Health 2.0: A lot of Hot Air in This Balloon

by | Apr 27, 2009

balloonThe Health 2.0 hot air balloon is beginning to leak air, drifting ever downward to earth, or at least that is what was hoped for in attending and observing the latest happenings in this market at the Health 2.0 conference last week in Boston.  We at Chilmark Research like many of the apps in the Health 2.0 market, we just seek a bit more balance, a little less hype, more reality, more real, less Memorex.

It’s Getting Hot in Here

Despite the event’s location, a city known for Yankee practicality, the denizens of Health 2.0 brought their Silicon Valley, anything is possible, just throw enough money at it mindset to Boston, which made it difficult to take many of the Health 2.0 companies’ demonstrations seriously.  For example, sitting in on the morning Health 2.0 Accelerator session on Day One, I was struck by the completely nonsensical business model of one young company that wanted to create a single health rating service, in the “Cloud” of course, that other services such as HealthGrades or Angie’s List would provide their ratings data to.  The company’s founders argued that by doing so, they could create a rating service with more reviews/doctor and thus higher statistical accuracy.  The “statistical argument” makes some sense, but there is no business here as any company that currently charges consumers to see their data (doctor reviews) is not going to relinquish that control to some other entity.  Crazy thinking.

Then we had the latest Health 2.0 darling, HelloHealth which is about as hyped a company as they come having their story recently published in the Hype-Cycle rag, Fast Company.  Now in HelloHealth’s case, I do admire the company for its novel approach of attempting to directly connect consumers to doctors and they may indeed have something here. Beneath the glossy Health 2.0 facade and intriguing model though is a company that has failed to scale having only added a couple of new doctors, they’re up to seven now, since formal roll-out six months ago.  Despite all the marketing, clearly something is wrong with this picture.

  • Could it be the difficulty to do referrals outside of the HelloHealth network?
  • Could it be the inability to automatically load consumer/patient’s labs into HelloHealth?
  • Is it that to promote HelloHealth, they use virtually every successful Internet business model (in their demo they mentioned among others: Amazon, Apple, Facebook, Twitter) as an example of what HelloHealth provides, which for a skeptic such as myself sends up the warning flare?

One thing is for sure, having heard their pitch, seen what they have accomplished, have a better understanding as to what the platform can and cannot do, this app is not ready for the main stage.  And we are not the only skeptic as a doctor present at Health 2.0 also has some reservations.

The numerous demos by various Health 2.0 companies did not provide enlightenment, as they were not much more than an elevator pitch, and analysts hate to be pitched, it just makes our skin crawl.  But in this case, these young companies were more a victim of the format that strives to show a broad array of apps, thus limiting demo-time to a paltry 3-4 minutes.  The organizers of Health 2.0 would be wise to be more selective in the vendors they choose allowing those chosen to go into greater depth (why are they different, where will they succeed, how they differentiate from 800lb gorilla, WebMD, etc.) and even let them bring a customer who can tell their story as to how the vendor’s app directly affected them in the management of their health or the health of a loved one.  Without those stories, those truths, that eliminate hype and bring forth reality, we the audience suffer under a steady stream of hot air.

Bright Lights

In and amongst the detritus of Health 2.0, there were some excellent highlights, stories, and reflections by various presenters which follow:

John Wennberg of Dartmouth Health Atlas fame gave us real numbers (analysts love numbers and stats, especially when the logic behind them is valid) pointing out where some of the real problems are in today’s healthcare morass (think acute care and end of life).

John Halamka of Beth Israel and Roni Zeiger of Google Health were very open and transparent as to what went wrong when e-Patient Dave tried to move his Personal Health Information (PHI) into Google Health.  Halamka stated that it was a mistake to allow transfer of admin data, which is well-known to be almost useless and chock full of errors.  Roni just put up a post on the issue today. John put one up last week.

During the Accelerator 2.0 meeting heard about some interesting partnerships between traditional HIT vendors and Health 2.0 companies such as: Sage, change:healthcare & Kryptiq.

