Esther Dyson Interview About Health 2.0 and Why She Invested in OrganizedWisdom

We recently had a enlightening conversation about health 2.0, technology and innovation with Esther Dyson (seen to the left flying! Picture courtesy of Zero-G).  We've posted the highlights of our discussion below. 

We're thrilled to have Esther involved with OrganizedWisdom as both an investor and on our board of advisers.  Esther is one of the best known and most respected names in high-tech. She's a long-time catalyst of start-ups in information technology. Since the early 1980s, she's been closely involved in dozens of major development in computing technology and her insights have been a great guide to the future of technology innovations and their impact on business, society and individuals.  Esther's primary activity is investing in start-ups like OrganizedWisdom and guiding them as a board member. She specializes in online services and, more recently, IT and healthcare/genetics, and space travel.

Esther is an early investor and sometime board member of numerous successful technology companies including 23andMe, Medstory (which was acquired by Microsoft), PatientsLikeMe, Meetup, and Flickr and Del.icio.us (which both were acquired by Yahoo!) just to name a few. Esther is also on the board of advisers of the Health 2.0 Conference.

Unity Stoakes: As active investor in so many health companies and an advisor to the Health 2.0 Conference, you have a great perspective on new start-ups just launching.  What trends and innovations are you most excited about?

Esther Dyson: The thing that excites me the most is all the research and discoveries that are being made around genetic information. That's just part of something even broader, which is – there's gonna be a lot more information available.  We'll be able to understand the impact of treatments, and the relation between treatments, conditions, environment...We're gonna know a ton more. 

Unity Stoakes: What opportunities do you see for innovation or improvement with health search over the next few years, and really what do you think needs to  happen to make health search more useful to the average person?

Esther Dyson: Well, right now you're reading a lot about behavioral targeting of advertising; the notion is: You track someone's behavior online, you collect a lot of data and you can show them more relevant ads.  Imagine if, instead of tracking someone online without them necessarily knowing, you could ask someone, "Will you give us your health information?"

Then, instead of showing you more relevant ads, we can also show you more relevant content. And ideally, there's a difference between, "Oh, this guy goes to the travel site, let's show him an airline ad,".... and the guy who, in some form, tells the system, "Oh, I'm traveling to Paris next week," and you can show him an offer for 20 percent off on a flight to Paris.  That is not targeting, that’s actual personalization of the message to the person's specific circumstances.... In the same way, you can give them specific health care advice. We don't just guess you have headaches; we know the specific condition that is causing those headaches so we can personalize the content and make it more useful.

Unity Stoakes:  You've been a board member or early investor in so many innovative Internet and technology companies [23andMe, PatientsLikeMe, Flickr, Del.icio.us, Orbitz, Meetup, Medstory and dozens of others].  What lessons do you think health care companies could be learning from these types of companies to help people better manage their health, reduce costs, create a better health care system?

Esther Dyson: Well, certainly, one big area is the sharing of information, the sharing of experience, and people's interest in looking at their own data. On Flickr, you share photos.  You also look at your own stats: "How many people looked at my photo?  How many people thought it was interesting?"  On the medical side, that's somewhat akin to PatientsLikeMe. People might say, "Well, Flickr's frivolous, and PatientsLikeMe is serious."

But it's still a natural human instinct that information about yourself is fundamentally more interesting than information about other people. As people look at more health information, it's got to foster healthier behavior. As people pay more attention to their personalized health information, and as they generate more information to look at, we will have much more information to do research on, and figure out what the correlations actually are between behavior and genes and exposure to environmental things, and various kinds of diseases, and also which therapies are good for them.... Just as we are seeing on sites like Flickr where it's really about sharing, people are just beginning to feel much more comfortable with going online with creating data, looking at data, and are no longer as scared of all the stuff as they used to be. This won't happen all overnight with health information; it just takes time.

Steven Krein: What do you think happens in the market with the creation of new content, and new answers, and new information that could be made available as a result of now giving people so much more information that they’ve never had about themselves before?

