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The Web-based health-management tools collectively known as Health 2.0 generally suffer from a major shortcoming, in that they typically put the onus on individuals to learn about them and put them to use. But a few startups are taking an interesting new tack by getting health insurers to offer their Health 2.0 services to their customers — an important development, although one that may present a whole new set of problems.

Last week I wrote about American Well, which plans to offer Web-based video chats with doctors via insurers, although it doesn’t appear to have struck any such partnerships yet. So one of the first companies to actually take this plunge with a major insurer appears to be the health-focused search company Healthline Networks, which today is announcing that Aetna, one of the largest health insurers in the country, will be offering a new service to its members using Healthline technology. Dubbed Aetna SmartSource, the service will be integrated into Aetna’s existing online members-only Web site in order to provide “personalized” responses to various health-related queries. (Over time, that is; the service is only available to Aetna’s 30,000 employees so far, and the insurer only plans to roll it out to select employer-based plans over the course of the year.)

In practice, that means any Aetna member who logs onto the insurers site will be offered the same kinds of searches Healthline offers on its own site, such as queries related to disease, symptoms, medications or treatments. At Aetna, however, the results will be matched against a patient’s own medical history, at least as it’s recorded in the insurer’s claims information, in order to provide what Aetna and Healthline think are the most “relevant” results. (Click on any of the following images, which I’ve cut-and-pasted from a slideshow, for larger versions. They’re still kind of fuzzy, I’m afraid.)

The interface itself is intriguing enough, and the personalization touches that are visible in a demo seem moderately useful. Searching for doctors, for instance, will specifically turn up those in the Aetna network that are also geographically close to the patient, while a “costs” tab will outline what various medical treatments or drugs would cost at particular medical centers or clinics.

SmartSource also includes a fascinating-looking disease “health map” that visually links all the important topics you might want to explore about a particular condition, from diagnosis to treatment and prevention:

It’s a lot harder to say, though, exactly how well this sort of personalization will work when searching on disease symptoms or medications — or to what uses the information will be put by the insurer itself.

Healthline CEO West Shell acknowledges, for instance, that Aetna will know exactly what its members are searching for, although he dismisses concerns that it might be tempted to put the information to nefarious use, such as seeking ways to divest itself of members whose searches suggest they might be worried about developing a serious — and expensive-to-treat — condition. (Dropping coverage this way is generally illegal, although you don’t have to look far to find stories of insurers that have done something very similar, even without knowledge of their members’ search history.)

The other problem, of course, is that many of these tools don’t appear to be available to anyone without health insurance — or even anyone who doesn’t like the idea of their insurer peering over their shoulder while they search. That will probably change over time, of course — Healthline says it would be happy to make its tools available as applications for personal health-record services from the likes of Microsoft and Google. So while it’s interesting to see a major insurer like Aetna, which appears to cover 36.7 million people, stick its toe in the Health 2.0 waters, I suspect these sorts of services still have a long way to go.

See our earlier coverage of Healthline here.

The Health 2.0 conference earlier this week was crammed with startups all touting their plans for transforming the broken U.S. healthcare system via innovative technology that empowers patients. Many of these companies are all essentially offering variations on the same themes, but six stood out for their efforts to reinvent the doctor-patient relationship in new and sometimes disquieting ways.

We have the lowdown over at VentureBeat LifeScience.

(UPDATED: Added screenshots and a link to video of the Myca patient-record interface.)

The just-concluded Health 2.0 Conference in San Diego showcased some 30-odd startups and Web sites — with dozens more in the audience — all intent on using the Internet to improve patient care, streamline healthcare practices and bolster the ability of individuals to take charge of their own medical treatment. There’s lots more to say, and I hope to do so over the next few days.

For now, though, I want to highlight six startups with some big, and very different, ideas for reinventing the doctor-patient relationship — everything from making it deeper and more convenient to practically doing away with it altogether.

Visualize your medical records, keep your doctor on call

In their current form, even electronic medical records have a significant drawback: Most amount to little more than a digital representation of the paper forms that preceded them and consist largely of dense lines of biographical, family and medical information. (This is, of course, a fine place to start given that only 14 percent of all U.S. physicians use such systems in the first place, but it’s not exactly the end of the story.)

