One year ago, I discovered that I had contracted Type 1 Diabetes. I was 36 at that point and it's relatively rare for someone of my age to suddenly get Type 1 Diabetes - indeed they used to call this form of diabetes "juvenile diabetes", because it mostly occurs in children. So it was quite a shock to discover that I had it! Immediately I looked to the Web to find out all I could about this condition. I discovered a thriving community of 'health 2.0' apps and social networks, which I then wrote about in this blog.
As it's now a year later, I thought it'd be good to review health 2.0 - as I did with Semantic Apps last week. What has changed in web-based health services over the past year? And indeed what web tools do I use to help me manage diabetes?
Note: on Monday afternoon we will be talking health 2.0 with some industry experts on our podcast show, RWW Live. It will be broadcast live at 3.30pm PST Monday (6.30pm EST). You can tune into the show, and interact with us via the chat, by clicking here.
Probably the biggest change over the past year in health 2.0 has been the number - and quality - of health web apps that have become available.
Currently I use a couple of iPhone apps on a daily basis to help me manage diabetes: Diametic, for inputting glucose readings and insulin shots, and Weight Tracker to track my daily weight.
But there are some far more innovative web apps in health 2.0, starting to make their way into the real world. In March we mentioned ReliefInsite, a site that allows people to map, monitor and analyze their pain. Another clever app is Pharma Surveyor, which helps people understand and personalize their medication regimens.
What we're all really wanting in healthcare web apps is the ability to connect with health systems and manage our health online. We're certainly not there yet - for example there's no way for me (in New Zealand) to connect online to my doctor or diabetes specialist, or to blood testing labs and chemists.
But there is progress being made, particularly in the US. In March at the Health 2.0 Conference, Bill Allman from HealthCentral.com noted some services that help consumers find, evaluate, and make an appointment with a doctor or health provider - e.g. Healthcare.com, Xoova.com, Healthgrades.com, Vitals.com, and Carol.com. All of those services offer variations on the theme of enabling users to research local health resources, get reviews of them, and even book an appointment online.
Then there are apps such as MyMedLab - which enables consumers to order and pay for many routine lab tests online, then go to their local lab to get their blood drawn and have their results sent to them electronically.
There are also solutions for connecting consumers with professionals. For example Kryptiq is a provider of connectivity solutions for healthcare, for information sharing among healthcare professionals, their colleagues, and patients.
So connecting to healthcare professionals is happening, slowly but surely. How about medical diagnosis via the Internet then? Still a long way off, but companies such as IBM are experimenting in this arena.
There is a lot of competition now in the area of online health records. Google Health and Microsoft's Healthvault are essentially doing the same thing - both are platforms, neither tries to be a healthcare provider or conduit between healthcare professionals and patients, and both have search as their business model.
In August we profiled one of the startups going for the professional market - Practice Fusion is aimed at professionals (doctors), calling itself a 'Google Apps For Doctors'. miVitals is another startup which we've profiled that is trying to find a niche as an online records service.
We've also seen the rise of so-called "wellness management" services - Daily Strength and Aliveworld are two examples.
Meanwhile in the health portal space, Everyday Health (which merged with Revolution Health in October) has been the big mover this past year. A couple of weeks ago, Medical Marketing and Media reported that Waterfront Media's Everyday Health had surpassed WebMD to lead the online consumer health space. According to comScore's Media Metrix data, released in mid-November, Everyday Health had 25.7 million unique visitors in October, compared with 19.6 million for WebMD.
Other leaders in the space according to comScore are: AOL Health (10.4 million); About.com Health (9.1 million); MSN Health (8.8 million); Yahoo! Health (8.6 million); NIH.gov (8.1 million); Walgreen Co. (6.4 million); and UnitedHealth Group (5.1 million).
If I may return to diabetes: there is still a great deal that isn't understood about Type 1 diabetes, for example there is no cure (although there are a number of experimental treatments) and the medical community still doesn't know the exact cause of it. Fortunately, the Web is a great place to search for and explore information about diabetes - or any other health condition. Of course you must be careful about which sources you trust, but that almost goes without saying on the Web.
Some of the best information websites and search engines for health:
There are many others, too many to list in one post!
There are a number of community sites - some focusing on doctors and services, like Vitals and HealthGrades, and others focusing on treatments and information like WEGOHealth, Trusera and CarePages. Others are somewhere in between, like MedHelp. Two of the ones that have caught my eye in the past year are Sermo - a social network for physicians - and Carol.com, which is creating a market for consumers with health plans to buy discreet bundles of medical services.
