Why WebMD Is History: The Next Generation of Web-Based Medicine


The healthcare industry has been waiting a long time for its “2.0” moment. As social networks like Facebook and LinkedIn exploded in the late 2000s, so did e-commerce, enterprise SaaS, and cloud services. Business models, features and strategies have all dramatically evolved in the past decade and the valuations of many IT companies have taken off. But the Health 2.0 transformation is finally here, and it’s going to be profound—dramatically changing the way patients obtain health and wellness information, track their progress, and interact with providers and physicians. It’s going to be an exciting time in Silicon Valley as next-generation information startups address the multi-trillion dollar healthcare market.

The first generation of Web-based health information tools emerged during the dot-com boom. Organizations like WebMD, Wikipedia, health.com, and Mayo Clinic began to give patients much more information than they ever had access to before. But these sites are like dinosaurs in today’s age. Even beyond look and feel, users just are not getting the information they want. In a 2010 Pew Study, over 50 percent of adults reported that the health information they found online was of “no help” at all. No help at all online? That’s an amazing opportunity for startups.

So what needs to happen? The status quo is that users go online and search or navigate their way through sites that provide medical content. It’s static and one-way. Health 2.0 web applications will become more personalized and interactive. They will begin to use individualized quantified data and patient history to give very specific feedback to users. Service models will evolve to the point that physicians are integrated into the online experience.

The first critical component for any new online medical information product is to establish trust. Patients want to believe that the information they are getting is accurate, and they want any information they provide to remain private and secure. Sites like Wikipedia suffer because it’s hard to know if their information is accurate or not. Sites like WebMD and Health.com lose a tremendous amount of credibility because their visitors are immediately inundated with advertising. How does one trust a site’s content when its entire model is predicated on attaining advertisement dollars?

Mayo Clinic establishes credibility based on its brand, but another way to do this is to have doctors validate the information. Patients trust their doctors, and getting physicians involved in the Web experience can be a huge boost in establishing this incredibly important validation. In addition, integrating physicians into the Web experience can help make the experience more interactive, sticky and valuable. Companies like WellnessFX and HealthTap—in which my compay, Asset Management Ventures, is an investor—are on the right track here.

Patients should certainly be able to get curated and timely information. The medical profession is filled with scientific studies, confusing names for therapeutics, jargon, and Latin words. When everyday users seek information about a medical problem, they need to get back information that is easy to understand and digest in simple, everyday English. Latency has no place here either—the expectation for any interaction with the web is that feedback is immediate. This means that companies need to be developing on Android, iOS, and HTML5 so that their applications can be accessed anytime, anywhere.

Personalization will be another critical component in improving a patient’s online experience. One factor driving this is the emergence of the quantified-self sector. There are currently hundreds of young companies offering connected devices to collect and analyze personal data pertaining to blood pressure, weight, pulse, activity level, sleep patterns and mood. Patients ought to be offered personalized medical information based on the readings from such devices. Partnerships will play a key role and companies will need to figure out whether they are platforms, data collectors, or data analyzers and where they sit in the value chain.

There are currently no dominant platforms, and this may be a hard area for startups to move into. It’s difficult for platform companies to generate scale without some compelling application or service that inherently solves a problem and attracts a critical mass of users. Of course, existing enterprise applications or electronic health record systems used by large medical providers could solve this problem, but I would still keep my eye on smaller companies like WellnessFX (advanced lab testing) , AirStrip (FDA approved patient monitoring), and Avado (patient relationship management), which sit between patient and physician and could evolve into interesting platforms that collect consumer-generated data and integrate it with the providers and their electronic health records and then run analytics on these data.

In order to be long-term, sustainable businesses companies will, of course, need to have a viable monetization model. As previously mentioned, advertising can present problems when people are looking for credible, unbiased information. Advertising also doesn’t bring in much money on mobile devices. Would traditional healthcare payers get involved? Perhaps, but it’s unlikely that there will be direct reimbursement for health care information any time soon. It’s not unfathomable to imagine insurance companies offering reduced co-payments or deductibles for patients who find the answers to their questions on the Web, thus avoiding costly doctor visits. What about charging the end consumer? Patients already assume basic, public health care information should be free, but what they may pay for is quick access to certified physicians. I feel that most consumers would be willing to pay some money (perhaps up to their co-pay amount) for a home-use, mobile-phone-compatible diagnostic tool that would help them to avoid having to drive their sick child to the hospital.

So what kind of world could this be? Well, imagine you start by having a DNA test. You also use a daily monitor that measures activity and mood. When working out you track your pulse and exercise intensity. At night you track your sleep. You regularly measure your blood pressure, weight, and body mass index, and, perhaps annually, get advanced blood work done. When feeling ill, you can run basic diagnostics from home using your mobile phone and attachments. All of these data are seamlessly transmitted to the cloud and combined with your medical history. Sophisticated algorithms can correlate data and give you periodic reports on your health and also highlight when you may have problems (this is an area where IBM’s Watson project may shine).

If you don’t feel well, then you first go online to a site where you enter your symptoms. This information, combined with data related to your history and statistics, will give you a first attempt at a diagnosis. Or perhaps a reply will ask you more questions to hone in on an answer. If you need to speak with a medical professional, you first do this online with e-mail, chat, or a video feed. This integration of quantified data, online content, medical history and online physician input could serve as an early triage system that would save everyone time, improve patient outcomes, and save the healthcare industry billions of dollars. Companies are now developing the building blocks for all of this; it won’t be long before it’s all brought together.

Skip Fleshman is a Managing Partner at Asset Management Ventures, which has invested in Health 2.0 companies such as CardioDx, HealthTap, Lark, Proteus Biomedical, and Maverix. Follow @SkipFleshman

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