So in the same way that Web publications have adopted designs that exploit the advantages of the new medium (which also took time — even the pioneering online magazine Slate launched with a design that quaintly displayed page numbers just like a print publication), the folks at Myca have re-envisioned the display of medical records for the digital age. Unfortunately, the company doesn’t have any screen shots of its interface on its Web site, but their conference demo was quite striking. (You can see a brief 25-second example in this video produced for the conference; forward to 1:19 to see the Myca interface.)

Calling up a patient’s record displays her major health problem — asthma, say — surrounded by floating word tags for each of her other medical conditions, each sized larger or smaller depending on its severity. Clicking into any of these conditions zooms and centers it in the display, again surrounded by word tags for various important details, each of which can be expanded in place — for instance, visual displays of the patient’s recent medical appointments for the problem, or prescription drugs she’s taking, or X-rays and other medical images immediately available for viewing.

Here are two screenshots I just grabbed from the above-linked video (click for larger versions):

“The whole point of the interface is to show you exactly what’s going on,” says Jay Parkinson, a young New York City doctor with a pioneering Internet-based practice who now serves as Myca’s chief medical officer. “It’s kind of the geek squad for medicine.” (For more about Parkinson, who grandly proclaims himself “the future” on his Web site, see this interview at the WSJ Health blog. Don’t miss the comments, where Parkinson squares off against critics of his approach.)

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For empowered “medical consumers” to really transform the healthcare system, as Health 2.0 proponents would have, clear pricing and quality data for medical care is essential. Unfortunately, such information is currently in short supply.

The startup change:healthcare aims to fill that void with a revamped Web site, just launched this afternoon. And it’s a nifty idea, if unfortunately still flawed in execution. See our review at VentureBeat Life Sciences.

Can social networking help restrain, or even lower, healthcare costs? The Nashville, Tenn., startup change:healthcare is primed to find out.

Healthcare plans are inexorably forcing more cost-sharing on patients — a strategy some call YOYO, for “you’re on your own” — which means that the actual cost of medical care is looming larger for many Americans. Healthcare free-marketers think that’s a good thing, arguing that cost-consciousness will make people better medical consumers and cut down on the overuse of costly services. Their counterparts, meanwhile, worry that fewer people will be able to afford decent care and that individuals motivated to scrimp on medical care will tend to forego preventive check-ups that could catch serious conditions early, thus actually driving up costs over the long run.

Either way, we’re all likely to have to start paying more attention to what our medical care costs, not least because higher deductibles, coinsurance and co-payments are probably going to saddle us with a larger share of the bill. Yet medical pricing is murky to the point of almost complete opacity, since it’s difficult and at times almost impossible to find out what doctors or hospitals actually charge for an appointment or a procedure. Even then, costs can vary widely depending on how old a patient is, where she lives, whether she’s insured or not, and even what hospital or pharmacy she happens to step into.

It’s this informational void that change:healthcare hopes to address with a freshly revamped site that’s just gone live. The new service wraps together the startup’s previous two Health 2.0 services –MedBillManager, a subscription service for helping people manage complex medical bills, and FindYourDoc.com, a physician directory that change:healthcare took down several months back in anticipation of the redesign — and bolsters its social-network aspects, particularly the ability of users to share medical-cost information and rate their doctors or hospitals. The ultimate idea is to build up a database — one supplemented by data from employer healthcare billings, Medicare and other sources — that can help anyone shop around for high quality but inexpensive medical care.

We’ve covered change:healthcare in the past — see here and here, for instance — but I held off reviewing its offerings in light of the pending redesign. That was probably just as well, since FindYourDoc in particular had a slapdash feel to it, thanks to some odd display quirks and some gaps in hospital data that probably weren’t the site’s fault (it relied heavily on Medicare data at the time) but which were disconcerting nonetheless.

More after the jump:
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Like any other Internet craze, Health 2.0 is plagued with a glut of startups that are all doing variations on the same thing — health-related search, social communities, and physician ratings/directories.

So how do startups make it when one site looks much like the next? Over at VentureBeat Life Sciences, we take a look at CareSeek, a doctor-rating and would-be community site that specifically aims to attract nurses and other caregivers — in other words, to go deep where others go broad. Check it out.

The Health 2.0 movement, as I’ve noted before, makes some big claims about the Internet’s power to transform the relationships between patients and doctors, hospitals, insurers and each other. Some of that is undoubtedly true, and there’s a fascinating amount of innovation going on in this area– helped along by a recent torrent of venture capital.