With the number of U.S. adults who are Health 2.0 consumers now said to be over 60 million, there is obviously a big market for social networks. I have been a member of a great diabetes social network, Tu Diabetes, since last November. I haven't logged in as much as I should've, but when I have it's been a source of inspiration and support. In last year's post I mentioned a bunch of Facebook groups - but I must admit that I haven't used any of them.
Of course, there are lots of niche bloggers covering all kinds of health issues. For diabetes, a few of my favorites are Amy Tenderich's DiabetesMine, Lemonade Life, Ask Manny Hernandez (the founder of Tu Diabetes), and SixUntilMe. Do also check out some of the more general health 2.0 blogs - Indu Subaiya and Matthew Holt's The Health 2.0 Blog and Bertalan Meskó's ScienceRoll are two of my all-time favorite blogs.
If you want a much wider selection of health 2.0 blogs to subscribe to, you simply can't go past RNCentral.com's excellent list of Top 50 Health 2.0 Blogs. Or if you want a search engine based around those blogs and more, then our own Marshall Kirkpatrick has created one of his famous 'magic searches' for health 2.0: Top Health 2.0 and Medicine Blogs.
To be honest, I don't think I've used the Web as much as I could've in managing my diabetes. Partly that's because many of the most innovative apps are not available to people who live outside the US - e.g. I wouldn't get much benefit from using Google Health, as it only connects to healthcare systems in the US (and only parts of the US, at that).
Also, it took me a few months to adjust to having diabetes and by that stage I was set in certain offline habits - such as entering my glucose readings into the paper notebook I was supplied with by my diabetes nurse. It was only when my paper notebook ran out that I was prompted to use a web app instead!
There is a more psychological reason too: over the past year I've felt that I was spending enough time offline doing diabetes management (injecting myself with insulin twice a day, exercising, eating good foods, etc). So I think that, subconsciously perhaps, I resisted spending online time on diabetes management too. I wanted to just get on with my job and life, without letting diabetes get in the way of what I did before I got it.
However, those are excuses. I recently started to use the Web to monitor my diabetes (the iPhone apps mentioned above). And I hope I can make better use of Tu Diabetes and other online health management apps more over the next year. Perhaps that will be a New Years resolution!
As always in posts like these, I have only listed a tiny fraction of the websites, blogs, social networks and web apps that are available in the health 2.0 field. I invite you to list those that are missing in the comments below. And don't forget to tune into RWW Live later today, on the topic of 'health 2.0'. It starts at 3.30pm PST Monday (6.30pm EST).
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Thanks for that Richard - some great resources which I will have to work through. I have been Type 1 for many years and have yet to find an online app which gives both myself and my consultant the data we need in the format we need it.
I have looked at the iPhone app you mention as well as one or two others and a combination of difficulty getting data off them and having it structured in the same way as the paper diary you mention has stopped me from using them.
Have a look at this - altho it is very Web 1.0: diabetes.sinovo.net
keith
Posted by: keith bohanna | November 24, 2008 9:22 AM
Great article, Richard. I too am a recently diagnosed diabetic, but Type II, not Type I.
This article is really useful and an example of how the personal can inform online journalism.
Posted by: Stephen Wellman | November 24, 2008 10:23 AM
Hi Richard,
Thank you for putting together this comprehensive "tiny" list for diabetics. I would like to take this opportunity to introduce our new site: http://www.ehealthme.com . eHealthMe has been covered on http://www.diabetesmine.com before.
We enable diabetics (and other patients) and health professionals to run large, long term drug safety studies of their meds. Here you can check and compare the interactions and side effects of your meds from 10MM adverse outcomes since 1977. An innovative community is also available for users to collaborate to get better drug outcomes.
Thanks,
Johnson Chen
Posted by: Johnson Chen | November 24, 2008 10:26 AM
Stephen, sorry to hear about your recent diagnosis! I do encourage you to sign up to Tu Diabetes, it is really a great community of people with diabetes.
Posted by: Richard MacManus
|
November 24, 2008 10:39 AM
One of the best articles about health and medicine 2.0 recently. Kudos to Richard!
Stephen, you can also join dlife.com, a huge community of diabetic patients. You can find information there and plenty of support.
Posted by: Berci Mesko | November 24, 2008 10:52 AM
Great write up.
On Google Health: even if you did live in the US you wouldn't get any benefit from it. What a waste of potential it is. Only a few medical providers are linked with Google. I have checked with my doctors and there is no way i can get digital info from them and import into Google health. They all say that they are working to integrate with Google Health but nothing seems to happen.
