DiabetesMine founder Amy Tenderich noted that they had "many iPhone-based entries, but what these two students have designed goes beyond a single logging, data calculation or learning application." She listed the following reasons this concept stood out (edited version):

• The LifeCase & LifeApp solution is a glimpse of the future; they've taken the integration of diabetes devices to its fullest conclusion.
• The phone acts as a glucose meter, controller for your pump, and data logging application all in one, with built-in capability to share the data across platforms. The case even houses a lancet and test strip storage for a complete, all-in-one solution.
• The system could easily be expanded to include continuous glucose monitoring (CGM).
• This system is not limited to the iPhone models, but could be implemented on any smartphone.
• The technology to make this system happen is all here and functional. It just needs some visionaries to push for implementation.

In regards to the last note, this is only a prototype currently. However, we agree with Amy that this is the future of diabetes mobile phone apps - and points the way to how mobile phones and the Internet will improve other health care appliances in the near future.

The app also enables users to email their readings, along with a message, to other people such as your parents or nurse. Plus it has charts and lists - not unlike another iPhone app which this author uses to manage diabetes, called Diamedic.

The new LifeScan iPhone app isn't the only initiative to use Web technology to improve the lives of people with diabetes. DiabetesMine, a website run by Amy Tenderich, is running a competition for an iPod-like device or web app for diabetes management. According to Tenderich, "21m Americans live with diabetes, yet the devices we rely on generally don't hold a candle to the sleek design of consumer electronics (think iPod)." The 2009 DiabetesMine Design Challenge is offering a prize of $10,000. It's sponsored by the California HealthCare Foundation (CHCF), with support from global innovation firm IDEO, and by health blog Medgadget.com.

The Internet in Everyday Objects

We're increasingly seeing the Internet-enabled objects that up till now have been offline experiences. Earlier today we described how a UK company, partnering with Penguin, built 6 web-based book applications - including one that used Google Maps for a 'flyover' experience of storytelling, a Twitter book, and one where real time user keystrokes were tracked as part of the story. The creator of those, Dan Hon, told us that he was excited to see Bluetooth connectivity enabling a vastly improved interface for glucose monitors. He said that developments like this could be the stepping stones toward a future of ubiquitous computing - we're inclined to agree.

The next step of LifeScan's Internet-connected glucose monitor might be to have all that iPhone functionality in the glucose monitor itself, doing away with the need for the iPhone. Right now the cost of that would be prohibitive, but we can imagine a time in the near future when touch screen UIs and Internet connectivity in everyday devices will be commonplace and inexpensive.

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?

Consumer Web Apps

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.

Connecting to Health Professionals

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.

Medical Records

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.

Portals

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).

Search and Information

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:

• Patients Like Me: this one is getting a lot of interest in the industry; it allows you to drill down and see people with your condition, on your drugs and see what did or did not work for them.
• DoublecheckMD: uses natural language recognition to allow consumers to search medical texts and match symptoms with the drugs they’re on.
• Vitals.com: a one-stop shop for information about physicians; uses reported empirical data, patient reviews, and an algorithm extracted from physician reviews.
• Organized Wisdom: "the Wikipedia of healthcare".
• American Well: a "virtual visit" service, profiled recently in The New York Times.
• Kosmix: a kind of search-portal for many different verticals - one of which is diabetes.
• Healia: a health search engine that gives you filtering options.
• Healthline: a health information portal.
• CognitionSearch: semantic web health search.

There are many others, too many to list in one post!

Community

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.

Blogs

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.

My Own Health 2.0 Usage

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!

What Are Your Favorite Health 2.0 Sites?

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).

I encourage you to check out the 5-minute video, embedded below. Admittedly it means more to me than most people, because I actually have diabetes. But it's an eye-opening video for anyone wanting to know how the Internet and web 2.0 can help change the healthcare system, right now.

Not a Magical Elixer

OK, let's be clear - the Internet is just an enabler. Of course there is a lot of work to be done to remove the piles of red tape and inefficiencies in healthcare. But it's good to see healthcare gradually become web-enabled and the video celebrates this. If nothing else, consumers have much more healthcare information at their fingertips via the Web and are able to gather and socialize with people in specialist social networks such as Diabetic Connect. Amy also noted in her email to RWW that the Web is "changing our relationship with the medical establishment & pharma companies, so they finally view us as consumers, demanding the right products and treatments to help us live better." Here's the vid:

See also:

• Health 2.0 - Apps & Trends to Watch
• Health Care at SXSW - Health Getting Hot With Tech Crowd
• Top Health 2.0 Web Apps

In this post, I'm somewhat selfishly going to review the diabetes sites and apps I found across the Web. But this post also serves, I hope, as an introduction to the more general topic of 'Health 2.0' - a.k.a. healthcare that uses the Internet. Over the weekend, Frank Gruber posted an excellent round-up of health 2.0 resources on the Web. Frank pointed out that the big sites, like Web MD and HealthLine, are the resources most used. But there are a lot of newer sites and apps that offer a more modern, Web 2.0 approach. He also noted that both Microsoft and Google are making moves in health 2.0. For example see our story earlier this year on Microsoft acquiring MedStory.

Defining Health 2.0

As with Web 2.0, there is a lot of debate about the meaning of the term 'health 2.0'. According to the Health 2.0 conference blog, their definition "is currently focusing on user-generated aspects of Web2.0 within health care but not directly interacting with the mainstream health care system." This means things like search, communities, and tools. As yet Health 2.0 user-generated content has not been connnected to the wider health care system - which, according to the Health 2.0 conference organizers, hasn't even adopted Web 1.0 yet!