There’s a downside to the movement, though, and that’s a bizarre oversupply of sites that are all doing slight variations on the same thing. Were you able to pick a Health 2.0 site at random, chances are good you’d hit one of dozens of online physican directories, health-specific search sites or health “portals” with some sort of attached social community. (Or even a site doing some combination of these, such as the health-search-and-community site iMedix, which we reviewed here.)

Probably nowhere is the glut so severe as among sites that aim to help patients find — and sometimes compare — doctors. Consider, for instance, the case of CareSeek, a Solvang, Calif., startup that last year launched a doctor-rating service called, reasonably enough, NursesRateDoctors.com. The idea was straightforward: Let nurses, who are in an unmatched position to observe doctors and their treatment of patients, could dish anonymously about physicians worth seeing — and those to avoid.

But lots of other entrepreneurs had similar ideas for doctor directories and rating services. “When we started, our competitive analysis showed there were maybe six sites doing this,” says CareSeek founder Gale Wilson-Steele. “We recently counted 31. The doctor review and rating space is very big and very noisy. But it creates a problem — no one is going to go to all these sites and rate the same doctor 31 times.”

CareSeek sought its advantage by appealing specifically to nurses, who frequently chafe at the perceived lower status of their profession relative to doctors. The company built its own director of doctors (for some of the general difficulties that presents, see my dCard post) and then went all-out to attract the attention of nurses. “We did everything,” Wilson-Steele says. The company ran banner ads, attended trade shows and handed out gift certificates and chocolate bars bearing the message, “Help raise the bar in healthcare” and the site’s address. CareSeek even set up a laptop in a medical-uniform shop and offered a discount to nurses who agreed to rate a doctor on the spot. (More recently, it also established a partnership with an online nurses-uniform site.)

The idea is a variation on the old strategy of specializing in order to stand up to larger competitors (which in this case includes WebMD, RevolutionHealth, and — soon enough — Google Health). “We just have this specialized information,” Wilson-Steele says. “At some level, hundreds of patient reviews aren’t better than two or three good ones.”

More after the jump:

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(UPDATED: See below.)

Well, the WSJ says so in this somewhat breathless report that states Google will announce its long-awaited personal health-record service today.

My first thought was that the announcement was timed to get Google on the record in advance of the Health2.0 “Spring Fling” conference in San Diego next week, which will feature lots of talk about the role of the Internet in improving healthcare. Another possibility is that Google is pulling a bait-and-switch similar to that of Navigenics, which last November “announced” its personal-genomics service but held off launching it until — well, until not yet.

Yet a third possibility — and the most likely one to me — is that, as this CNET article states, Google CEO will merely “preview” Google Health at the annual meeting of the Healthcare Information and Management Systems Society, supposedly the largest healthcare IT meeting in the world. Whatever it is, don’t hold your breath; the WSJ itself states that “[i]t wasn’t clear when the Google service for creating personal health records will begin to be available for consumers to access.”

In fact, the WSJ article doesn’t actually describe Google Health in any sort of detail, and instead is largely devoted to pointing out the major challenges facing personal health records, many of which will sound familiar to regular readers here. These include:

• Limited adoption of electronic medical-record systems. Only 14 percent of U.S. medical practices even use digital records, which will complicate the process of moving medical information to the Google system.
• Incompatible electronic medical-record systems at hospitals and doctors’ offices. Because existing digital-record systems use different data formats, systems like Google’s will have to be able to import most, if not all, of them, pushing up complexity and cost.
• Privacy. Third-party systems such as Google’s aren’t regulated by federal medical-privacy laws, giving providers plenty of freedom to, for instance, sell ads tailored to your medical profile. (Google told the WSJ that “trust between Google and our users is one of the absolute cornerstones of our business.”)

Unmentioned by the WSJ is another nagging question, which is the extent to which patients can “customize” their medical profile — which, when it comes down to it, means the ability to selectively share, edit or even delete information. As I’ve noted before, such customization could undermine the usefulness of health records to doctors, while limiting peoples’ freedom to edit them makes them a whole lot less “personal.”

To be sure, a preview by Schmidt is better than what we’ve seen so far — mostly screenshots of what appear to be leaked early prototypes of the Google Health site, plus a vague announcement of a Google Health pilot project in Cleveland. In fact, the CNET piece mentioned above actually delivers some of the goods, offering a brief description (but no screenshots) of the preview.

Among the intriguing new details: The service will allow customers to “customize” their health records, although CNET doesn’t say by how much; will be integrated with Google’s maps and email applications to allow people to more easily search for doctors and save their contact information; and will allow third-party widgets that work within the platform, such as one that might alert patients through Google’s calendar when it’s time for them to take medication.