In a discussion on “expert” (clinician info, peer reviewed journals) versus “patient/consumer” information a patient gave a compelling argument that during her cancer treatment, information from fellow cancer patients was far more useful and pertinent.  In her words: “the doctor and researchers have never directly experienced the disease for themselves, they do not know what it is like to actually go through the treatment, other patients do.”  Quite profound. Could this lead to a change from the type of content providers currently provide their patients? Might they begin augmenting “expert content” with patient/consumer content, say pointing them in the direction of PatientsLikeMe or MedHelp for community support?

Dr. Frenadouple of Renaissance Health, is quite the forward thinker believing consumers should have full rights and access to ALL of their records, period! The good doctor went on to say that the only way we’ll see change in healthcare practices is if people/consumers start voting with their feet.  He and Renaissance Health want to be in front of that movement, which they believe is inevitable, and are doing what it takes to get there.  They are walking the walk – impressive.

Over lunch, Scott Shreeve gave a great deep dive on the recently announced $10M X-Prize that is focused on healthcare.  Many at the table questioned whether or not the X-Prize can actually addressed a system as complex as healthcare, a valid argument.  Scott stated that the X-Prize Foundation is still in the process of further defining the structure of the challenge and welcomes feedback.

Another cancer survivor spoke of the dire need to have someone who cares when battling the disease.  It could be a loved one, a doctor, or other human. The important point being made is that technology, no matter how fancy, easy to use, information loaded, etc. at the end of the day will not give you a hug and say everything is going to work out.  You need that human touch.

Looking Ahead:

Most of the companies on display at Health 2.0 will not be with us in 3 years time.  There are simply too many companies with too little differentiation, chasing too few dollars with faulty business plans.  The market is not yet at a state of maturity that will lead to broad adoption, consumers are simply not that engaged, yet.  The majority of clinicians, a trusted source of information and advice for consumers perceive most Health 2.0 apps with a jaundiced eye as well, further hindering adoption.  That is not to say the whole market is awash in such companies of questionable business plans, questionable value and low prospects for a future.

We at Chilmark Research know a number of young companies, many of whom were not at Health 2.0, and some that were, who are extremely busy serving clients, talking to prospects and wooing investors.  Many of these companies are gaining traction in the market and have the numbers to back it up, a key metric that was rarely on display at the Health 2.0 conference. Therefore, while the Health 2.0 conference provides some perspective on this market space, it is far from complete.  Do not judge a market by what you see or hear at a conference such as this, but what you learn out on the streets talking to company executives, listening to their customer’s stories and seeking and finding clear differentiation that will stick. It takes more work, but it is well worth the effort.


  1. Matthew Holt

    John, if we’re all about being transparent, please tell us who “we” are? Or is this a case of one person trying to make their singular opinion look a tad more general. Perhaps, hyping it a touch? BTW, if you want to take over the “Health 2.0’ss all hype” leadershp, you do have a little competition! Ha ha!

    More seriously, if you dont like the format of the conference–fine. complain away. Enough complaints and we’ll change it. But we tend to listen to the crowd (via the survey) rather than the one person who thinks they know it all. (And you’re not the first to tell us!)

    But the idea of the 3-4 minute demos is to give an example to the panel–not to tell us everthing about that company or service. Surely you can tell us how they differentiate from WebMD? Or if not, why they don’t. You are the analyst after all. (Hint: start with Medscape vs Sermo)

    And concluding that a movement is dead because several of the companies in at the start won’t be around in the future is, frankly, a crappy piece of forecasting. After all, look at how many companies started in the PC business, and how many are around today? Lots fewer, but there are lots more PCs.

    Everything you say about Health 2.0 has a grain of truth, but there is one area where your analysis is lacking. How much is this going to matter for health care?

    That’s the real question and it’s one that you’ve ignored with your myopic look at only the individual companies. They are at this conference because they are examples of what we (i.e. the organizers) think are important–not to do your analyst work for you.

    I guarantee you that several of the ones you think are going away will be here in several years, and several of the ones that weren’t here that you like so much will be dead. That’s capitalism and it’s fine.

