Tue

May 29
2007

Artur Bergman

Artur Bergman

Healthcamp 2.0

I had the pleasure of attending Healthcamp this weekend, an unconference focused on innovation in the health sector.

Healthcare spending in the US is roughly 16% of the GDP, or an astonishing 3 trillion dollars; about $6500 per person. From an innovator's point of view a lot of this infrastructure seems archaic, with a lot of data silos and incompatible computer systems. The idea behind Healthcamp is to promote the principles of Web 2.0 and bring innovators together in healthcare.

For me, the most interesting part of this is the rise of the expert consumer. A brilliant article on Salon; "Psych meds drove my son crazy" by Ann Baeur covers what happens when a rare disease meets doctors with too little time and skewed incentives. Google gave her the power to research and find someone to help her son. In my own recent experience with the medical establishment, I got copies of all the image scans they did. These scans are in the DICOM format. I was able to use a very impressive opensource application, OsiriX, to mainly distract myself by creating 3d renderings of my torso. It did let me understand and gave me the ability to talk with my doctors in a more efficient way, making me a much calmer and informed patient.

My favourite startup at Healthcamp, MEDgle allows healthcare consumers to enter symptoms and find the most probable causes. It is based on an expert system, with the data entered and classified by experts. It guides you along, asking what additional symptoms you have based on the ones you already told it about. Once it shows you a list, it will perform a websearch, or directs you to the Wikipedia article on the topic. After a soft launch last month, they claim that around 50,000 unique users have tried it out.

With Googles recent investment in 23andMe, a company that dedicates itself to "bringing you personal insight into ancestry, genealogy, and inherited traits", it is clear the interest in consumer DNA testing is increasing. Presenting at Healthcamp was Infogene, a small company founded by a Stanford genomists using a licensed genotyping technology from Stanford, to provide personalized tests such milk tolerance and capability to break down caffeine. After the presentation, the group discussed the reliability of unlicensed gene testing. By not providing a medical service, Infogene does not need to be FDA approved. While this drastically reduces the cost for the consumer, it opens up a potential future full of both legit and fraud operations. For medically indicated testing DNAdirect provides a large array of medical tests and helps you interpret the results. The importance of DNA testing for pharmaceuticals is increasing. The Mayo Clinic is already using gene testing to look for different capabilities to metabolize drugs, guiding the doctor's choice of anti-depressants to give particular patients.

Finally, Richard Shoenhair, founder of ReMedic.com, talked about breaking down the data silos. Currently the onus is on the consumer to manage and make sure medical records are transferred correctly between medical establishments. This is an error-prone process, where the average medical data exchange in an emergency room is between one and four hours. If you are suffering from an urgent condition, a data delay of an hour or four might be far too late, even with the best doctors. ReMedic offered website, call center and fax services that let you quickly get to medical data stored with them. Using information from an identification card you carry, emergency rooms could request records be faxed to them anywhere. ReMedic was sold to BlueShield/BlueCross and has since then not been active, however MedicAlert provides a similar service. Sadly, it is very much an old-style, hard to use web application.

Example of rendering I did, as a consumer, to better understand what was happening to me.

I am increasingly interested in healthcare. It began with my personal experience, but it's an industry bringing in relatively new technologies and principles, like Web 2.0 and opensource. These are prepared to change the healthcare landscape. If you have any suggestions of innovative new research and technology, please drop me an email: sky at crucially dot net.


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Comments: 3

Deepak [05.29.07 09:54 AM]

Companies (pretty much every pharma now) routinely use pharmacogenomics to evaluate drug response, especially to identify any adverse reactions. The most commonly used omics method is probably gene expression, but there are others that are becoming common. In addition a number of companies are developing diagnostics that use gene expression or some other genomic indicator as predictive or prognostic indicators.

In general, companion diagnostics will become more prevalent as time goes on (not as fast as some would like) and you'll find genomic, etc technologies being increasingly used in clinical trials.

There is however a huge gulf between molecular medicine and the patient side of things. Healthcare informatics still does not usually include molecular information, and the challenges of how to manage it responsibly and effectively are going to be critical in where medicine goes. Currently, when you look up causes in a search, you get broad answers, usually from a more classical reductionist medicine approach. The challenge is going to be (a) including molecular information in disease related searches (b) personalizing this information if possible. The latter is the ultimate goal and we are years away, scientifically, socially, ethically and politically. Hopefully we'll get there.

Scott Kozicki [05.29.07 07:13 PM]

Interesting. I've not heard of this conference and frankly it's not surprising that I've not heard of it and that the website looks a bit, ahem, beta. The Valley still doesn't understand health care and probably never will. Health care is not blogs. It's not Web 2.0. It's not going to give a shit about what technologies come and go, or the number of eyeballs this or that site has attracted. Health care is literally a universe unto itself. Immensely complex, particularly globally, and dwarves most countries when it comes to capital resources. Applying technology to current health care is like putting jet engines on a horse drawn carriage. You'll only accelerate the stupidity.

What's needed in health care is transformation of incentives on the part of purchase, patient, and provider. Then and ONLY then, will real sustainable gains be made in quality, access, cost, and application. The National Institute of Health did a study about 2 years ago where they determined that if you just took the money that's spent on advancing the state of the art, and applied it to reducing the deviation of access and quality, you'd get a much higher return. That's right. Stop developing new shit and just apply the shit you have and you'd get a better outcome.

I think that says it all right there.

Michael [05.11.08 10:18 AM]

A very good story.

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