It’s tempting to conclude that this steady drip-drip-drip of information is part of a master PR plan for generating maximum enthusiasm for the Google Health service. (If so, it’s working brilliantly.) As for the launch itself, I suspect we won’t be able to miss it when it actually happens. Accept no substitutes.

UPDATE: Google Health chief Marissa Mayer makes the official announcement in this blog post. The bottom line: A launch of Google Health is likely “in coming months,” but not now. There are some nifty screenshots, though — one of which we’ve basically seen before — but I’ve reproduced them both below for reference. (Click either for larger versions.)

Plenty of startups these days want to help you find and compare doctors online, but there’s a problem: Each one independently compiles its own basic information on physicians, leading to a welter of inconsistent data.

Now a consortium of nine health-related companies, many of them part of the “Health 2.0″ movement, have a solution — an open data standard they call dCard (for “doctor card”) intended to serve as a Web-wide template for physician information. We have the scoop over at VentureBeat Life Sciences.

(UPDATED: See below.)

A group of nine healthcare companies and providers are aiming to turn the tables on often disorganized medical record-keeping — by standardizing information about doctors themselves.

The effort, known as dCard, is aimed at bringing a certain degree of order to the mishmash of information that dozens of online physician directory and rating services currently deal with. Most of these sites grab as much basic information about doctors as they can from publicly available sources — typically consisting, at a minimum, of the doctor’s specialty, contact information, and medical education — then rely on doctors themselves to flesh it out, correct any errors and provide updates, which is pretty clearly untenable for most overtasked physicians.

The solution offered by these nine organizations is to standardize a sort of “doctor dossier” via dCard — which, straightforwardly enough, stands for “data card.” “doctor card.” (UPDATE: I was working off an older copy of the release when I wrote this item, and the group changed the name in the intervening 24 hours. I’ve also updated the release.) The idea is to establish basic standards for doctor information that can be shared among adherents, improving the accuracy and clarity of information for health-conscious consumers while also making it easier for doctors to “own” their own online information by keeping a single source — as opposed to dozens — up to date with as much or as little detail as they like.

The group’s release about the standard, which it’s expecting to finalize in April, is here (PDF link). The founding organizations include Nashville, Tenn.-based change:healthcare (our coverage); Within3, an online network for health professionals; OrganizedWisdom Health, providers of a human-edited and doctor-reviewed health-search service; and a number of other largely Web-based healthcare-information organizations. (See the bottom of this item for a full list.)

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The impending — or so it’s seemed — launch of Google Health has spurred any number of comparisons, invidious and otherwise, to Microsoft’s flashier but ultimately disappointing launch of HealthVault last October.

Now that Google has finally announced its first big health project with the Cleveland Clinic, though, it’s far from clear exactly how its platform is going to address nagging privacy issues and the fundamental question of how much control patients will have over their records. We unpack the Google Health announcement over at VentureBeat Life Sciences.

The burgeoning movement known as “Health 2.0″ makes some pretty big claims about the power of social networks and Web services to transform the sprawling mess we like to call the U.S. healthcare system. One of the central principles is that providing individuals with better information about medical treatments and procedures will make them better “medical consumers” capable of exerting market pressure that can improve quality and lower prices.

There’s nothing at all wrong with that notion in the abstract, although there are plenty of reasons to doubt whether “empowering patients” this way will really produce significant change. Among them are the fact that the majority of medical costs in any given year are run up by a small minority of the population, many of whom are often so sick that they aren’t in any sort of position to shop around for the best deals. Measuring the quality of healthcare is also a thorny problem that no one seems to have really gotten a handle on at this point.

Still, anything that helps better inform patients and enables them to make the best medical and financial decisions possible has to be applauded, and that’s a direction that many Health 2.0 startups seem to be headed in. I’ll be writing more about a number of these efforts over coming weeks and months, because some of them are already starting to shed some interesting light on medical and insurance practices that were previously all but invisible.

One of them is a Nashville, Tenn., startup called change:healthcare. The company is probably best known for its site MedBillManager, a subscription service intended to help people with complex or “consumer directed” health plans — such as those with high deductibles — cope with their medical finances. Until late last year, change:healthcare also offered a physician and hospital site called FindYourDoc.com, which also presented some preliminary information on medical costs at some hospitals. That site has been down while the company integrates its offerings under the change:healthcare brand and unveils a new emphasis on letting people share and compare their medical costs. I’ve held off reviewing either service until the integration is done, which change:healthcare says will happen by March 1. The company raised $1 million last October, which we wrote about here.