Until then, Google health is just a few links to some other usless online health web sites.
Posted by: Jmartens | November 24, 2008 11:12 AM
Thank you so much for mentioning my blog (Lemonade Life)! I'm honored to be included in your list of favorites. I hope you will participate in our 1st Annual Diabetes Community Secret Santa! It would be great to have you a part of it.
Cheers,
Allison
Posted by: Allison Blass | November 24, 2008 11:45 AM
Your question "how about diagnosis via the web?" sparks my interest because www.kwikmed.com is already doing this. Kwikmed presented at Health 2.0 and demonstrated its branching technology software which creates a medical record for physicians to review and decide whether or not to prescribe. The company is the ONLY website that has worked with regulators to create a model for the online delivery of care. Today it is licensed to sell only five medications, speciifically ED drugs, a hair loss drug and a smoking cessation drug, but kwikmed believes it may soon have approval for additional medications. In August 2008 Mayo Clinic Proceedings published an article about how kwikmed's software based model of diagnosis is SAFER than traditional medicine. Diagnosis on the web is a REALITY today. See Mayo Clinic article at http://www.mayoclinicproceedings.com/inside.asp?AID=4747&UID=
Posted by: Peter Ax | November 24, 2008 1:26 PM
Very interesting read and thank you Richard for including MyMedLab in your list. It truly is an exciting time to be in the Health 2.0 space and we're just getting started.
We believe that step 1 in any 21st Century solution involves creating a Personal Health Record and getting an unbiased evaluation of your current health. This starting point has real value regardless of who you are.
For those of you young and healthy, it gives a baseline in good health to compare to as you get older. For those of us in the "middle age" category who only seek treatment when we absolutely have to, it tells us what we need to work on. And for those with chronic conditions, it allows you to get involved in your care like never before.
Once you know your numbers you can begin to make informed decisions, formulate a plan, and track your progress over time. Health care is not getting any better or cheaper without your input. Get involved, your health and your family are depending on it.
David Clymer, CEO
MyMedLab
Posted by: David Clymer | November 24, 2008 6:33 PM
My husband has contracted Type II Diabetes, which has been pretty scary for us. At first I freaked, but after reading some great blogs, Web MD, and "Living Life as if Thinking Matters," written by Randy Wysong, my mind is more at ease, as I have learned about some great tips to keep him healthy. Thanks for your great information also.
Posted by: Becky | November 24, 2008 10:16 PM
Thanks for the shout-out Richard! Very informative post.
I noticed that under communities you didn't mention www.DiabeticConnect.com, the newest and fastest-growing social network for people with diabetes (I am Community Manager). We already have over 12,000 members in just 4+ months.
Posted by: AmyT of www.diabetesmine.com | November 24, 2008 10:35 PM
A very informative post-- and I wish you could have met Health 2.0 under better circumstances. Would love to mention ExperienceProject.com, where we've built a very large network based solely on shared life experiences-- the largest subset among them being health.
Posted by: Arron | November 25, 2008 1:22 AM
Great article, Richard. I think you might be interested in our site too: RateMDs.com (http://ratemds.com). We have over 600,000 user-submitted reviews for US and Canadian doctors.
Posted by: John | November 25, 2008 8:57 AM
Richard, thanks for the reference. This is a fascinating survey of where health on the web is currently at.
The value of Aliveworld, along with a set of simple tools for setting and tracking your health goals and measuring progress is the mechanism for gathering a group of supporters around you. We've found that one of the things that makes it easier to make and maintain any serious change in your lifestyle is the support and motivation you get from others who want you to succeed - family, friends, health professionals. In Aliveworld you can invite any number of people you trust to have access to your progress record. You can focus on self-managing your lifestyle and monitor issues like exercise, weight, diet, blood sugar, etc. Your supporters can view your entries and leave comments, offering you encouragement and maybe suggestions when it's needed and applause when it's due. The system can automatically notify your supporters when you need a fillip, if you want it to.
Cheers,
Gail
Posted by: Gail Romano | November 25, 2008 12:49 PM
The term “Health 2.0” has been bandied about quite a lot recently, but I think we are some ways away from seeing it actually fulfill its promise. My concept of Health 2.0 is a system of online tools that access hosted, centralized information such that all the participants in health care – patients, physicians, payors, pharmaceuticals, hospitals, etc – can interact seamlessly with each other, share information, and form appropriate communities.
