Sex, drugs, rock and roll, Victoria’s secret bras manufactured with formaldehyde, motivating kids to move about more, and texting potential sex partners your latest STD test results: the 2010 Health 2.0 Conference in San Francisco was more about real, whole health and the person-patient than about cool new tech.

Furthermore, the Health 2.0 Conference turned a lot of preconceptions on their head on October 7 and 8, 2010, in a standing-room–only ballroom at the Hilton Union Square.

Who could have predicted that government employees would light the room up with high energy and innovative thinking more than a panel of illustrious Silicon Valley venture capitalists? Not me, and I get paid to forecast for a living.

The Conference has grown beyond its San Francisco roots: there are many new chapters of H2.0, from Tokyo to Chicago, DC and New York, among them. But San Francisco’s meeting, held in the autumn annually, is the big one.

Some of my favorite moments from the meeting follow…

Donato Tramuto of Physicians Interactive kicked off the first dueling panelists with a poignant story about his sister-in-law’s loss of life from a preventable medical error in a hospital. “What unites us here today – common passion and commitment to drive innovation in an industry where every single person will access some form of health care….Technology is an indispensable element in improving the quality of our delivery system. Medication error could have been avoided by using an EMR. I know the pain and suffering that can be incurred by a health system crippled by an inefficient system of technology.”

In a lunch-launch of ten companies, the crowd favored Castlight Health, a start-up with $81 million in hand, to provide price transparency to the ever-growing legion of health consumers who need tools to help them health-shop for MRI scans, hip replacements, and ER visits. This type of service should do well in light of the expansion of both consumer-directed health plans (including MSAs, HSAs and HRAs) along with the general trend of health consumers paying more out-of-pocket for their health plan co-pays and coinsurance amounts as employers look to stem the cost increases of health plans.

ShareCare launched this week, Jeff Arnold’s start-up 10 years after his starting up WebMD, which he sold to Healtheon in 1999. Timing is everything, and 11 years later he’s launched his newco. Arnold videoconferenced in Dr. Mehmet Oz, one of ShareCare’s plethora of partners, from Pfizer to Walgreens and the Dove brand. And, of course, Oprah’s name was bandied about. Dove, is spending $3mm to be part of the effort (according to Forbes’ reporting). This website will feature content created by both physicians and clinical professionals along with marketing partners.

I had the honor of interviewing John DeSouza, CEO of MedHelp, on the big stage to kick off day 2 of the conference. The backstory of MedHelp is that in 1993, founders Phil and Cindy were researching online on Compuserve, seeking information about the worsening health status of Cindy’s mom. In 1994, MedHelp was born out of that health-seeking experience. Sixteen years later, MedHelp has organic growth of 10.5 million visitors a month — organic growth meaning that the organization does not pay search engines online to direct traffic their way. This is not a trivial point. The other non-trivial point about MedHelp’s growth is that they have never receiving funding from the venture capital community.

Jeff Goldsmith made the case that the U.S. health system is tribal, which accounts for its complexity: that cultures and tribes fight over resources. He noted that, “It is easier to buy than to grow new IP [intellectual property],” in light of the declining productivity of the pharmaceutical sector. When pointing to a photo of Jimmy Buffett Parrot Heads (fans) at a concert, he warned, “It’s terrifying to me what is going to happen here. 21 million Baby Boomers will be single by 2015. Who will take care of us? If the kids living in our basements hang around for a few more years, they may make a seamless transition to being caregivers from parasites….The Health 2.0 community must help society to manage chronic conditions and Boomers’ bad health habits.”

Tim O’Reilly, one of the most inspiring speakers at the conference, challenged the audience to “Change the world by spreading the knowledge of innovators.” He believes that, “Data is the ‘Intel Inside’ of the next generation of computer applications, but…it is pretty clear that data isn’t coming from your phone…it’s coming from the cloud” (computing). O’Reilly observed that, “We are building a single global computer in which everything is connected – this is the context for Health 2.0. Everything else is an access device.” O’Reilly also noted the importance of looking at data, both that which comes out of devices and behaviors and data shadows: “When we go to a restaurant to see leftover food on our plate — that is information. We can learn from this.” Finally, let’s remember O’Reilly’s experience that, “Innovation begins when people are having fun, playing around.”