In the meantime, though, change:healthcare has produced a couple of interesting case studies that illustrate how widely the cost of drugs and medical tests can vary within a single geographic area — a fact of which most people (myself included) are almost wholly unaware. This is the sort of information that could be very useful to the uninsured and anyone without a comprehensive, major-medical style health plan that covers just about everything — the very sort of plan that is quickly going out of style at the moment.

To gauge the variation in drug prices, change:healthcare conducted a phone survey last November of six well-known pharmacy chains in four different Nashville neighborhoods, asking each for the price of six prescription drugs: Copaxone, an injectable multiple-sclerosis drug; the antidepressant Zoloft; the fibromyalgia drug Lyrica; Lipitor, a statin that lowers cholesterol; the sleep aid Ambien; and the allergy/asthma drug Singulair. The survey turned up some surprisingly wide disparities among the pharmacy chains, such as the fact that a Lyrica prescription costs more than twice as much at Rite-Aid as it does at Walgreens. No single pharmacy was consistently the cheapest, and prices could vary considerably even at different branches of the same chain. Kroger, for instance, charged twice as much for Singulair in one Nashville neighborhood (Green Hills/Belle Meade) as it did in another (Franklin).

These are obviously price disparities that can only exist because of the system’s opacity and, to be fair, the lack of incentive for many insured individuals to shop around for the best prices in the first place. All this leaves pharmacies free to take advantage of information asymmetries, even to the extent of cutting deals with pharmacy-benefit managers that disadvantage anyone who’s paying full freight for their prescriptions. You can see the full results of the survey here at change:healthcare’s blog (scroll down for the PDF link).

The second survey involved looking at the cost of a simple medical test for streptococcus infection, the sort of thing anyone with a sore throat and a fever might need. Here, change:healthcare not only found wide price gaps among 13 different Nashville-based healthcare providers — all selected randomly from a list of general practitioners produced by a major insurer — it was actually unable to get information from five of them for a variety of reasons. (Two phone numbers were incorrect, one office turned out to be a sleep-disorder center, another suggested a walk-in clinic, and the last insisted that the caller select the doctor as a primary care physician before they’d provide the test.) The cost of the test ranged from a rough estimate of $50 to potentially as much as $259. The full study is available here.

To be sure, two small case studies don’t necessarily prove anything about the state of healthcare pricing on a national level, much less lend support for the notion that giving individuals better information will restrain overall healthcare costs. What’s more, they’re provided by a company with a vested interest in building demand for services that will help individuals compare healthcare costs, so some perspective is definitely in order. Still, these results are indicative of the irrational pricing that undoubtedly affects many areas of medicine, which is likely to impact increasing numbers of Americans as insurance coverage grows ever more miserly. At least, that is, in the absence of some sort of comprehensive nationwide healthcare reform, although that’s a subject to revisit another day.

(UPDATED: IAC put out a release this morning — see below.)

The HealthCentral Network, an Arlington, Va., collection of health-information sites, raised roughly $50 million, paidContent reports. Investors included some big names, include Barry Diller’s online media and commerce conglomerate IAC, Sequoia Capital, Carlyle Group and Polaris Venture Partners.

HealthCentral runs about 30 health-related Web sites, ranging from general-info offerings like HealthCentral.com to disease-specific sites such as OurAlzheimers.com and MultipleSclerosisCentral.com. (The company also owns the DrKoop.com name, although that site is no longer affiliated with the former Surgeon General.) The sites are all essentially clones of one another in style and appearance, and generally offer a grab-bag of general or disease-specific information and some seemingly sparsely attended forums.

HealthCentral doesn’t seem to produce much of its own content, either; it lists five different sources, including Harvard Health Publications, HealthDay, and Thomson, at the bottom of its sites. In other words, it’s difficult to see exactly what makes the business worth the sums investors are pouring into it, as you can easily find much the same stuff on a half-dozen other sites.

In short, the whole HealthCentral Network looks a lot like a crass money-grab — a minimal deployment of resources designed to catch, if not retain, the maximum number of eyeballs. Which means that this latest investment is simply the latest in a flood of hot money that’s been pouring into health and so-called Health 2.0 sites over the past year or so, a trend that’s looking more and more like an unsustainable bubble with every transaction.

