Good Intentions and Bad Investments: EHealth and the Reality of Market Forces

Introduction: Eysenbach’s well-cited Law of Attrition was the first peer-reviewed journal article that effectively captured the phenomenon of users dropping out of controlled trials. Moreover, attrition permeates all areas of Web 2.0 technology and is not exclusive to controlled trials. Other ongoing challenges include sustaining search engine rankings, competitive IP and software platforms, program conversion rates, and investor confidence. For eHealth programs to be successful, overcoming diminishing returns requires a consistent refueling of reinvention, reinvestment and capitalization. Objective: This presentation is designed to assist researchers, inventors, entrepreneurs and investors by illustrating real-world examples of potential roadblocks and strategies for overcoming them when working in the field of eHealth. Background: For over nine years Evolution Health (formerly V-CC Systems Inc.) has built, maintained, and promoted Internet-based brief interventions, CBT programs and social networks for governments, pharmaceutical companies, non-profit organizations, universities, insurance companies and health plans. While the majority of experience has been in Canada, the United States and the United Kingdom, the company has recently expanded its reach to Japan, Brazil and Argentina. Through real-world examples, this presentation will underscore the need for projects and enterprises to embrace technical design principles, expandable software platforms and effective promotion. Discussion: The vast majority of failed projects are the result of misallocation of budgets and lack of realistic planning, or what the company refers to as Internet Math. Conversely, successful long-term projects begin with a realistic understanding of ongoing investment. eHealth programs, while never perfect, are only effective if they are current, maintained, upgraded and promoted. Programs that are statistically effective at time of publication are often rendered ineffective when converted to a non-academic environment due to their inability to compete in the marketplace. Conclusions: While there are financial barriers to entering the field of eHealth, there is still much promise for patient researchers, inventors, entrepreneurs and investors. However, these stakeholders should be prepared to navigate time-consuming costs surrounding development, launch, ongoing upgrades, maintenance and legal fees. Sales cycles for business-to-business models are long and the vast majority of business-to-consumer models have failed. If eHealth programs are to reach their potential and augment the traditional delivery of health care services, an increase in government funding and ongoing partnerships between vendors and research institutions is required. []

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