    I really welcome you looking into Health 2.0 because it needs analysts to take a rigorous outside look. But please remember the big question, and while lost in the trees, don’t forget to give us your thoughts about the forest.

    • John

      Great feedback Eugene, thanks for taking the time to provide such a thoughtful review and response to my early comments about what your company is attempting to do in the healthcare space. At this point, we will probably have to agree to disagree as where you see a potential business/operating model, I do not. Just do not see how you are going to be able to get the data up into your cloud service, let alone how these ad supported rating services will survive with such deep cuts in ad spending and pharma, always the one with deep pockets, extremely reluctant to support such rating services for pretty obvious reasons.

      Of course, I could always to proven wrong and it certainly will not be the first time and unlikely to be the last. With that I wish you and your team the best of luck and feel free to contact me if I can be of any assistance.

  2. Indu Subaiya

    John, regarding your point, “We at Chilmark Research know a number of young companies, many of whom were not at Health 2.0, and some that were, who are extremely busy serving clients, talking to prospects and wooing investors”, I just wanted to mention we have an open speaker/demo submission process on our site and spend hundreds of hours sorting through and previewing companies. But of course, even with that process, we can’t uncover everything alone and are constantly introduced to rising stars through journalists, VCs, entrepreneurs and our friends and colleagues in general. Rather than be mysterious about who these other more substantive companies are, I believe it would be in the companies’ best interest if you were to write about them, expound on their business models and tell us and the world why they’re great. Indeed, we’d love to meet them so we can continue to expand our focus and showcase the best that’s out there.

  3. G

    John – excellent commentary. I for one have seen this script, long before they penned it Health 2.0. The promoters of this deflating hot air balloon will question your motives – but the “veracity” of your observations holds, no matter which spin master tries to come at you. I am glad to see you call a spade a spade.

    This phase shall pass too – and as you have stated – in 3 years these shennanigans will be in the rear view mirror. I have myself written a few eulogies for these tech-spun fads over the years – both as banker and entrepreneur in eHealth. It is amazing how people in the “fashion” business have very short memories and just simply lie to themselves.

    Thanks again for the great and honest commentary!!!

    As for the lost souls trying to prod you about the real companies in this space – they miss the basic point – these “real” companies want no part of this deflating hot air balloon called Health 2.0.

    • Matthew Holt


      No one is questioning John’s motives (although I may be questioning why he’s using the plural like the Queen of England).

      And “promoters” — me at least — have been calling spades spades for a damn long time. Go check THCB for the last 5 years if you’re not sure.

      But unlike you (and somewhat John) we’re doing this all out in public, not hiding behind initials, not claiming that there are “special secret real companies that want no part of this conference” without naming them.

      And given that the aim of the conference is to change health care as we know it by using technology to promote transparency, pray please tell us as a banker what you’ve done to help achieve that–other than to describe a bunch of fellow “entrepreneurs” as spinmasters and to falsely say that they’re attacking John’s motives. I’m not attacking his motives (and I have seen anyone do that).

      What I am doing is questioning the unit of his analysis–which he puts at the individual company level. That’s completely different.

      So come join the conversation instead of slagging a straw-man of your own creation.

      • G

        @ Mathew Holt –

        “What I am doing is questioning the unit of his analysis–which he puts at the individual company level”

        Since you have decided to take personal shots at John’s unvarnished observations (and the reason I commented on the post) – let me give you a taste of the same.

        While I don’t follow your ramblings – I did get a taste of your pontification recently. I will use that as an example to point out why your ramblings while out in the open is just NOISE….. you are the same person who recently suggested Google’s sharing feature may be a “killer app” and has the “potential to be really disruptive.” (well it was already a feature with other PHR platforms) Well if that is your killer app – and the bar you have set for your collective expert analysis – say no more. The 2.0 stuff is just a feature set among others – NOT A PRODUCT – I just dont think you want to accept that fact. But I understand – you make your living in this space.