We’ve covered several related launches such as Microsoft’s HealthVault, Kosmix RightHealth, HealthCare.com, Healthline, and a roundup of other startups here. Valleywag has more on HealthCentral in particular.

UPDATE: IAC issued a release on its investment this morning, which doesn’t move the ball forward in any meaningful way. But at least the deal is confirmed.

Trust the reliable folks over at Google Blogoscoped to unearth a login page for the long-awaited Google Health service before it actually launches. Neither the login nor any of the links on the page seem to work, but it’s another tantalizing glimpse at what Google may soon be unveiling.

It’s worth noting that Marissa Mayer, who took over the Google Health project after Adam Bosworth unceremoniously decamped to launch his own health-related startup, said last October that Google Health would be coming in early 2008. So the timing is certainly about right.

As for clues — well, the login page doesn’t offer too many. The blurb to the left of the screen (see screenshot below) promises online health profiles, the ability to download medical information from doctors and hospitals, personalized health advice, some sort of physician directory, connections to “time-saving services” and a sharing system so your family and caregivers have access to your medical information.

Microsoft’s HealthVault (see our coverage here and here) promised much the same thing — minus the doctor directory and personalized advice, at least — but initially was so bogged down in heavy-handed security and user-unfriendliness that I’ve heard scarcely a word about it since. (Plus, there are those nagging privacy questions.) Scads of Health 2.0 sites also offer various pieces of what Google appears to be promising, although to the best of my knowledge, no one has really put all these features together before.

Anyway, it will be fascinating to see how Google approaches many of the same issues that have bedeviled Microsoft and the many startups trying to slice off a piece of the Health 2.0 pie. With any luck, we won’t be waiting much longer. (Hat tip to bbgm, where Deepak Singh rightly wonders what personalized health guidance and “time-saving services” might actually mean.)

See also our previous coverage of a Google Health prototype (or so I assume), also featured on Blogoscoped, here.

(UPDATED: See below.)

For all the fuss over “Health 2.0″ companies that hope to revolutionize the U.S. medical system by tapping the bottom-up information-sharing capabilities of the Web, the unfortunate fact is that many of them are busily piling into business areas that are already seriously overcrowded. Worse, many seem to have no business model at all. iMedix, a new site hoping to draw users into a community where they can share information about their medical conditions, illustrates both of these tendencies.

For starters, iMedix aims to stake out a position in both health-related search and patient-community building, neither of which is exactly a new idea. The Health 2.0 Wiki lists 11 different healthcare-community sites — a conservative count, as there are several others, including iMedix, it hasn’t yet rated — at least seven of which do much the same thing iMedix intends to do. These range from broad patient communities like DailyStrength and Inspire to communities focused on diseases such as diabetes and psychological disorders.

Online health search sites are even more common, running the gamut from Google’s health directory and Microsoft’s HealthVault to portal sites like WebMD and Healthline to human-organized sites such as Organized Wisdom.

The upshot of all this is that anyone hoping to make a splash in these areas had better have built one hell of a better mousetrap — which, of course, is exactly what iMedix claims to have done. Essentially, the site aims to put users in immediate touch with others who share similar medical or health interests, allowing them to chat in real time or send personal messages back and forth. It then aims to tap this community to improve its parallel health-info search service, inviting users to rate the sites returned by each search with a thumbs-up or a thumbs-down.

All of which is fine in broad outline — it’s the execution that leaves something to be desired. The iMedix opening screen is a fairly bare-bones affair (click on the image at left for a larger screenshot), offering a search bar and a list of “getting started” community options for finding your iMedix “friends,” seeing who’s online, and checking messages. It’s certainly a different approach from the crowd-the-page-until-it-groans tack that some online-health sites take, but information-packed it’s not.

The meat of the site lies in its online community, which users are encouraged to join by creating a profile, choosing an avatar and inputting their medical interests and any other personal information they care to share. A “People” page shows an array of other users and their profiles, each of which gives you the opportunity to initiate conversations and trade information. The effect, though, is a bit unsettling — it’s like looking at a wall of mugshots, all representing individuals pleading with you to chat with them or send them messages.