There are multiple currents in health care moving toward this goal. The patient-centered “self-help” current is the focus of this blog post. A patient with a specific health need (Type I diabetes), who is motivated to use web tools to access information and manage his/her health is a powerful force in healthcare (referred to by many as “consumer-driven” health care). With no disrespect intended to interested and enthusiastic individuals seeking to better their own health management, when taken alone, this does not change the overall health care picture on a macro level very much.
The other currents are also significant, and have yet to evolve to the level of patient-generated Personal Health Records – physician behavior must change to widely adopt electronic medical records, and do so in a way that the data is hosted, sharable, and available for integration into personal health records. This is the vision of Practice Fusion’s free EMR – to give physicians the tools to generate their in-office chart notes in a way that appropriate data can be shared with other practitioners also taking care of the same patient (reducing needless duplication), and can form the basis of building a patient-centered portal (a Personal Health Record populated by one’s doctor’s medical records). Multiple communities can arise from this – from a simple, private and secure doctor-patient community, to communities among professionals looking to improve general levels of care, to communities involving public health agencies looking to track epidemiologic data. The sky is the limit. However, to get to there from here, we need to build a few bridges still – and one of them is the change in physician behavior that results in using “EMR 2.0” tools, which are a necessary building block (even a cornerstone) of the vision of Health 2.0.
Posted by: Robert Rowley, MD, Chief Medical Officer, Practice Fusion | November 25, 2008 1:30 PM
Richard,
Thanks for a fantastic post. I have a close family member (in their 20s) who learned that she/he has Diabetes Type 1 about five months ago. So far she/he hasn't done a lot online either. And now you've explained clearly why. So much more needs to be done to expand awareness and understanding of Diabetes Type 1. This is a great start. A most sincere thanks.
Posted by: Debbie Weil | November 25, 2008 2:00 PM
Richard - Thanks for the excellent overview of health 2.0 applications. It will be really interesting to see what new and enhanced consumer health applications will surface by next year. The ingenuity and creativeness of entrepreneurs to help improve health and healthcare is heartening and something that we should be thankful for this Thanksgiving.
Posted by: Tom Eng, Healia | November 25, 2008 2:26 PM
Hi, all. Fascinating, edifying post and interesting responses—which demonstrate both the interest in Health 2.0 and the many applications engendered by and typifying it.
I am so glad that you featured on RWW Live: Health 2.0 Abe Lederman, President and CEO of Deep Web Technologies and creator of the new search engine Mednar and Robert Shelton, CEO of Private Access, a suite of web-based applications that promises to solve the privacy hurdle that the medical community faces when attempting to recruit subjects for clinical trials. Private Access really is an innovative product that will hugely benefit patients by educating them about the clinical trials process and thereby enabling them to participate in that process more, which is often a help to individual patients in the trials and which at the least advances science as whole. Both of these men are enabling researchers and laypeople to acquire information of direct relevance to them in often frightening or scientifically perlplexing situations. That is Web 2.0 at its finest. I have tried Mednar and am impressed with it—especially in its capacity to deliver into my email inbox the latest research on whatever medical condition I am interested in.
Thank you for keeping us all apprised of such important social, technological and medical developments.
Posted by: Hope Leman | November 26, 2008 6:17 AM
KQED, the local San Francisco public radio station did some interviews around this topic in their "Health Dialogues" section.
Seemed like a great introduction:
http://www.kqed.org/radio/programs/healthdialogues/
Look for "Health 2.0" with guest Amy Tenderich from DiabetesMine.
Posted by: evbart | December 2, 2008 11:11 AM
Thank you for this great summary of the health space online!
I would like to share a site as well. DiabeticLivingOnline.com is an extention of the sucessful magazine Diabetic Living from Better Homes and Gardens.
This is a link to the press release with more information about the site http://www.prweb.com/releases/2008/12/prweb1698174.htm
Posted by: Janell Pittman | December 5, 2008 3:16 PM
Dear Richard,
Thank you for your very helpful post. I understood when you said that you had not spent as long online as you might because in a way it was your refuge when life was changing a great deal. That is the case for very many people at all stages of illness, and it makes good sense. It's important to keep hold of your identity when something like this happens.
I wish you all the very best in the coming year,
Anne Marie
Posted by: Anne Marie Cunningham | December 12, 2008 5:36 AM
Personal Health Records allows patient to provide doctors with valuable health information that can help improve the quality of care that patient receives. Personal Health Records can help to reduce or eliminate duplicate tests and allow you to receive faster, safer treatment and care in an emergency and helps to play a more active role in yours and your loved ones’ healthcare.
Posted by: Personal Health Records | December 17, 2008 1:41 AM
I like your posts, It makes me thinking.
Posted by: HGH | December 20, 2008 2:34 AM