The Future of Definitions and Developers

Optimized-NegroponteIn the Health 2.0 world we’ve been talking about and having fun with definitions. There’s a whole list of technologies being used in health (SaaS, cloud, mobile, community, sensor et al.) that my partner Indu Subaiya and I (and others) have called Health 2.0 since 2006. They mimic exactly what Tim O’Reilly defined as Web 2.0 — which of course we shamelessly aped and adopted.

Some (like Rock Health’s Halle Tecco in a comment about what digital health is and isn’t) think of Health 2.0 as being consumer-focused. In the 1990s we called this B2C, as opposed to B2B for professionals or institutions. But we believe the difference between Health 2.0 and run of the mill health care IT is essentially the same as the difference between cloud-based vs enterprise client-server software. Any visitor to a Health 2.0 conference since 2007 could have heard Indu and I define it that way. And we’ve since seen huge numbers of Health 2.0 companies focused on the B2B market.

Mainstream health care IT went client-server (mostly) in the 1990s and generally still is, as a trip around the HIMSS floor will confirm. Then there’s eHealth — the dominant term in the late 1990s that was the original analog (I had to get that word in somewhere) to what’s now called Web 1.0, or broadcast web with limited community features.

Web 1.0/eHealth was not client server enterprise software, but it’s OK to believe, as we do, that the technologies underlying Web 2.0 are qualitatively different enough to call them something else — even if it’s more of an extension of the web than a transformation. Some diehards believe it’s all been the same since 1994, and it’s fine for them to believe that. After all there were lots of communities online in email list-servs and bulletin boards, and the early WWW was not enterprise client-server.

Then there’s the newly resurgent “digital health” (notice how I got my use of analog in first) which Eric Topol, Paul Sonnier and others have popularized in the last year or so. But I’m not sure that “digital” is new, given that Nicolas Negroponte’s book Being Digital is 18 years old, and the term digital health, as Malay Ghandi points out, was first used in 2000. And a real futurist, my old colleague Paul Saffo explained that “Digital is Dead” in a brilliant essay back in 1997.

But what’s starting to happen is that mainstream health care is now courting the formerly ignored world of (insert your choice of term here!). That makes lots of exciting opportunities for developers and it’s why we’re hosting a conference for them called Health:Refactored. But it does leave us with a problem.

All definitions are by definition-limiting and therefore wrong. The question is, are they helpful? If everyone (including enterprises) is moving to Health 2.0/digital health/eHealth etc., how do we understand the next frontier? We’ll be working on that …

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