        And yes – I don’t need to tell you who I am because I choose not to be in 2.0 delusional league. And I am not building my ventures to impress the 2.0 crowd either.

        But I am happy to see that people like John Moore call out the total lack of utility in these fads (he may be one unit as you put it – but his thoughts are a collective digest of the many others who choose not to live in the press – but build their companies).

        And besides if you can’t handle the truth when I just use one of my initials – imagine how crazy you will be when I bring out the funny stick and call you out with all five letters in my name.

        I will say this again – Enjoy the last leg of the Health 2.0 delusional pathways…. as with everything, all of this hype will be in the rear view mirror – very soon.

        You remind me of Rodney Dangerfield – I CAN’T GET NO RESPECT….

  4. Kurt

    thank you great post. I wasn’t at the conference, but I completely agree with your thoughts.

  5. John

    It is unfortunate that you do not take time to reflect on what was stated in this post for if you did spend time to think before acting, your response may have been more measured, articulate and less defensive bullying.

    In response to some of your points:
    1) I often use the plural “we” for Chilmark Research for I do have a couple of associates that I work with and solicit their opinion(s). Using “we” simply acknowledges their input. Note, I do not pay them, thus they are not listed on the site.

    2) Having been an analyst for years now, I have experienced many a hype cycle (see Gartner for definition) and was even suckered into the dot com buzz around eProcurement and eMarkets virtually all of which ended up in the gutter. I see far too many similarities in the Health 2.0 hype that cannot be ignored. My argument here is that as the conference organizer, it is YOUR job to educate the audience and conduct some due diligence in advance. The recent event did little to convince me that either was done or at least not done to a sufficient level of scrutiny to provide value to your audience, or at least those in the audience that have familiarity with the market.

    3) Nowhere in the post did I state that Health 2.0 is dead. Where the heck did you get that idea? What I did do was state that most of the companies that demo’d at your event will not be around in 3 years, which is a reasonable forecast and as I recall one that one of your panelists, Esther Dyson, said much the same thing while she was up on the stage. Sorry Matthew, I’ll side with Esther and my own research and analysis on this one.

    4) Not sure where you get the “myopic” view of the analysis and write-up as the write-up talked about companies, speakers, highlights, a whole host of things. Did you actually read the whole post or just the first two paragraphs and the conclusion. Please re-read, there is more here than what was regurgitated in your response.

    I think that hits the high points of your questions Matthew and thanks for your response. Do hope that in time you will see the above as constructive criticism and not take it as personally as you apparently have for you and I are both in this, I believe, for similar reasons – a desire to see new models to correct many of the ills that are endemic to the healthcare system today.

    Actually, have written a number of posts on companies, both big and small. Recent ones include a post on HealthString, who has an interesting model and a post on HealthVault/Mayo, who presented at your event is another example.

    Do suggest that the format of Health 2.0 change to allow for actual users of a vendor’s solution to take the stage and talk about how the given app helped them. Nothing like a real life story to light up the audience.

    Thanks for the positive feedback. While I am not out to completely thrash the Health 2.0 movement, if there is indeed a movement at all – still not completely convinced outside of a few known successes such as PatientsLikeMe or Sermo that this really has legs, we will see.

    The challenge for any of these companies is consumer engagement, and not just once they get sick. As I pointed out in the post, we have a long ways to go to see significant, broad adoption in a market where consumers have been detached, clinicians skeptical, a fairly ineffective govt. and far too many reactionists (privacy pundits) to move the needle in a positive direction.

    That’s not to say it is unnecessary or that there is no market here. There are opportunities, but they will be on the edges and in the cracks of what we have today. The challenge, as you well know is determining who has done their homework, found a crack to exploit and has an effective model to leverage that crack into something broader and more sustainable.

    Thank you for dropping by, reading the post and providing the feedback.

    Again, thanks everyone for the comments, most appreciated.

