The Health 2.0 conference returned to San Francisco for the fifth year, with a record-setting attendance of 1,500 this time around. The zeitgeist continues to be that of information technologists eager to fix all the problems of healthcare. 
With 35% of doctors carrying iPads and 85% with smartphones, there is plenty of opportunity for technology, but this year, there was also a closer attention to payment models and to incentives for use, both financial and psychological.
In his keynote, Mark Smith, President of the California Health Care Foundation, said that while technologies such as the Internet had transformed banking, travel and research, medical consultations were still being done the same way they had for the past 50 years. However, it is not enough to provide technology. He stressed that he wanted to fund projects that incorporated financial models that would encourage use. He said too much of what he’s seen in the past resembled the Underpants Gnomes of South Park, with business models consisting of 1. Invent Widget, 2. ????, 3. Profits!
Smith said that the most important element of any new initiative was that it reduce costs, not just by shifting them around, but by reducing the “perverse incentives” that encourage volume above all else. Other opportunities lie in improving convenience to patients, rapid learning for providers on how to make sense of the increasing volume of data and enrollment for the uninsured. As an example of how this could work, he cited how Kaiser-Permanente’s introduction of Electronic Health Records reduced specialist visits by 25%.
There was plenty of innovation on display on the stage and in the exhibit hall, such as:
• A heart rate tracker from Basis that you wear like a wristwatch
• A web site from GoodRx that does comparison shopping for prescription drugs
• Consumer health management and social media systems from WellnessFX, Numera Social, HealthTap and OneRecovery
• GE Intel Care Innovations home monitoring and communication system.
One of the most interesting talks was from Alexandra Drane of Eliza. She used her company’s automated phone call system to conduct a survey of patients, asking them to rank the problems in their life in terms of how much those things mattered to them and how much they received support on those issues from the medical establishment. The ratio, which she called the Ostrich Index, was around 1.0 for typical medical issues such as obesity, but far higher for other sources of stress such as consumer debt. Furthermore, people with multiple issues with high Ostrich Indexes were far more likely to suffer from serious illness. Her message to the audience was that it needed to take a much broader perspective on issues that affected health and that “health is life, not what’s measured in the doctor’s office.”
