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One year ago, I discovered that I had contracted Type 1 Diabetes. I was 36 at that point and it's relatively rare for someone of my age to suddenly get Type 1 Diabetes - indeed they used to call this form of diabetes "juvenile diabetes", because it mostly occurs in children. So it was quite a shock to discover that I had it! Immediately I looked to the Web to find out all I could about this condition. I discovered a thriving community of 'health 2.0' apps and social networks, which I then wrote about in this blog.

As it's now a year later, I thought it'd be good to review health 2.0 - as I did with Semantic Apps last week. What has changed in web-based health services over the past year? And indeed what web tools do I use to help me manage diabetes?

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Note: on Monday afternoon we will be talking health 2.0 with some industry experts on our podcast show, RWW Live. It will be broadcast live at 3.30pm PST Monday (6.30pm EST). You can tune into the show, and interact with us via the chat, by clicking here.

Consumer Web Apps

Probably the biggest change over the past year in health 2.0 has been the number - and quality - of health web apps that have become available.

Currently I use a couple of iPhone apps on a daily basis to help me manage diabetes: Diametic, for inputting glucose readings and insulin shots, and Weight Tracker to track my daily weight.

But there are some far more innovative web apps in health 2.0, starting to make their way into the real world. In March we mentioned ReliefInsite, a site that allows people to map, monitor and analyze their pain. Another clever app is Pharma Surveyor, which helps people understand and personalize their medication regimens.

Connecting to Health Professionals

What we're all really wanting in healthcare web apps is the ability to connect with health systems and manage our health online. We're certainly not there yet - for example there's no way for me (in New Zealand) to connect online to my doctor or diabetes specialist, or to blood testing labs and chemists.

But there is progress being made, particularly in the US. In March at the Health 2.0 Conference, Bill Allman from HealthCentral.com noted some services that help consumers find, evaluate, and make an appointment with a doctor or health provider - e.g. Healthcare.com, Xoova.com, Healthgrades.com, Vitals.com, and Carol.com. All of those services offer variations on the theme of enabling users to research local health resources, get reviews of them, and even book an appointment online.

Then there are apps such as MyMedLab - which enables consumers to order and pay for many routine lab tests online, then go to their local lab to get their blood drawn and have their results sent to them electronically.

There are also solutions for connecting consumers with professionals. For example Kryptiq is a provider of connectivity solutions for healthcare, for information sharing among healthcare professionals, their colleagues, and patients.

So connecting to healthcare professionals is happening, slowly but surely. How about medical diagnosis via the Internet then? Still a long way off, but companies such as IBM are experimenting in this arena.

Medical Records

There is a lot of competition now in the area of online health records. Google Health and Microsoft's Healthvault are essentially doing the same thing - both are platforms, neither tries to be a healthcare provider or conduit between healthcare professionals and patients, and both have search as their business model.

In August we profiled one of the startups going for the professional market - Practice Fusion is aimed at professionals (doctors), calling itself a 'Google Apps For Doctors'. miVitals is another startup which we've profiled that is trying to find a niche as an online records service.

We've also seen the rise of so-called "wellness management" services - Daily Strength and Aliveworld are two examples.

Portals

Meanwhile in the health portal space, Everyday Health (which merged with Revolution Health in October) has been the big mover this past year. A couple of weeks ago, Medical Marketing and Media reported that Waterfront Media's Everyday Health had surpassed WebMD to lead the online consumer health space. According to comScore's Media Metrix data, released in mid-November, Everyday Health had 25.7 million unique visitors in October, compared with 19.6 million for WebMD.

Other leaders in the space according to comScore are: AOL Health (10.4 million); About.com Health (9.1 million); MSN Health (8.8 million); Yahoo! Health (8.6 million); NIH.gov (8.1 million); Walgreen Co. (6.4 million); and UnitedHealth Group (5.1 million).