  6. Matthew Holt

    G, I have no idea what you are talking about–and you’re accusing me of rambling? Where do I attack John personally, other than accusing him of using the term “we” when he means “I” (I also hate the use of the term “we’re pregnant”). But if you personally don’t have the courage to put your name behind your convictions, that’s your problem not mine

    John, we may not agree on what should be the role of a conference organizer, but I’ve been an analyst for probably as long as you have and I’m sure my won/loss record is just as good or bad as yours. So you dont need to lecture me about the hype curve.

    There’s nothing in the least bullying or unmeasured in what I wrote and I stand by it.

    My point, which you seem to have missed as badly as I’ve apparently missed yours–and if you really want I can go through your piece line by line–is that every aspect of the conference that you talk about (with the exception of one paragraph about “expert vs UGC”, and another about Wennberg’s stuff which while excellent is not exactly new!) is either in praise or criticism of individual companies. And we both agree that many individual companies will not survive–same as with any new market. There’s no dispute there and never has been.

    In addition there’s a healthy dose of criticism of the organizers (me, Indu & Josh) for the format of how we ask our demo-ers to present themselves. I have no problem with any of that, and obviously we take all our audience feedback very seriously. All I’m telling you is that our intention is to give examples in quick demo format to the panelists.

    You may not think that worked (and in a couple of cases I agree with you); and you may not think that’s what we ought to have been doing. But that is what we were trying to do.

    And maybe I’m leaping to conclusions but when you say the balloon is leaking, ideas are crazy and the audience is suffering, I’m not taking it as a positive review! Not that it matters, so I apologize if I leapt to the conclusion that you’re saying the movement is dying…I just think that’s the impression you’re conveying. My apologies for misinterpreting you.

    However, when I say you are missing the forest for the trees, I’m very serious. Again, I’d really be interested in figuring out what you think about the big question. Will Health 2.0 (whichever definition you like but no any individual company) have a real impact as part of the future of health care?

    That to me is the most important part of the entire discussion. And one I’d welcome hearing your opinion about.

  7. Christine Kraft

    This kind of dialog is based in the “poverty consciousness” — the belief that there just isn’t enough (of anything) to go around.

    My vote – for Health 2.0 and beyond – is for abundance. Matthew, you are a powerful leader. John, so are you. We learn from you both, even as you work on different angles, concerns, milieu, etc.

    I want both of your careers and opinions to flourish. Yet, admittedly, I may have a stronger affiliation to one camp over the other.

    We must make more room for dissenting opinions in order to make lasting change. Health is value-embedded, so only through dissention can the dialog advance.

    This is the time to open up the valves, but to take good care of each other so no one is washed away. There is absolutely nothing to lose if we approach these debates from the place of abundance.


  8. Dmitriy Kruglyak

    I am happy to cede “Health 2.0 is all hype” leadership to John 🙂 I simply do not have enough time and interest to comment on every nonsensical and irrelevant thing coming out of those delusional quarters. There are more things to life than argue with clowns.

    In any case, I have been doing it in the past just to get the ideas out there and help people start thinking and understanding what is going on. Now I am glad I am no longer the limiting point for this education in critical thinking and diffusion of reality check viewpoints 🙂

    John, great post and analysis as always. Keep it up!

  9. John

    You state: “However, when I say you are missing the forest for the trees, I’m very serious.”

    I guess will have to agree to disagree.

    First, hard to call this a forest when there is very little in the Health 2.0 camp that is thriving. Maybe to quote Monty Python, a “shrubbery” is a better analogy, ad yes, I see the shrubbery just fine.

    As to Health 2.0 and its future impact on healthcare? Regardless of definitions for Health 2.0, I have never supported the term to begin with, rather I look at the market through the lens of “consumer-facing technologies that will assist them in better managing their health and/or the health of loved ones.” No Health 2.0, no Web 2.0 or any other marketing hype, just what are the apps, the technologies that will assist the consumer, period.

    BTW, the latest in the healthcare hype I’ve seen recently is Health 4.0, trust you are not behind that one 😉

  10. John

    Please, I beg you, do not pass the ““Health 2.0 is all hype” leadership” baton to me. I really don’t want it. Please find another worthy soul. 🙂

  11. Matthew Holt

    John, fair enough although please look at the shrubbery and not just the bulbs!

