Consumer empowerment, patient-physician relationship, and sociotechnical issues

1:30-3:00pm MaRS CR2, Medicine 2.0 Congress, Toronto (Sept17, 2009)

"Good Intentions and Bad Investments: EHealth and the Reality of Market Forces"

Presenters: Trevor D Van Mierio (Evolution Health- formerly V-CC Systems; Toronto/San Francisco, Canada), Rachel Fournir (Evolution Health, Toronto/ San Francisco, Canada), Breanne John (Evolution Health, Toronto, Canada)


This presentation took more of a generic approach and discussed the state of eHealth in general without focusing on a specific product.
Trevor based the talk on Gunther Eysenbach’s ‘law of attrition’ reiterating the fact that attrition across technology takes places despite engaging people in promoting and making the program. Moreover attrition permeates across all technology. He went on to discuss the dot-com bubble and how the company Evolution Health initiated. A focus on the “internet math” or the dot-com death spiral, also known as the ‘common faulty business model’ provided a high level indication of the common challenges in sustaining eHealth.
Emphasis was made on the three essential components of healthcare- (i) personal (ii) complex, and (iii) revenue-based. The burning question posed was “Why does it take so long to get a customer in eHealth?” I believe the question is more about the sustainability as opposed to getting a customer to use eHealth solutions going back to the law of attrition.
An interesting practice highlighted by this firm was the “Continuous Product Development Lifecycle” in which as soon as you implement a solution, part of your team starts looking into redevelopment to arrive at innovative ways of providing a solution. For all this to happen simultaneously, there is a need for collaboration and partnership with interest groups such as researchers, patients and academicians. Strong collaborative initiatives would make the solutions and its newer versions more sustainable and make investments more fruitful. The question here would be with regards to cost. Who would bear the cost of research? Do we need to budget for research funding, how much additional government funding can be sought out for various studies? To what extent would partnerships with vendors and academic institutions can be solicited for ongoing product developments?
While the speaker provided examples from Japan, the country being renowned for its fascinating interventions, emphasis remained on having thorough documentation, involving programmers, researchers, investors, lawyers, project managers, promoters, business development personnel, accountants and other related skilled professionals on board to work cohesively in the field of eHealth. I believe many other factors can come into play when discussing the market forces depending on the nature and complexity of innovation.