From my persective, Social Media reminds me of that saying “if you have a hammer every problem look like a nail.” If social media eventuall adds value for healthcare consumers will eventually adopt it. How come we never hear anything these days about Friendster and Myspace – weren’t they the Twitter and Facebook only a few short years ago???

Yeah, so it’s hard to change behavior. Yeah it’s a good thing to have more preventative and primary care.

But Health 2.0 communities and tools are clearly helping patients and saving lives here and abroad. And there’s oodles of research from Kate Lorig/David Sobel and lots of others that online (and offline) support groups help patients achieve better outcomes at lower costs.

So is the complaint that spending on building Health 2.0 technolgies is crowding out spending that should go to preventative care? I think that’s the point of Darthmed’s comment on Fard’s piece here. If so that’s totally laughable. Maybe, maybe (even counting Revolutions big dump) a total of $1 billion has been spent in recent years building Health 2.0 technologies. We spend $250 Billion a year on cardiac treatments that have very dubious efficacy. Americans spend $10 billion a year on supplements that don’t do anything (according to most rigorous scientists). We spend $14 billion a year on a single drug (Lipitor) that many people say is harmful, let alone has insufficient evidence of doing what it says it does (reduce death from cardiovascular disease)

Point 2 is more crucial. Are we building tools for just already engaged patients? My answer would be that the tools make patients who had the potential and latent desire to be engaged get involved very easily. Clearly we don’t have all levels of patients as engaged as some of us might like–but more Health 2.0 technologies will be developed to bridge that gap.

And if we don’t get to everyone, so what? We’ll get to more people and do more good than giving up.

Weightwatchers has had success showing that easy tools plus communities can lead to behavior change. That’s exactly what Health 2.0 does (combine tools and community support). And yes there are still obese people. That’s life–not everything will work 100%.

But I’m most puzzled by darthmed’s claim that instead of Health 2.0 we should just ” legislate that patients should be entitled to receive within 24 hours of demand a one page health summary from their doctor + a copy of test results that they ordered and scripts that they wrote in the past 12 months, and leave it up to the clinics to work out how they deliver on it.”

Err…who does he think is behind that demand? It’s the predominantly Health 2.0 crowd behind http://www.healthdatarights.org leading that charge. The Health 2.0 technology crowd would love that easy access to data.

How DarthMed sees that as contradictory to Health 2.0 is beyond me. And maybe it’s just intellectually sloppy on DarthMed’s part to talk about billions of public dollars going into linking records, and equating that with Health 2.0. The ARRA/HITECH stimulus dollars are primarily about getting physicians to use electronic clinical workflow tools, and part of that is a demand to make the data able to be presented to patients. That’s exactly what Darthmed wants (and what the Health 2.0 evangelists of which I’m barely one) want too.

We might agree that instead of the modest carrot the government is offering, they could use a much bigger stick (e.g. no data no pay) to get to the same place, but in the real world of Congressional politics, that isn’t going to happen.

So I’m bemused by Darthmed’s demand that “Health 2.0 – prove yourself quickly or step aside”

And if we’re really all for diabetic screening et al for the underserved (and I am) why isn’t Darthmed screaming about the collapse of the health care reform bill? In that as part of his “buyout” Bernie Sanders got $2 billion increased funding for community health centers which do exactly what Darthmed is looking for. Surely the loss of that funding as health care reform dies is far worse than any “waste” on Health 2.0 technologies.

Again, it’s possible to get people to focus on doing things that help make their lives better, but it would be wrong to focus on technology rather creating, disseminating and duplicating best practices in behavioral change — for the short and long run.