Usually I’m wary of putting time into big-budget health portals, but San Francisco based Healthline deserves a mention. They have a portfolio of healthcare search, navigation and content that is syndicated through a growing network of big web properties like AARP, Health.com, iVillage, AOL etc.

Healthline was founded in 1999 as YourDoctor.com and was re-launched as Healthline Networks in 2005. It’s got some deep-pocket investors behind it (Aetna, NBCU, Kaiser Permanente, Reed Elsevier, US News & World Report to name a few) so I’m not surprised that they have managed to create (what they call as) ‘Consumer Healthcare Taxonomy’ of >1 million terms and 250K medical concepts. That is what powers their proprietary ability to organize and present contextually-relevant health information to a viewer. Personally I dont think much of it, given that there are plenty of precursors in the medical ontology area (SNOMED, UMLS…) that match this feat.

So Healthline can power health search in multiple ways (symptom, treatment, doctor, drug) and help consumers navigate to the right information. They have also branched out into health-specific ad network, PHR etc. Regardless, I’m interested in mentioning Healthline because of their excellent 3D Body Maps. They have a neat library of 3D animations that lets you partially control and understand body structure and function. Much like CareFlash. Development of these consumer-oriented educational health content repositories is a positive trend, although it’d be much nicer if all these individual attempts were cataloged in one place, giving a complete guide to educational 3D health and wellness content on the web. Like what Clicker does for Internet television.

Vitals is a physician search and rating destination. The fact that we need such tools is indisputable, although there are a plethora of sites that claim to have this ability now (DrScore, RateMDs, HealthcareReviews, HealthGrades, DoctorScorecard to name a few) . Which is part of the reason why none of them is successful enough to be the ultimate source of such information. Board certification, address, affiliations, publications, education etc. are all public information anyway (albeit in obscure hard-to-find databases that are generally out of scope for a normal patient). Its the subjective rating and candid feedback from actual patients that is hard to find. The fact that there are multiple places claiming to be the repository of such ratings is not helping the situation.

Ranting aside, I like the user-friendliness of this site- very easy to navigate and see relevant information. They also do a good job of digging up public information from various sources and aggregate it all in a as-comprehensive-as-possible profile. Was also impressed by the fact that they have a healthy growth in traffic (now more than half a million unique’s every month, according to Compete).

Given the fact that potential users perhaps value ratings/recommendations/comments from other patients most, the biggest issue with all such sites is how to validate such information. In my search for multiple doctors, user ratings were almost non-existent. But even if they were as abundant as on Amazon, how does one establish their authenticity? I was able to submit ratings on one doctor without submitting any proof that I was ever treated by him (in full disclosure, the rating didn’t show up right away so its not that simple apparently. For example, their FAQ page says you can only rate your doctor once a month). Not sure about their revenue model either, since its free for users. Regardless, this is a good site to bookmark, just for getting all the public information about your doctor in one place.

ZocDoc is a free service that allows patients to book Doctor appointments online in New York City. It started in September 2007 as a service to help people find and make dentist appointments in NYC, and has now includes other specialties too (like primary care, dermatologist, ENT, ortho, OB/GYN, allergist, podiatrist, etc.)

Patients get to use the site for free-  looking up physicians that accept their insurance and setting up appointments with them. Apparently, physicians need to pay to join ZocDoc and their enter availability info. Given their recent start, focus on one metropolitan area, the monthly unique visitor count is significant (20K+ according to dataopedia).

Interesting idea overall, kind of OpenTable.com for clinical care. The fact that you can set up a guaranteed appointment with a care provider today is a great feature (hard to execute in all cases though). What blows me away is the backing they have- Khosla, Bezos and Benihoff! That has got to be the most incredible investment partner team I’ve seen so far in any small healthcare IT startup.

While we wait for President Obama’s public plan, the 46 million uninsured Americans need some options. Healdeal aims to bring the free market model to healthcare as one of them. The goal is to provide a marketplace for self-pay (uninsured) individuals to connect and transact with providers registered on the website.

