Web startups aim to give consumers more control over their health

When new mom Leah Dillon needed advice for her son's first fever, she wondered where to turn. Recently arrived in Palo Alto, Calif., she couldn't ask neighbors for guidance and wasn't sure if she should page her son's pediatrician in the dead of night.

So Dillon went to a website called HealthTap, unveiled this spring by a startup in her neighborhood. An interactive Q&A database walked her through a set of recommendations-from doctors, not just anybody with an opinion and a keyboard.

"The Internet is so vast, you don't know where you're getting your information from," she said. "It gives me more confidence if it's backed by pediatricians."

The arrival of a new child also set Robert Auguste looking for technological help, but with spending, not symptoms. "All of the hospital bills started coming in, and I said, 'I have no idea how I'm going to get through all of this,' " said the consultant in Greenwich, Conn. "They're all from different companies, and it's confusing."

Then Auguste read about another Palo Alto, Calif., startup, called Simplee, which promised help organizing medical bills; he immediately signed on for the beta. "I went to this one dashboard and I could see, 'These bills are all related to the hospital; these are from the doctor.' It adds a whole level of simplicity."

HealthTap and Simplee are part of a growing wave of Web 2.0 startups that are using mobile and social technology to give consumers more control over their health. From turning smartphones into diagnostic tools to helping users shop for health plans and providers, these young companies hope to bring Silicon Valley know-how to bear on age-old problems.

"There's a ton of interest in this area, and for good reason: There hasn't been a lot of progress in applying information technology to health care," said Derik Pridmore of Founders Fund, the San Francisco venture capital firm launched by the co-founders of PayPal and Facebook.

Among his firm's investments are ZocDoc, which lets patients instantly book medical appointments online, and Practice Fusion, which gives doctors and patients more control over medical records.

Practice Fusion CEO Ryan Howard realized the need for such a system while working for Brown & Toland, a network of more than 800 San Francisco Bay Area physicians. "I started seeing a massive problem - the claims systems were so disparate," he said. "And I started thinking about patient records, which are even more complex."

Howard, who previously had built supply-chain technology to help companies like Wal-Mart find small suppliers, began noodling on a way to connect doctors to pharmacies, labs, and insurance companies and ensure a secure flow of patient health information.

Practice Fusion, rolled out in late 2007, provides the system for free to nearly 100,000 doctors and nurses, making money by placing ads on the platform. "It literally prevents the doctor from prescribing a medication that the patient will have an adverse reaction to," Pridmore said.

And while the road to broader adoption of electronic health records has been potholed - Google last month said it would close down its 3-year-old Google Health initiative - investors have been bullish on Practice Fusion, with Pridmore's firm leading a $23 million April venture funding round that also included Artis Capital Management and Felicis Ventures.

Despite the failure of Google Health, which aimed to let consumers input and update their health records online, Howard has high hopes for a feature that lets doctors in his network give their patients access to their charts, medications and immunization histories.

"Right now we're sort of Salesforce for doctors," Howard said. "We'll be at 100 million patients next year, which will let us become Facebook for patients." He talks of letting users put together online wellness plans with social gaming-type rewards and use "clinical crowdsourcing" to share information about their own conditions with other patients.

Helping patients by helping doctors was also the idea behind HealthTap. CEO Ron Gutman, who led an interdisciplinary research team on personal health while a graduate student at Stanford University and later founded Wellsphere, an online community of health writers, launched his latest venture in April. Within two months, it had added more than 1,200 board-certified doctors in all 50 states.

"We want to bring the doctor back into the center of the discussion," he said, "because if not, it's the blind leading the blind." (Gutman's wife, incidentally, is a retinal surgeon.)

What powers HealthTap is not just the database culled from peer-reviewed medical articles and curated by physicians, but a search algorithm that asks patients questions as they describe symptoms-much the way a doctor would during a visit. Gutman says the software provides better search results and gives patients a personalized "prep sheet" they can take to doctor's visits, making them shorter and less costly.

Users like Dillon appear to be sold. "As a new mom, you're constantly worried about every little thing, but you can't see your doctor every day," she said. "This is going to be my one-stop shop for health care. It saved me a trip in the middle of the night, it saved me money, and it works."

As for Simplee, which only came out of beta June 30, it too has its roots in a parent's search for answers. CEO Tomer Shoval, who at the time was a managing director of eBay's Shopping.com, had a "horrifying," flu-filled Mexican vacation in 2009, an experience made worse once the family arrived home and was inundated with invoices from medical providers and obtuse benefit statements from their insurance company.

"Each of them comes in a different format; you're not really sure if you've paid them or not," he said. "It kind of hit me that this is really broken." So Shoval left eBay last summer and in May began the beta, which he said included several thousand people covered by eight of the biggest insurance companies.

Once users register, Simplee pulls together information from their insurers on recent medical visits, out-of-pocket expenses and so forth. The software will also email a user to say a doctor's bill is on the way or remind them to take advantage of health plan benefits like free immunizations.

"The average family spends more than $3,000 a year on out-of-pocket expenses, and it's increasing every year," said Shoval. "We can't afford to ignore this anymore."

The service is free to consumers. And Shoval, whose 15-person company has landed $1.5 million in venture backing from Greylock Israel and others, plans to add a recommendation engine that would look at a person's insurance history and suggest new health plans based on their historical consumption of care.

"Consumers in every other vertical have transparency," he notes. "Why would we spend 30 minutes shopping for a running shoe or a digital camera, but not for a knee surgery?"



Here's a sampling of startups that are using social and mobile technology to give consumers more control over their health.

-Azumio: Offers an app for iPhones and Android devices that can measure your heart rate by using the phone's camera to measure blood flow through your fingertip.

-Castlight Health: Comparison shopping for health plans.

-CellScope: Makes an attachment for smartphones that lets parents email a photo of their child's ear canal to a , saving a trip to the doctor's office to diagnose an ear infection.

-Doximity: Smartphone messaging app that lets physicians communicate with each other and find referrals for patients.

-Fitbit: Helps users keep track of how much they're walking and how many calories they're burning, via a clip-on motion sensor.

-GravityEight: Internet platform to let users track their sense of well- being, measured by factors such as exercise and sleep.

-Massive Health: Stealth startup that's using mobile technology to help people with chronic conditions like diabetes manage their .

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