Esther Dyson: Well, first, I'd word that differently.  I wouldn’t say people are being given more information, I'd say people are getting more information. They're actively going out and getting it.  It's not just lying around.

Unity Stoakes: We're very honored to have you as an investor in OrganizedWisdom, and on our advisory board.  We're very early on in our evolution, and what we're building, and obviously very proud of our mission.  What did you see that helped you decide to work with and invest in OrganizedWisdom?

Esther Dyson: I saw that people are confused, and OrganizedWisdom is providing information that's relevant, rational and useful. Over time, I see this being expanded as well, to become a more personalized service as we've talked about.

Steven Krein: How do you explain OrganizedWisdom to others?

Esther Dyson: Well, interestingly, it's kind of like what Yahoo was, originally, in that it's not only a search tool.  It's a structured information source.  Unlike Yahoo, you actually produce the content, you don’t simply select it, and that gives it a certain consistency of quality.  It's health information that's organized and reliable, which is still hard to find.

Steven Krein: If there was a feature that you'd love to see integrated into OrganizedWisdom one day, what would it be that you think would make our service better?

Esther Dyson: Well, probably it would be something that looked at your personal health record and gave more personalized results than just what you search for.  For example, you feed in a list of the drugs you're on, and it would give you information specific to the conditions that those drugs normally treat.  It would also give you alerts when new relevant information appears somewhere.

 

Unity Stoakes: Health care seems to have been under focused on and under funded compared to other technology sectors. Are you seeing that shift now?

Esther Dyson: I'm seeing lots of regulations, legacy institutions and broken incentive systems; investors have been reluctant to go into a market where you often don’t get rewarded for doing the right thing.What's happening now is that a lot of the old systems are being eroded around the edges by  the new stuff.

Everything from "Minute Clinics", where people are simply saying, "I don’t want to deal with your reimbursement procedures." They don’t want to deal with all the bureaucracy.  "I'm just gonna go to the clinic and pay my forty dollars and get a prescription so that my kid isn't gonna suffer. Just treat the symptoms of the flu that my kid has, or check out his earache, or whatever."

Some people are opting out of the insurance program altogether, not because they can't afford it, but because they don’t want to deal with it. There are lots of people who need their health insurance and it's a useful thing, but the world is changing rapidly, and I think finally some of the institutions are going to respond. Investors are going to respond to that, too.

Unity Stoakes: Any thoughts on the election?

Esther Dyson: Yes. Both candidates have health plans. But neither of them is addressing all of the issues  It's not just about who pays;  it's about what they pay for. You need to pay for health, not for care.

Steven Krein: How does that happen?

Esther Dyson: It happens when you start paying for the difference between the expected outcome, and the actual outcome.... Take, for example, a hospital, and this is a real thing going on right now.  Say there's a hospital related infection. Somebody goes to the hospital, they have some procedure done, and they end up with an infection because of unsanitary practices in the hospital.  That happens all the time.  The hospital ends up treating the infection, and then getting paid more, because, hey, they treated this guy, they had to give him lifesaving meds, whatever.  So nobody in a hospital is trying to get people sick, but it does happen, and they get paid more when it happens.

Now, the payers are beginning to say, "We will pay for the heart procedure, but we're not going to pay for the hospital bill – the infection."  And suddenly, hospitals are realizing, "Wow,  we're not trying to get people sick, but we have to really keep them well or we're not gonna get paid."

Suddenly, you see better outcomes.

Steven Krein: And which candidate is more aligned with that philosophy, even though neither of them is talking about it?  Which do you think is better from the health care side of things?

 

Esther Dyson: I don't really care about health care.  I care about people.  I wouldn’t pick a candidate on who is better for the health care industry.  I do think Obama understands how you can use new technology more effectively.  I think McCain is a wonderful guy, but I think Obama just looks more into the future, and that’s what we need.

Steven Krein: Any last words of wisdom that you'd like to share with the industry, specifically the Health 2.0 industries?

Esther Dyson: The real message is that this is worth doing, it will take a while, and the more information the people have, the better decisions they’ll make.

Unity and Steve: Thank you very much for a great conversation.

Esther Dyson: Thank you both.