Jeremy Shane of Health Central offered some sage observations based on his constituents who, together, are “the voice of the holistic patient” in his eyes. “They come to us as more experienced patients and it’s our mission to try and satisfy them,” Shane said.

West Shell of Healthline said that health search online is “the most confusing information retrieval problem on the web. All the languages in health – insurance speaks in billing codes, docs in Latin, consumers in quasi English.” He showed a colorful, rich visual dynamic image of a heart, powered by Visual Productions and Healthline’s Body Maps tool; this should be a useful tool to enhance health literacy. Shell sees that, “the [health] insurance industry knows they have to use their data more effectively not only for health care but new business models.”

Arguably the most dynamic panel of the 2 days was the trio of “brothers in arms” from — think of it! — the Federal government. Aneesh Chopra (CTO of the White House), Todd Park (DHHS), and Peter Levin (VA) described the healthy fruits of the Open Government initiative which spawned the Community Health Data Initiative (CHDI) and the many projects that are utilizing public health data from counties, Medicare and Medicaid, CDC and the VA.

Chopra introduced the segment announcing that, “It is the American peoples’ data – released for free in a tsunami of data.” He’d like to make the Department of Health and Human Services the NOAA of health data — NOAA supplies weather data throughout the U.S. “What if Health and Human Services did the same thing with health data?” as NOAA does, Chopra asked.

Levin discussed the Blue Button initiative for the VA, which allows veterans to download their health data from practice settings onto personal thumb drives. This links with the MyHealtheVet system, which 1 million veterans use for personal health records. While there are about 6 million vet’s who could be using these PHRs, 1 in 6 is still a strong base to build on.

One of the most impressive new start-ups to Health 2.0, First Life Research, is an Israeli company which has converted hundreds of thousands of messages dealing with prescription drugs online: their tagline is, “Patient experiences at your fingertips.” Gideon Mantel leads the organization, and talked about his application of the semantic web in developing the portal. He estimates that there are 600 million posts online written by patients; First Life Research is converting this patient language into actionable medical insights, covering over 9,000 prescription drugs. For Singulair alone, Mantel has mined about 25,000 posts coming from 13,000 authors. Mantel has built a decision tool for health consumers, looking at messages’ data on side effects, drug effectiveness, switching, interactions, and other factors. He showed percentages in these various categories that look quite different than those generated in limited clinical trials published in the literature.

Alex Ressi of Tweet What You Eat has built a way to crowdsource a calorie counting database with reference data on Twitter that gives the user real-time feedback. Ressi’s goal is to create “the simplest food diary you could ever keep.” Built in 2007 to lose weight for own wedding, Ressi’s tool has morphed into a community of “twye” people interested in watching their calorie intake. Why Twitter? It was integrated into Alex’s everyday life. The heart and soul of twye, Ressi said, is the forum featuring lots of successful weight-loss stories.

Other interesting companies to watch coming out of beta testing include healthTap from Ron Gutman of Wellsphere fame (looking like a platform for participatory health), Zamzee from HopeLab (to encourage young people to engage in ‘going more, getting more,’ motivating physical movement for health and fun), and an emerging thoughtleader in John Moore of the MIT Media Lab’s health program.

As always, Doug Solomon of IDEO inspired and taught, this time under the banner, “this is what sex sounds like.” He described a project with the goal of reducing the number of unplanned pregnancies in the U.S. for women 18 to 29. In other words, he said, the challenge was “to change behavior in the face of one of the most powerful biological urges on the planet.” A few of the key learnings: prototype the right tone of voice (and test the messages), weed out industry jargon, and meet people where they are. Check out for more information.

