SWW3923movement is the 5
and final ‘C’ – care that is more efficientand empathic.II.
VOLUTIONARY STAGES OF CONSUMER
Health 1.0 (1C) = content
, the “read-only” Web. Examplesare WebMD, early DrKoop e-newsletters, and searching for clinical information on MedScape.com.
Health 2.0 (2Cs) = content + community. Health 2.0
addscommunity on top of new and existing content. Health 2.0services provide ways for patients to collaborate usinginformation accessed online: patients start trusting patients.An example of a
service is DiabetesMine.com, run by blogger Amy Tenderich .
Health 3.0 (3Cs) = content + community+ commerce. Health 3.0
plus the addition of commerce, whichinvolves firms building business models based on consumersaccessing content and forming groups. Commerce is the portion of
that successfully adds value. Value isdefined by four important characteristics: (1) spans thecomplete process, (2) always connects to a specificstakeholder (3) differs for every individual stakeholder, (4)must be delivered through a sustainable process .Commerce is the function that adds value for both theconsumer and the clinician. It is important to note here that‘commerce’ in a consumer-centric system can be defined asany transaction-based model, not necessarily one that ismonetized. The commerce requirement of
can besatisfied simply, with the consumer sending information/datato the service, ‘transacting’ with the system via transmissionof personal identifying information – for example, byestablishing a user account and logging in repeatedly to awebsite.Indeed, many
companies are built upon 'free' or 'freemium' access models. In a 'freemium' model, basicinteraction with a site is free, but users are charged for a premium membership, which provides additional value-addedservices (e.g. SugarStats.com).Examples of current
companies are AmericanWell, Carol.com and Organized Wisdom. In some
models, like searching for a condition-based WisdomCard ™on Organized Wisdom, consumers transact with the system byinteracting using personal identification data (user login, etc).This method of commerce, the 3
,maximizes value for both parties - the consumer gains aWisdomCard compiled by a Health Guide utilizing semanticweb techniques ("smart search" or “human powered search”),while the company gains additional user data anddemomodelics that inform future search topics. This user interaction is precisely what creates value, literally ‘organizingwisdom’ via an informed user base. In the
sphere,simply gaining a new user increases value for companies, asuser-strength/community-strength numbers often drive marketvaluations and are a primary data set used to secure advertisersand venture capital.At an industry-wide level, with the onset of the
phase entrepreneurs will test business models that move beyond traditional ad-revenue based income streams. Health3.0 will be heralded by an era of mergers and acquisitions:small, inefficient, redundant offerings die out, someorganizations will merge with larger firms, and additional partnerships will develop among Health 2.0 startups.
Health 4.0 (4Cs) = content + community + commerce +coherence.
This evolutionary stage connects the real world of brick-and-mortar systems with the virtual world of onlineservices.Coherence features in
companies will connect patients and professionals in new ways: facilitating human-to-human conversations that determine care pathways both onand offline. Health literacy developed in earlier stages isemployed here – patients become an integral part of thehealthcare conversation, proactive partners in care responsiblefor setting and working towards personal wellness goals.At the
stage we begin to move beyond a flawedencapsulation approach to treating illness and injury, whichhas resulted in today’s perpetually fragmented deliverysystem. At the
stage we see an emphasis placed onoptimizing health and wellness, prior to a disease state, allalong a consumer’s lifeline.
will begin to emerge when multiple stakeholder groups realize the system lacks coherence necessary to evolve.Businesses, hospital systems, NGOs, governmental agencies,consumers, nonprofits, foundations, providers, caregivers, pundits, academics et. al. begin to agree that although manyofferings provide access to content and community, as well asto the most advanced medical technologies, there remains acatastrophic gulf. New coalitions and partnerships willacknowledge the value of cooperative work groups in buildinga bridge to better care.As a result, interactions between consumers at theintersection of the “real/virtual” axis and the“patient/professional” axis, as the authors will illustrate usingthe ‘
, become much more coherent. Real-time, seamless interoperability is achieved as companies joinforces. Here we present a scenario that incorporates multiplestakeholder interactions and illustrates what is possible withthe advent of
AN EXAMPLE OF HEALTH 4.0
A consumer is out shopping and begins having difficulty breathing – but the problem is not so severe that sheimmediately seeks emergency care. The patient logs onto aweb browser from the store, using her BlackBerry. This is anew symptom onset.She accesses a chat with a doctor function, which includeslive streaming video, via the American Well system.American Well is an existing
firm which allowsusers to access online physician services. Access is paid for bythe consumer’s insurance provider.This first portion of our scenario is not far off in the future – a physician-chat function will actually be available using theAmerican Well software as a service (SaaS) platform later thisyear. However, American Well is currently only enabling live