Of course, the moment you sign up, you’re up on the wall as well, unless you explicitly choose to change your setting to “offline” or “invisible.” The exposure can be immediate — within minutes of establishing my profile, I’d already received a message from a self-described Israeli biotechnology student who wanted to tell me all about a new “business initiative” that sounded suspiciously like a weight-loss scheme. Unlike other community sites, there are no online forums or any other way to take in or share info with others in a group — here, it’s all one-on-one. Whether this sort of thing works for others is a matter of individual preference, but it’s a little creepy for my taste.

iMedix is also fairly insistent about getting you to input as much personal information as possible. A progress bar at the top of the screen measures the “completeness” of your profile, and the site frequently asks if you’d like to add more information to your profile — for instance, after completing a search on some topic. Of course, this is all pseudonymous, but I can’t help wondering whehter people are really going to want to let their personal health interests, coupled with their age and location, hang out for everyone to see.

The site’s search function (see screenshot at left) has a few interesting gimmicks, most notably an autocomplete function that’s surprisingly good at filling out complex medical terms. The quality of search results, at least on rarer conditions, however, leaves something to be desired. I looked up Fabry disease, a rare congenital disorder, and the first entry returned was this almost information-free page. Google, by contrast, popped up a helpful resource page on the condition from the National Institutes of Health. The search function doesn’t seem to cope particularly well with symptoms, either — a search for “stabbing chest pain” returned a pair of forum posts from other sites instead of anything helpful. Supposedly user input will help hone the search results, but there’s little evidence so far that it’s had much effect.

Which is, perhaps, a little unfair of me, since iMedix only officially launched on Dec. 10. It’s entirely possible that the community features will prove wildly popular and the search results will skyrocket in quality. We’ll have to see, but so far, the hype over the site — such as its nomination for a “best new startup” award in the Crunchies — seems premature. Among other things, I found it odd that despite having what iMedix co-founder Iri Amirav told me were “thousands of users,” the site never displayed more than a dozen as being online at any given time.

Actually, the more I think about it, the stranger this site seems. In effect, iMedix users have only two sources of information — the intermittently useful search function and individual conversations with other users. Now, some of these people may be great resources — I didn’t have the time to chat with them to find out. The effect, though, is to give the site a conspicuously information-deprived feel. Some of this may simply reflect the fact that iMedix was founded by two Internet entrepreneurs with no medical or healthcare background at all. The company does claim to have an advisory board consisting of “strategic investors, successful internet entrepreneurs, information retrieval specialists, artificial intelligence professors and medical experts,” but it’s not exactly encouraging to see the medical experts listed last there.

The other mystery about iMedix is exactly how it plans to make money. Amirav says the site is exploring options for advertising — it already runs a few inconspicuous Google Adsense ads — but to call his plan “vague” would be an insult to vague plans. (It amounts to something like: Online health is a big business that’s growing quickly, so we’ll build out the site and advertisers will flock to us.) Of course, advertisers might be interested in aggregated data from iMedix users, but Amirav was adamant that the site will never share any user information with anyone, and implied that would include anonymized, aggregated data. That’s certainly a plus from the user perspective, assuming iMedix actually holds the line there, but it’s not at all clear how you sell advertising against an undefined, monolithic community.

All that said, iMedix is still very much in flux, and will undoubtedly continue to grow and change in response to feedback as long as its funding holds out. It’s certainly different, although whether that’s a good or bad thing remains to be seen.

UPDATE: So iMedix won a Crunchie for “best new startup.” I’m still not a fan, at least in its current incarnation.

UPDATED: See below. Also, this is now part one of a two-part post; for the second part, which actually reviews the HealthVault service, click here.

Microsoft has finally unveiled its first stab at managing personal health records on the Web, and it’s an interesting, if underwhelming, attempt to realize a future in which individuals have much more control over their personal health information.

Called HealthVault, the Microsoft offering combines yet another healthcare-info search engine with the record-storage application itself. Both are very clearly Microsoft products, with all the clunkiness and user inconvenience you’ve come to expect from the Redmond giant.

For starters, to use any of this you apparently have to give up Firefox, and possibly any other browser alternative to Microsoft’s own Internet Explorer. For instance, the search engine, dubbed HealthVault Search, doesn’t seem to want to display results in Firefox (click the upper image at left to see it full-sized).

Viewed in IE, however, the page displays perfectly. (In the lower-left image, I’m using IE Tab, a Firefox extension that renders pages using the native IE engine).

To be fair, the Firefox version eventually does display the same information a scroll or two down the page, past the field of hypnotic green boxes. But this is still an inauspicious sign.

