The Economist: Is Health 2.0 Good Medicine?

09 Sep The Economist: Is Health 2.0 Good Medicine?

Economist (ĭ-kŏn’ə-mĭst) n.

1. A specialist in economics
2. An economical person.

My father has been a subscriber to the Economist magazine for as long as I can remember. He continually sings its praises and regularly feeds me a steady stream of relevant articles. I have come to appreciate the Economist as the pinnacle of business thought elitism and secretly wished I had a subscription in order to enhance my own international business acumen. Reading the erudite analysis of world currency fluctuations, teasing out the international ramifications of social policies in Bangelore, and pontificating on how Chinese rice futures will impact the price of gas in your neighborhood just makes you feel smarter. Even their tag line is, literally, authoratiative: “The authortative weekly newspaper focusing on international politics, business news, and opinion.“

It is therefore with some surprise, and mirth, that I came across a September 6 Economist article regarding – get this – Health 2.0! (Perhaps another sign that Health 2.0 is “legit”).

Essentially, the article’s perspective is a “Web 2.0 technology applied to Health care” (scroll down for Matthew Holt’s contrarian definition) viewpoint as opposed to a more inclusive definition of “next generation health care delivery” (which I favor; with the technology being an important part of an overall movement). It reviews the dramatic rise in user generated content, as manifested in the classic YouTube, Facebook, and Wikipedia fashion, as it is applied to healthcare, as manifested by OrganizedWisdom, Sermo, PatientsLikeMe, and a host of other social networking sites and the interactive way in which patients in these communities interact.

The very concept of Health 2.0, as identified in the article, is a result of a need to more effectively participate in ones own healthcare. The fact that the health care industry has never really created an architecture of participation, or a way to engage the patient in their own care, has resulted in the patient taking matters (or in this case technology) into their own hands. Medicine, and physicians, have long benefited from collaboration with each other – and now patients are being let in on the care process. The pent up demand for this type of collaboration and interaction is only just beginning. Just wait until we get to pervasive electronic medical information, genomic profiling, advanced medical informatics and analytics, and universal access to health care delivery and we will have some interesting new relationships as it relates to the “collective patient”-physician relationship.

Some additional interesting fodder from the article:

• ~33M (of 100M people online ) are thought to have found significantly helpful health information on the internet; only 3M found information that caused them serious harm (in accurate, incorrect, etc).
  
• 20% of internet users have created some sort of health-related content
• The accuracy of information of many patient user communities is very high: 2004 BMJ study showed only 6% inaccurate information posted at popular on-line Neurology site.
  
• The American Cancer Society found that inaccurate information was typically rooted out and expunged within 2 hours of posting on average.
  
• Harvard Professor of Medicine highlights the effectiveness of “Wisdom of Crowds” mentality to augment the training, experience, and accuracy of physicians. This “aggregated understanding” (which I affectionately call the Borg Effect, or alternatively Collective Intelligence) will continue to be a new and increasingly important part of a “collective patient”-physician relationship.
• Drivers of patient aggregation sites include more patients suffering from multiple, chronic conditions; internet’s ability to organize hundreds of patients with rare disease efficiently, and and unprecendented explosion of medical knowledge which requires new forms of shared memory.
  

The article concludes with some obvious cautions regarding accuracy of information, sharing of personal health information and the permanence of internet data. But the conclusion is that the “upside [to sharing information online] outweighs the risk“. So much of this has to do with the many open source principles that I grew up with (Meritocracy, Transparency, and Legitimacy) and the health care equivalent drive toward transparency, collaboration, and value. Combining all these ingredients in a healthcare is not only good medicine, it will make for some great economics as well.

Vous voyez, l’argent n’est pas vraiment tout !