Another major surprise in real-world health mode was, launched by Ramin Bastani this week. With the tagline, “Spreading the love, nothing else,” Bastani wants people who engage in sex to stay healthy. Qpidme’s service enables users to get their STD test results routed to the mobile phone of a prospective sex partner. Follow Ramin on Twitter @Qpidme to see how the program develops.

Alex Drane, founder of Eliza, talked about our unbalanced lives which lead to less than optimal health behaviors and less than good outcomes. “We don’t do what we know we should do because our lives get messy,” Drane knows. Big life issues – money concerns, bad sex, relationships, caregiver stress, job stress — get in the way of our positive health engagement. She presented “The Ostrich Index,” the delta between how important something is to us and whether we feel supported by the health industry for that objective. Diet and exercise are being supported; however, job and caregiver stress, relationships, unhealthy sex lives and money concerns — not so much.

Dr. Roni Zeiger spoke as a health citizen with Alex when unveiling their launch of Their objective is to make talking about health, well, sexy (more on this effort in a future Health Populi).

One of the most sage speakers on the program was Dr. John Mattison of Kaiser Permanente. He wants to see, “sustained behavior change – there has to be a very conscious effort to insure that decisions are informed by as much information as possible available soon to be enhanced with genetic information for individuals. We’ve fallen far short – if information therapy were effective McD’s would be selling veggie burgers only.” Dr. Mattison expects that social decision support and games will bolster personal health decisions. He asked how we accelerate the pace of change and scalability?

Practice Fusion is on the way to scaling up. A totally web-based, free electronic health record, Practice Fusion showed off with many of its service partners including but not limited to Surescripts, Google,, YouTube, Vimeo, Quest, and LabCorp. The EHR is built on open standards, and continues to look for new applications to expand functionality. It’s probably the only EHR on the market today to incorporate a physician selection function: in this case,, which sees itself as Zagat and TripAdvisor for doctors. 4.5 mm patients per months use Vitals to look up doctors. Dr. Chrono powers the ability with Practice Fusion for patients to schedule appointments online.

The final panel of venture capitalists capped off the meeting in agreement that new technologies in health care that get funding must be focused on processes and applications that reduce costs — not ‘toys’ that are cost-increasing and don’t add value.

Health Populi’s Hot Points:  This conference was preceded by a half-day of Patients 2.0, spearheaded by ACOR‘s Gilles Frydman. For real-world context, please read my post of 7 October 2010, which sets the larger picture in which to place the Health 2.0 Conference.

Indu Subaiya and Matthew Holt, founders of this Conference, incorporated more patient-centered perspective and real-life, whole health into this year’s agenda. In its fourth year, the Conference has matured: some developers demonstrating in 2007 have gone into the sunset, while others have grown and morphed beyond search into full-fledged communities and participatory medicine destinations.

The question of business models is on many of our minds as the recession, health reform, and patient/health engagement continue to trend in their own directions. These forces converge and drive the need for new metrics on which to base  business models beyond advertising. While some start-ups are heavily geared toward advertising, consumers’ demand for authenticity, transparency and trust may lead them to other sources of health engagement: Jeremy Shane (Health Central), Alex Drane (Eliza) and Chris Cartter (MeYou Health) all spoke in some length about the need for authenticity. They understand that, coupled with trust, authenticity is an enabler for health engagement. This emerged as a top-two factor in the 2008 Edelman Health Engagement Barometer.

Of course, health literacy underlies engagement, as well. Doug Solomon’s attestation that meeting the health citizen where she/he ‘is,’ where they live, is why will work, why Text4Baby is already taking hold in its target market segment, and why WEGO Health has become a favorite for many health activists.

Even without health reform, patients both insured and uninsured are engaging with the Internet, both in 1.0 and 2.0 guises, in growing numbers. Mobile is a game-changer in health, equalizing web access across the races, as Susannah Fox’s Pew Internet & American Life survey tells us. Those building newcos in this dynamic environment will also need to consider new ways of measuring success. Patients 2.0 and government’s movement toward Data Liberación have set the stage for the disruptions to begin.