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.