Search

The first thing you might do if you discover you have diabetes, is do some Web searches on it. In my case my doctor and specialist had already explained the basics of the condition to me: it is fairly easily managed, via testing your blood a few times a day and injecting insulin maybe a couple of times a day (it varies by person). Also you must drastically cut your sugar intake in food and drink, and exercise moderately. There is no cure at this point for diabetes, so this routine must be followed indefinitely. So I was told all that, but still I was curious to find out everything I could... so, to the Web search engines I went!

My next port of call was a specialist health search engine. Frank mentioned Healia in his post, a health search engine that gives you filtering options. In my tests, it didn't really throw up much new info that I needed. WebMD had better info, but it wasn't presented very attractively.

Healia

Another 'vertical search' option for health is Kosmix, which has a kind of search-portal for many different verticals - one of which is diabetes. Now this is more like it! There are guides, images, Q&A, videos, "trusted sources", news, a forum, and more - all very nicely presented and easy to access. Even the ads were relevant to diabetes. There are a lot of areas to explore in this portal from Kosmix, making it the best search resource I found on the subject. But it will depend on what you're looking for - in my case, variety and good presentation are key factors to help me explore this new condition I have.

Kosmix Health

For more info on health search engines, see of course our network blog AltSearchEngines. Editor Charles Knight wrote a post in June reviewing health search engines (including a list of them) - his conclusion was that WebMD was best, but he also recommended revolutionhealth , CognitionSearch , Healthline , among others. TauMed is another one I've come across that I like. Finally, check out the Great Debate on health search engines on ASE.

Health 2.0 Blogs

Search is all very well for finding information, but what if you're after a more personal connection - or social groups.

The Health 2.0 Blog is a great starting point for healthcare on the Internet. It's a community blog that started in November. There's also an accompanying wiki and Facebook group.

The Diabetes Mine blog is a more personal day-to-day reflections blog about diabetes, by Amy Tenderich. The most recent post is very relevant to me - it's about being diagnosed with Type 1 in your mid-30's!

Another great site for diabetics is dLife, an attractive portal of info and forum options. It recently launched an aggregator for diabetes blogs, Blogabetes [via ScienceRoll].

dLife

There are many more blogs related to health and technology - check out the blogrolls of the above sites, or a list such as this one.

Social Networks

So what can social networks provide for diabetics? As to be expected, there are a number of Facebook groups about Diabetes - over 500 of them in fact! The biggest is 'Find a Cure for Juvenile Diabetes', which has 5,470 members. I joined up to a few of these groups, but I wanted something more.

I eventually found Tu Diabetes, an online community for people with diabetes that was created in March 2007 by Manny Hernandez using Ning. Manny describes it as a place "where the members help each other out, educate ourselves and share the steps we take every day to stay healthy while living with this very serious condition." One person described Tu Diabetes as "like 'MySpace' on insulin"! The site recently reached 1,400 members and it is a great example of a niche social network, as the below introductory video from Manny explains:

Diabetes Web Apps

SugarStats is an app that allows you to track, monitor and share your blood sugar levels "and other key statistics" online. It is based out of Hawaii and was founded by Marston Alfred, who was diagnosed with Type 1 Diabetes over 15 years ago. Normally diabetics have a paper journal in which they log the blood tests we are required to carry out 3-4 times a day. SugarStats has potentially very useful aggregation, graphing and trending tools, plus you can share your stats with relatives or other diabetics. SugarStats also has a mobile version - even Twitter integration!! For more reasons why online diabetes tracking is better than the paper-based version, see this post on the SugarStats blog.

SugarStats

There is a free and premium version from $8.29 per month (with extra features such as Food/Carb Tracking & Graphs, and SSL security). I've signed up to the free version to try it out, but I can see myself upgrading if it works well for me. Overall, SugarStats is an excellent use of web 2.0 to enhance healthcare treatment.

Health 2.0 Events

Getting back to health 2.0 in general, in recent years health 2.0 conferences and events have sprung up. There was a BarCamp-like event called HealthCamp at the end of last year (no sign of a follow-up event though). The Health 2.0 Conference was held on September 20th, 2007 in San Francisco. There's some good coverage of this event on the Diabetes Mine blog.

The next Health 2.0 conference is 3-4 March, 2008 in San Diego, and the topic is "Connecting Consumers & Providers". For more information see www.health2con.com.

Conclusion

This is a pretty indulgent post really - basically I needed to do research into diabetes management for my own purposes, and I have blogged what I discovered. But beyond that, I hope this post gives you a good idea of what is available on the Web when it comes to healthcare.

There are a lot of people much worse off than me, both in terms of diabetes (it's much tougher for children to cope with) and other health problems that people endure. Also it's still early stages in "health 2.0" - i.e. for some the Web may be of little use. But the Web is increasingly enhancing healthcare - certainly it is very useful with a condition such as diabetes, which is common worldwide and is something that can be managed on a daily basis.

I'm sure I've missed some health 2.0 and/or diabetes resources, so please add in the comments. Also if you want to discuss how the Web has helped you (or not) with a health issue you've experienced, then feel free to leave a comment.

Top image: Diabetes Trophy, by PhotoPieces