Nexthealth: a picture worth a thousand words

Jen McCabe Gorman drew a picture at HealthCampDC on Friday that I really liked. Luckily, I found this image of her Medicine 2.0 presentation, so nobody has to decipher my sketch.
Click image to view full size original.
Jen McCabe Gorman with a consumer-centered care illustration

The one difference is that, on Friday, Jen pointed out that the outer square (“content”) is Health 1.0 and Health 2.0 begins with the “community” square. After reading her research paper, I now understand that the next inner square is Health 3.0, or content + community + commerce and the final, innermost square is Health 4.0, which would add coherence to the equation. Health 4.0 in this model is the “evolutionary stage connect[ing] the real world of brick-and-mortar systems with the virtual world of online services.”

The paper is well worth a read, whether you agree with this model or not. I’m going to have to think about the following points, for example:

Another weakness of current Health 2.0 initiatives is the tendency of communities to attract similar people. Many focus on connecting “like-minds,” relatively homogeneous groups such as patients with the same diagnosis or physicians in the same subspecialty. Similar groups then generate very similar content. Users become settled and ‘comfortable’ and thus less inclined to venture out and advocate for other consumer groups and sytemic change.

Which groups did they have in mind when they wrote that? has been held up as a great example of an information resource. Yes, they are homogeneous (98% white) but are ACOR members less likely to advocate for systemic change? I wouldn’t say that to e-patient Dave’s face (or Deborah Bell’s, or Gilles Frydman’s…)

Again, read the paper and then sharpen your critiques because I have to hand it to Jen and her co-presenter, Maarten den Braber, who went completely 2.0 for the event. I couldn’t make it to Toronto (hey Gunther, how about not scheduling it for the first week of school next year?) but I can still read their paper, view their slides, and follow the comments.

Jen and the whole Nexthealth crew make me wish I could spend a semester in the Netherlands – or as e-patient Dave recently wrote, What is it with the Dutch?


Posted in: reforming hc





9 Responses to “Nexthealth: a picture worth a thousand words”

  1. Susannah –

    Great points, especially with regards to ACOR and e-patients stirring the pot advocating for systemic innovation.

    And consider this an open invitation to visit the Netherlands anytime; the Nexthealth crew loves company :).

    Best –
    Jen McCabe Gorman

  2. JMG says:

    Also, as one of Nexthealth’s Board of Black Swans, Carlos Rizo, pointed out when he sent a link to us this week – we’re not the only ones using this kind of terminology:

  3. Susannah Fox says:

    Thanks, Jen! I’ve heard rumors of a Health 2.0 in Paris – or will it be Amsterdam? I really appreciate the way you published “in the open” and clearly want to hear from people. That’s participatory medicine (the phrase this crowd is pushing as we ourselves move past the e-patient stage).

  4. > what is it with the Dutch?

    For centuries they’ve had a knack for connecting people with what they need. If I understand my history correctly, it made them quite a successful commercial nation for a long time.

    More recently, I’ll never forget the “aha” moment I had in Amsterdam, late one night, when I noticed a bustling all-night pastry shop with the most delectable looking things in a front-window showcase. Bustling all-night pastry shop?? Then I noticed…. ohhhhh, it’s directly across the street from the front door of one of the city’s famous “coffee” houses.

    Now that’s an entrepreneur.

    On a more sober note, re people getting complacent and forgetting to advocate: my experience is that radicals are radicals, and some people (no matter how much they benefit from a shift) aren’t inclined to advocate. C’est la vie.

    I want to read the article and think about the model. Sometimes I encounter someone who’s way ahead of me, and it usually doesn’t serve me well to react without reading the field reports. But that may not be for several days.

  5. Regarding the supposed homogeneous nature of the ACOR groups:

    It is most unfortunate that most of the ACOR are populated mostly by caucasians. But within every list, if you pay attention, you can see enormous differences of education and financial abilities. These differences are never put in the open since everyone understands that they share something much more unique and profound that an educational degree or a golf club membership.

    Belonging to a group of 100’s or thousand’s of sufferers of a rare and by definition often mis-diagnosed and mis-treated disease is one of the most powerful feelings people will ever experience.

    The vast differences in personal expertise in these communities is what generate the now famous “wisdom of crowds”. That is how lay people can become, against all prior expectations, incredible micro experts, able to profoundly transform the odds of thousands of patients, single-handedly!

  6. The image link is broken. Since the discussion is about the image, I would very much like to be able to see it. Many thanks for checking into this!

  7. Susannah Fox says:


    I’m so sorry the image isn’t showing up. We recently moved the blog to a new platform and it appears that some files were left behind. I will upload the image when I find it again, but in the meantime you can view the slide deck here (go to slide #9).

  8. fredcobio says:

    #sbcPA Quantified Self also search for nexthealth

Leave a Reply