not doing everything by phone and internet.

  6. Kevin
    Kevin March 6, 2008 at 8:42 pm | | Reply

    Sorry to read about your brother’s experience and sorry to have to disagree but your comparison of a random pediatrician to a highly trained pediatric endocrinologist who already has an established relationship with the patient is not a comparison at all.

    Further, there are fewer people entering medicine today and drastically fewer entering the field of diabetes care including endocrinologists specializing in diabetes let alone pediatric diabetes. There is no alternative but to leverage technology to allow increased access for patients with diabetes to a rare specialist.

    In general I don’t believe that the State of Texas is any more under served than any other State. However, at the largest diabetes summer camp in the country, which happens to be located in Texas, approximately 50% of the kids attending are seen by their pediatrician and not by a knowledgeable endocrinologist.

    Let’s take steps now to improve access to passionate, experienced and highly skilled specialists today vs. lobbying med students and trying to convince them to enter a specialty which pays poorly compared to their alternatives.

  7. Kevin
    Kevin March 6, 2008 at 9:43 pm | | Reply

    Hey everybody,

    Just in case you were curious like I was about what Gary Scheiner (CDE) is doing, he has a website that does a very good job of explaining it located here:

    http://www.integrateddiabetes.com/index.shtml

  8. Challenge Diabetes
    Challenge Diabetes March 6, 2008 at 9:59 pm | | Reply

    Health2.0 Movement Missing the Mark

  9. AmyT
    AmyT March 6, 2008 at 10:01 pm | | Reply

    Lauren,
    I guess I should have mentioned that the docs in this post are actually combining web-based care with in-home or at-work visits! They claim that using the Internet will help save them enough time on the small stuff that they’ll actually be freed up to go “out in the field” to patients who aren’t able to get in to their office (for whatever reasons).

    Sounds good, anyway…

  10. Lauren
    Lauren March 6, 2008 at 10:23 pm | | Reply

    I am a medical student, and I think there are myriad reasons why students choose certain specialties. In my experience it rarely comes down to income. At any rate, endocrinology (like any specialty) still pays far more than primary care.

    I remain wary of telemedicine in general, after having worked in the medical field for 6 years. However I have not yet begun my clinical rotations, so perhaps my ideas will change as I begin to take care of patients myself. All that I’ve been taught, however, says that face-to-face encounters with patients are crucial to proper diagnosis and care.

    As for the dearth of endocrinologists, there is no shortage of people trying to get into medical school. I speak from experience. The year I applied was insanely competitive. Maybe we need to open up more seats in medical school classes around the country, to increase the diversity of specialties chosen by graduating classes.

  11. nancy b
    nancy b March 7, 2008 at 6:18 am | | Reply

    Thank you for the information and conversational, non threatening tone in your approach to Diabetes. It is this type of site that is most helpful to those who have diabetes and may not be as vocal or knowledgeable in finding out the truth and hope in this, or any, chronic condition. Also, I just want to remind your bloggers that there is a Diabetes Alert Day on March 25 and a site where people can take a test to see if they are at risk for Diabetes. That url is http://diabetes.org/alert
    Thanks!

  12. Anonymous
    Anonymous March 7, 2008 at 9:55 pm | | Reply

    I’d just like to point out (as Kevin’s posts do not) that he is the CEO of the company that he mentions in the posts.

    The way his posts are written seemed to make me think he was a “surprised” person by what the company is doing, but he’s the guy who runs the operations.

    It’s a great idea, and I’m sure it will help thousands of parents, and he went through the difficult rounds of getting FDA approval. But he should at least disclose what he’s up to. :-)

  13. monica
    monica March 8, 2008 at 4:45 am | | Reply

    I would like to suggest a therapy to all who are diabetic. Once a time my sugar level was also high and I tried a lot to control it. But nothing was happened and I remained failed to achieve that. All were same. But after following ‘Ayurveda’ treatment and diet therapy (which was prescribed by them) I recover myself with a standard blood sugar level. Still now I am following these therapies. And now I am far better than previous. My fat level has decreased. So, with my personal experiences I can suggest to all for this therapy. A few days ago I got introduced with a site where I found many experts of this field. http://www.rvita.com/expert-network.html. And also find a community where I shared my personal experiences with a lot. http://www.rvita.com/communities.html . Hope this will also be a fruitful way to find out the correct answer, which you really need to know…

  14. Kevin
    Kevin March 8, 2008 at 8:20 am | | Reply

    Hey anonymous,

    There’s this neat little feature enabled on Amy’s blog that allows you to click on the person’s name and go to their website. You should try it.

    I have always been open as to my motivations and it is important for me to promote technologies and programs (both mine and others) that don’t always get referenced like they should.

    Next time you post it would be great if you would use the disclosure feature that I use by posting your name and making sure that you also add your website address or some other way of disclosing who you are.

    Full disclosure, respect and accurate reporting are critical to the health and wellness of the online diabetes community.

    (see the posted by: Kevin? – go ahead and try it out.)

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