    I think it’s easier to say “Health 2.0” than to say “consumer-facing technologies that will assist them in better managing their health and/or the health of loved ones.” but we’re pretty much talking about the same things 🙂

    But you do know that you have to do what Dmitriy says. It’s the law of the Internets…

    as for the 4.0 version, that’s Jen McCabe Gorman’s terminology, and much as I love Jen, unenthusiastic is not how I’d describe her!

    cheers & I’m enjoying the banter in what I hope people realize is a respectful way, Matthew

    • John

      When I see something actually growing, thriving, I’ll take notice, don’t you worry about that, and such notice will be far above bulbs, above scrubs and if we ever get there, above the forest, but first we need seedlings (healthy vibrant ones at that) to nurture.

  12. Dmitriy Kruglyak

    John, no pressure to pick up the baton :). At this point I think the ideas of reason and rationality are spreading on their own.

    IMHO, anyone who has anything that is growing and thriving would be crazy to label it Health 2.0. Why get a promising project lumped with dreamers, delusionists and snake oil salesmen? Only those who have no fundamentals to rely on would need Health 2.0 label and approval of people like Ellsworth Toohey, I mean Matthew Holt. That’s exactly what “G” is saying.

    If anyone thinks “becoming Health 2.0” and going to these conferences is a path to success, please contact me for some great rates on oceanfront real estate in Las Vegas! LOL.

  13. Eugene Borukhovich


    We would like to thank you for extracting our presentation out of many during the three hour Health 2.0 Accelerator session. The young company you mentioned with the cloud reviews idea was us,, and we wanted to clarify the assumption by you that we base our business model on this idea. We are not in the doctor rating and review business – it is a commodity.

    First and foremost, the goal of our idea is to provide the consumers/patients valid statistical data so they can make an educated decision. Per your commentary (…“statistical argument” makes some sense”) we seem to agree – great!

    Secondly, while some companies may charge for the crowdsourced knowledge, there are another 30+ sites that do not, and their business model is based on advertising. We do not force companies to hand over their assets, we offer them the opportunity to show the link to their content. What we are proposing is an open platform that would be valuable to both patients and the physicians and force some players to adjust their proprietary models.

    “What Would Google Do?” by Jeff Jarvis covers a lot of the points and has guided our vision around the open platform:

    “Publicness is about more than having a web site. It’s about taking actions in public so people can see what you do and react to it, make suggestions, and tell their friends. Living in public today is a matter of enlightened self-interest. You have to be public to be found. Every time you decide not to make something public, you create the risk of a customer not finding you or not trusting you because you’re keeping secrets. Publicness is also an ethic. The more public you are, the easier you can be found, the more opportunities you have.”…..

    “Publicness also brings us collective benefits, as should be made clear by now from the aggregated wisdom Google gathers and shares back with us thanks to our public actions: our searches, clicks, links, and creations. Publicness is a community asset. The crowd owns the wisdom of the crowd and to withhold information from that collective knowledge—a link, a restaurant rating, a bit of advice—may be a new definition of antisocial or at least selfish behavior.”

    To paraphrase Clay Shirky (sorry Matthew) – “If we were not doing something right we would not have critics”

    Looking forward to many more face-to-face discussion at the next event.

    People can see our presentation on:



    Part I –
    Part 2 –
    Part 3-

  14. Jeff Brandt

    Great review and input,

    It is just the process that we have to go through anytime you have a Paradigm Shift in a vertical field such as healthcare. A lot of people get into the act to make fast money and they fall by the way side while other get traction and people say, what a genius. Examples, Amazon eBay even Microsoft. IBM had to beg Gates to take the job. The good news is that we learn a lot from others mistakes and false starts.

    So keep throwing out the ideas good or bad, and let the markets decide.

    Jeff Brandt
    motionPHR Personal Health Record for the iPhone
    mymedbox – Personal Health Record for the Google Phone



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