There is scope for such services, for sure. There are significant number of people who need care that falls outside the realm of what insurance covers. Second opinions, cosmetic procedures, international travelers are some categories that come to mind. But as always, business model remains the Achilles heel. If you are operating a platform that matches supply with demand, its more straightforward to make money in commercial domains, much like eBay or eLance. But healthcare is different ballgame. Privacy, outcomes, benchmarking, feedback, transparency are some of the confounding issues that need to be taken care of.

Currently HealDeal is a social venture, with no subscription or advertisement model evident. Hopefully they have deep pockets or influential allies to keep themselves above water. It’d be interesting to have it as an app on Google Health though, especially if they can strike partnerships with other related, pro-self-pay businesses like Myca.

While the conventionalists argue otherwise, there is some truth to the fact that plenty of health conditions can be taken care of without actually seeing the patient in-person. Based on that assumption, AmericanWell offers an interactive service that lets patients talk to a physician in real time, anytime.

The service went live in January this year and initially focusing on Hawaii. The basic ‘interactive consultation’ uses two-way video conferencing, audio and secure text chat. It’s a step-up from the usual definition of a ‘e-visit’ which are mostly asynchronous text-based communication. Patients join for a fee, as I understand (what frustrated me was that I couldn’t find how much the fee was. I would have expected that to be extremely obvious!). Physicians sign up and make themselves available in aggregated pools of their respective discipline, which in turn are tapped into by patient demand.

So will the health plans pay for this? Until now they had signed up only two customers- the Blue Cross-Blue Shield plans in Hawaii and Minnesota. Last month, United Health Group, the largest private health insurer in the U.S., said it would begin deploying American Well’s platform across its huge network of more than 70 million members.

The concept has some viability for sure. But like anything else, it remains to be seen how well it can permeate through the tough, unyielding US healthcare system. I’m sure we’ll see many more startups with similar approaches soon.

Consumer-Driven Healthcare (CDHC) may not have arrived yet, but startups have been sprouting around it for a while. Carol.com is the brainchild of Tony Miller (founder of Definity Health, another CDHC company that he sold to UnitedHealth Group in 2004) and was started in late 2007.

Carol.com’s original intent was to be a ‘marketplace for care’- a place where consumers with fat HSA’s could comparison shop for their healthcare needs. The site attempted to create “care packages” around specific conditions or medical needs (e.g. years-worth of outpatient asthma care, for example) and let consumers choose which provider to go with. Very neat concept, although in my opinion it’s probably more applicable to commoditized parts of care (like LASIK, botox) rather than a cardiac cath or appendectomy.

Turns out that Carol.com didn’t attract enough buyers and sellers to make this a viable marketplace- blame it on the economic downturn, lack of consumer awareness, or just plain bad timing. The statistics show a steady decline since Feb’08 (probably the peak of media coverage for Carol.com): 15K then to less than 5K in Feb’09.  As this article states, in late 2008 they had to make job cuts and re-think their strategy- which is since then to be a consulting and software services provider for healthcare organizations.

I doubt Carol.com will run out of money anytime soon (the website is still up for Seattle and Twin cities) given it’s founder’s previous success. But its unfortunate that good ideas like it go on life support while CDHC remains in its long gestational period. Someone needs to teach consumers how to drive healthcare… soon.

Vimo is a consumer portal focused on comparison shopping for healthcare needs. Founded in 2005, Vimo provides a platform for users to research, review, compare and price the following:

• Hospital Procedures
• Individual & Group Health Insurance Plans
• Health Savings Accounts
• Doctors

Compete.com data shows pretty good visitor count (more than 100Kvisitors/month), so they must be doing something right. Their services are free which makes the surgical procedure pricing tool even more impressive. I tried their doctor search tool too, and it worked pretty well for my location (returned more info than usual). Neat interface, fast results.