Once you can see it, the information provided by HealthVault search seems generally well organized, with a few exceptions. The display is somewhat reminiscent of RightHealth.com, which I reviewed here, although a bit cleaner if less comprehensive. Searching on conditions like “heart disease” or “diabetes” returns a set of organized links grouped under heading such as “personal health,” “conditions,” “procedures,” “drugs” and so forth. One major omission, however, is anything pertaining to symptoms, so if you have chest pain and jump straight to “heart disease” on this engine, you’re not going to find what you’re looking for. For that, you need to search on “chest pain.” While this makes sense in a logic-chopping sort of way, it almost certainly doesn’t map onto the way ordinary people are actually going to use health search. Surely it makes more sense to cross-index such info six ways from Sunday just to make sure people can find it when they need it.

The search results also pop up a major article on the subject from sources such as the NIH, Wikipedia or the Mayo Clinic, as well as a series of Web links via MSN search and some sponsored links that are clearly identified and in many respects even helpful, such as a widget that proffers related books on Amazon. Overall, it’s a decent effort if not exactly a knockout, particularly given that Microsoft is on more of an even footing with other startups in this area given its historical difficulty driving traffic to its Live.com service in the first place.

And small wonder, for when I try to get a look at HealthVault medical records, I’m immediately plunged into Microsoft Hell. My first attempt to create a HealthVault account forces me to register a Live.com account, which in turn wantsrequires me to divulge a bunch of personal information (birthdate, gender, occupation, industry, state of residence and Zip code) to MSN for no particularly good reason. It also asks for my marital status and the number of children in the household, but fortunately both questions are “optional.”

Then we get to HealthVault itself, which doesn’t consider my Live.com password strong enough and asks me to change it to something harder to crack. There’s a link to click for advice on how to do this, but clicking it somehow causes the site to resize my entire browser window to a narrow bar on the right-hand side of the screen. (The help file that opens there also doesn’t actually contain any advice on making a strong password, just standard FAQbait on what to do when, say, you forget your Live password — an option I’m already strongly considering.) I’m actually kind of bewildered here — you’ll just have to take my word when I say that I worry a lot about password security and that the one HealthVault is rejecting involves a mix of alphanumerics and in no way, shape or form resembles any word or phrase in English or any other language.

Aha. Turns out the FAQ does have the info I was looking for — buried in a link under “How to change your password.” You can see it here, assuming that link actually works. (I was only using lowercase letters and numbers.) I can’t blame Microsoft for wanting individuals to feel their medical info is safe, but this quickly runs into the central paradox of password security, which is that if you make the requirements too stringent, people won’t be able to remember their passwords and will jot them down on a Post-It, which is not exactly the most secure medium in the world.

With the addition of a capital letter or two, my password is in business. Or so it seems until I try to actually log in with it, at which point the site refuses to recognize it. I go through the password reset process, and it dings me because a new password can’t be the same as the old one — which would seem to imply that it should actually recognize the old one, right? No dice — the login page still barfs on me. So I change the password and finally the site logs me in. If Google gave users even a fraction this much trouble, it would be lucky to be worth $180,000, much less $180 billion.

But it’s not over. I answer a few more personal questions (name and birthdate, mostly) and then get an error page: “Could not return to program: The location information is missing for this program.” Well, that’s charming. Oh, it turns out I haven’t yet validated my e-mail address for either Live.com or HealthVault. A few moments later and I’m finally in.

At this point, I think I’ll cut my losses and review HealthVault itself in a separate post, which I’ll link here when it’s up. (UPDATE: My review of HealthVault and some overarching issues about personal medical records is now up here.)In the meantime, the NYT and the WSJ have more on the background of all this.

UPDATE: Description of search engine expanded considerably.

UPDATE REDUX: I descend into Microsoft Hell in order to establish a HealthVault account.

FINAL UPDATE: Added a link to my HealthVault review.

Featured companies: Change:healthcare, Gemin X Biotechnologies, Ipsogen, the Practice

Change:healthcare raises $1M for health 2.0 sites — Nashville, Tenn.-based change:healthcare, a provider of Web-based health information, raised $1 million in a first funding round. The investment firm Solidus, also based in Nashville, provided the cash. There’s no release, but the Nashville Business Journal did run this story.

Change:healthcare operates two “health 2.0″ Web sites designed to empower individuals by helping them better navigate the healthcare system. FindYourDoc.com offers a searchable database of doctors and hospitals, while MedBillManager is a fee-based service for helping individuals and families manage a confusing welter of medical bills and insurance statements.