Common explanation focuses on lumbering bureaucracies -- both business and governmental -- slow to embrace interactive innovation even within their OWN organizations, let along in partnership with others.
Whether it be the payer, employee benefit, local hospital, local doctor organizations, among many others, all must buy in to change for something to happen. And even the most change-willing of these sit on an old or richly complicated infrastructure that will take years and cost billions to change.
More cynical observers add that many businesses benefit by NOT offering the transparency user-centric technologies allow.
What is commonly missed is how much behavior change must come from us users. Many pundits note, quite rightly, that if our banking experience was like our health management experience, we'd all be forced to bank -- even use ATMS -- at one bank, often have wrong balances (because so many records are kept in hand-writing), and suffer hours (if not days) to physically move our records. So why do we tolerate this?
Much of our health decision-making has been beaten into our DNA to be delegated to someone else.
Our bosses or the government pick our insurers; our insurers or the government pick the options of plans that may guide what doctors we choose; our insurers or the government effectively set the prices of health (including our drugs).
We rarely engage with our health records -- never see them but to transfer them to a new doctor -- except to keep bill files for our insurance records.
This is completely different from online banking -- which effectively facilitates an off-line behavior (checking our balances, paying bills, withdrawing money, getting loans) we have ALL done for decades.
But things are changing.
Nothing in our lives is more important than our health and that of our loved ones. If taken ill, we are health-seekers/caregivers 24/7. If facing a long-term or chronic condition, we monitor our medications, our vital signs, our behavioral habits 24/7.
Because we are human beings, we get sick of being sick, and need reminders (and moral support) to keep doing what we need to do.
We are fed up with bills we can't understand, long phone calls that don't render answers, hidden costs that seem prohibitive, and our inability to get quality time with medical professionals that answer our questions.
Some great enterprises are leading the charge to give individuals the control, information and tools they need to make the best health and wellness decisions.
One of the most intriguing was launched last week by Microsoft's HealthVault, with whom our online condition-specific web company, www.HealthCentral.com, has chosen to partner.
HealthVault has created a consumer-centric platform enabling an environment of new online services for users to search, securely store and connect people with their health information.
The key words here are "consumer-centric" and "secure" -- which are near synonymous, and as important to the Facebook generation as they are to the over-35 crowd, which tend to be the sweet spot for health management issues.
Microsoft understands that their product is either as safe as your bank or is untenable. They have looked extensively at how people behave in health -- literally moved in with people and watched -- to offer services NOT about technology hype, but about how we organize our health decision making now.
This is key - there is NO silver bullet here, NO one epiphany. Success is about real, transparent and patient understanding of what people want, where their process pain is, where they are uneasy about technology in their personal lives.
Microsoft has worked with equal commitment with the government, large health and IT organizations and some of the most innovative entrepreneurial partners, building the connections and connectivity that over time will make the whole health ecosystem work more strongly.
What has struck me most is their understanding of "over time."
They have no illusions about the size of the institutional challenges or the consumer behavioral changes that are required here. Their first launch isn't trying to do everything, but make easier and better what they already do -- record keeping, health monitoring, product price comparing/buying, expert access.
They are not alone. Steve Case's Revolution has launched intriguing services in similar areas, and GoogleHealth is the great unknown. It's too early to analyze unique differentiation -- committed staying power for years is the first step. The business models will flesh out more over time. I see an incredible advertising opportunity here, as getting your right messages in front of the right audiences can be embraced as useful content.
But that will come only with complete transparency and permission of users. Trust and security is the watchword everywhere online, but exponentially so when our private health matters are the issue.