Search and Information

If I may return to diabetes: there is still a great deal that isn't understood about Type 1 diabetes, for example there is no cure (although there are a number of experimental treatments) and the medical community still doesn't know the exact cause of it. Fortunately, the Web is a great place to search for and explore information about diabetes - or any other health condition. Of course you must be careful about which sources you trust, but that almost goes without saying on the Web.

Some of the best information websites and search engines for health:

• Patients Like Me: this one is getting a lot of interest in the industry; it allows you to drill down and see people with your condition, on your drugs and see what did or did not work for them.
• DoublecheckMD: uses natural language recognition to allow consumers to search medical texts and match symptoms with the drugs they’re on.
• Vitals.com: a one-stop shop for information about physicians; uses reported empirical data, patient reviews, and an algorithm extracted from physician reviews.
• Organized Wisdom: "the Wikipedia of healthcare".
• American Well: a "virtual visit" service, profiled recently in The New York Times.
• Kosmix: a kind of search-portal for many different verticals - one of which is diabetes.
• Healia: a health search engine that gives you filtering options.
• Healthline: a health information portal.
• CognitionSearch: semantic web health search.

There are many others, too many to list in one post!

Community

There are a number of community sites - some focusing on doctors and services, like Vitals and HealthGrades, and others focusing on treatments and information like WEGOHealth, Trusera and CarePages. Others are somewhere in between, like MedHelp. Two of the ones that have caught my eye in the past year are Sermo - a social network for physicians - and Carol.com, which is creating a market for consumers with health plans to buy discreet bundles of medical services.

With the number of U.S. adults who are Health 2.0 consumers now said to be over 60 million, there is obviously a big market for social networks. I have been a member of a great diabetes social network, Tu Diabetes, since last November. I haven't logged in as much as I should've, but when I have it's been a source of inspiration and support. In last year's post I mentioned a bunch of Facebook groups - but I must admit that I haven't used any of them.

Blogs

Of course, there are lots of niche bloggers covering all kinds of health issues. For diabetes, a few of my favorites are Amy Tenderich's DiabetesMine, Lemonade Life, Ask Manny Hernandez (the founder of Tu Diabetes), and SixUntilMe. Do also check out some of the more general health 2.0 blogs - Indu Subaiya and Matthew Holt's The Health 2.0 Blog and Bertalan Meskó's ScienceRoll are two of my all-time favorite blogs.

If you want a much wider selection of health 2.0 blogs to subscribe to, you simply can't go past RNCentral.com's excellent list of Top 50 Health 2.0 Blogs. Or if you want a search engine based around those blogs and more, then our own Marshall Kirkpatrick has created one of his famous 'magic searches' for health 2.0: Top Health 2.0 and Medicine Blogs.

My Own Health 2.0 Usage

To be honest, I don't think I've used the Web as much as I could've in managing my diabetes. Partly that's because many of the most innovative apps are not available to people who live outside the US - e.g. I wouldn't get much benefit from using Google Health, as it only connects to healthcare systems in the US (and only parts of the US, at that).

Also, it took me a few months to adjust to having diabetes and by that stage I was set in certain offline habits - such as entering my glucose readings into the paper notebook I was supplied with by my diabetes nurse. It was only when my paper notebook ran out that I was prompted to use a web app instead!

There is a more psychological reason too: over the past year I've felt that I was spending enough time offline doing diabetes management (injecting myself with insulin twice a day, exercising, eating good foods, etc). So I think that, subconsciously perhaps, I resisted spending online time on diabetes management too. I wanted to just get on with my job and life, without letting diabetes get in the way of what I did before I got it.

However, those are excuses. I recently started to use the Web to monitor my diabetes (the iPhone apps mentioned above). And I hope I can make better use of Tu Diabetes and other online health management apps more over the next year. Perhaps that will be a New Years resolution!

What Are Your Favorite Health 2.0 Sites?

As always in posts like these, I have only listed a tiny fraction of the websites, blogs, social networks and web apps that are available in the health 2.0 field. I invite you to list those that are missing in the comments below. And don't forget to tune into RWW Live later today, on the topic of 'health 2.0'. It starts at 3.30pm PST Monday (6.30pm EST).

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