HEALTH 2.0 INTERVIEW SERIES — Fard Johnmar: “The first step is to decide what to change”

So far in our interview series leading up to the March Health 2.0 conference, we have talked with Scott Shreeve of Crossover Health and Ed Silverman of Pharmalot. Today we share our discussion with Fard Johnmar, founder of Envision Solutions and author of HealthcareVox.

Q: When you write about the Health 2.0 movement, you tend to put “movement” in quotation marks — as if Health 2.0 WANTS to be a movement, but really isn’t one yet. Why not?

A: Let me clarify my intent. First, the term “Health 2.0″ is one that has generated come controversy, mainly because some wonder what “Health 1.0″ is and whether appending “2.0″ to health has any significance. I’ve spoken with Matthew Holt about this. Based on our conversations, I think he uses the term Health 2.0 as a type of shorthand observers can use to illustrate how technology is playing a greater role in health.

In my mind, a movement is a grassroots effort being driven by a group of people seeking to change an entrenched system from without. In a few respects, the Health 2.0 community certainly qualifies. Some entrepreneurs in this space are hoping that technology can solve the many problems health systems around the world face. And, they are actively working toward this goal. However, others, for various financial and personal interests, are less interested in this agenda. This is part of the reason that I put the word “movement” in quotation marks, because it does not yet qualify. However, I would also note that I’m not sure people in the Health 2.0 community want to change it into a movement. Rather, they are interested in finding ways to leverage new technologies to meet their various objectives.

Q: You argue that Health 2.0 companies are too fragmented to have a policy impact, and that they need to begin working together. How might this cooperation take form, and what do you think it can realistically achieve? (Can you provide a couple of specific examples?)

A: I’m not the only one who has suggested that the players in the Health 2.0 world come together around a common purpose. I’ve mentioned the ideas of Marty Tenenbaum, creator of CommerceNet previously. He has suggested that businesses in the Health 2.0 space come together to form a network that would have the intellectual, human and financial power to generate real change in the U.S. healthcare system. Now, there are certain problems that are best left to policymakers, such as improving access to quality care. However, there are a host of other issues, including increasing the public’s ability to understand (and influence) healthcare costs, that Health 2.0 advocates could come together around.

The health industry is filled with examples of coalitions and public-private partnerships that have achieved great good. We don’t have the time to go into many of them here. But, what I would say is that the best partnerships are organized to achieve specific, tangible goals. I think the first step would be for the folks who are driving Health 2.0 to decide what it is they want to change. Once that happens, the rest is simply strategy and tactics.

Q: Even if Health 2.0 entrepreneurs come together to form a network or advocacy group, isn’t the likelihood that the promising startups will just get bought up by large healthcare companies anyway? Would such acquisitions hurt or help the “movement” as it’s currently envisioned?

A: I think the goal of many startups is to be bought out by large companies (inside and outside of the health industry). However, if Health 2.0′s proponents decide to achieve universal objectives, personnel/businesses may shift, but others will take up the charge.

Q: What are the four or five most exciting examples of Health 2.0 companies or Web sites that are currently online, and why?

A: Well, I’ve talked quite a bit over the past few years about companies I think are doing exciting and interesting work. This may continue. However, recently I’ve been focusing on some overall issues that are important in health, that go way beyond individual firms — although some have greater or lesser influence on them. They are:

• Patient privacy
• Healthcare information control
• Health behavior change

Based on my reading of articles, blog posts and other media over the past year, I think there is a conflict brewing between established health companies, Internet startups, government agencies and managed care organizations around who will be able to effectively address each of these issues and how they will do it. For example, one important question is who can we trust to protect our privacy? This is critical because new companies (especially in the area of genetics) are starting to gather data about individuals in unprecedented ways. What are their responsibilities?

I’m starting to look at companies within this context. Firms that are operating at a high level (no matter their size or niche) that appear to have the most influence in these domains are the ones poised to make the most impact on the health industry. I’ll be focusing on this topic a great deal on my blog HealthcareVox this year.

Q: How do you believe Health 2.0 will ultimately impact the current hot-button issues in healthcare — the large number of uninsured, the inefficiencies of the current system, and the high cost of care?

A: I’m not sure if Health 2.0 can impact access issues because that is something policymakers will have the most influence over. However, I do believe that technology can reduce inefficiencies and help consumers and others exert pressure on prices. This is because as pricing information becomes more widely available (and understandable), people (who will likely be asked to manage their own healthcare dollars) will gravitate toward the providers and services that provide the most benefit. This will take years, perhaps decades, but Health 2.0 technologies can certainly influence this process.

Q: What aspects of the Health 2.0 movement will have the biggest impact on the pharmaceutical industry, and on drug consumers? Can the Health 2.0 movement help bring down prescription drug prices for U.S. consumers?

A: Overall, prescription drug prices are out of the control of the individual consumer. The US regulatory/legislative structure has more influence on drug prices than technology and consumers ever will. In addition, with the flood of generic medications that will hit the market in a few years, drug prices have no where to go but down.

That being said, we are slowly moving to a system where drug companies are being asked to illustrate the benefit of their products in more profound ways. Technology will provide third party payers and consumers with detailed knowledge about the effectiveness of prescription drugs. I firmly believe that social media will help drive this trend because it will provide us — almost in real time — with information about drug side effects and real-world efficacy that is hard to get today. As more information becomes available, certain drugs will win while others will lose. I can’t predict how this will influence drug prices, but I’m sure it will have some impact.

Q: According to Ed Silverman at Pharmalot, pharmaceutical companies say they can’t be more transparent (and thus fully take part in the Health 2.0 movement) because of “regulatory oversight, trade secrets and fear of litigation.” Do you think these barriers to transparency are real? If so, how do you think the pharmaceutical industry might be able to overcome them in order to communicate more openly with consumers?

A: I certainly believe that the issues Ed mentions are very, very real. In many cases, it is much safer (and prudent) for organizations to remain silent about certain issues because of legal, ethical and regulatory concerns. However, there are a host of issues pharmaceutical companies can address that are pretty safe — especially at the corporate level. Given that the industry’s reputation is still poor (although some industry-backed surveys indicate it is improving) drug firms need to do a lot more to communicate about how and why they make decisions and be much more proactive and candid when communicating with the public. Social media can help.