HTV Interactive

Your Personal Health Assistant



Windom Health and Time-Warner's Full Service Network (FSN)


HTV Interactive - Your Personal Health Assistant, the place on the FSN where you can learn about your health, and make informed, guided decisions about what you need to do to be healthier and live longer.


Late 1995


On the Time-Warner's Full Service Network, Orlando, Florida


Because much of our health and well-being springs from our own behavior. Because we can do most of what needs to be done for our health, if we have the information. Because information is always the first step to health. Because, compared to other methods of spreading health information, interactive hypermedia is inexpensive, powerful, and effective.

According to former Surgeon General C. Everett Koop, "The new interactive media offer us powerful tools in the fight for the health of our children and our nation."

What is it?

HTV Interactive will be the health stop on the Full Service Network, where you'll find the information you need to make decisions about your life and health. With HTV, you can rate your health with self-tests that are simple and fun, find out what you can do to be as healthy as possible, and discover the health resources you have right in your own community, from clinics and recreation programs to self-help groups, classes, and clubs.

HTV Interactive is hypermedia: you can wind your own path through it, following your own interests.

HTV Interactive will become available in phases. Starting late in 1995, FSN users will use Phase I to give themselves quick "self health checkups" and explore specific questions about health. The system will help them decide what they can do to help themselves, when and if they should seek professional help, and what health care services in the area might be appropriate. It will help them set health-related goals, monitor their progress over time, and guide them through the lifestyle changes they choose, such as quitting smoking, moderating their drinking, shifting their diet, or learning new ways to manage stress.

In Phase II, the system becomes even more interactive, using intelligent agents and interactive audio to link users with others who share their interests or concerns, as well as provide access to doctors, nurses, and other health experts. Users can also organize a hike, join a mall-walking club, trade healthy recipes, or get involved with a support group - whatever interests them - all through HTV. The goal is to make it easy and fun for users to mak informed decisions about their health.

HTV Interactive is not meant to replace health professionals, but to help the users and the community resolve lifestyle and environmental problems that go far beyond the walls of the hospital and the clinic.

Is this health education, or is it entertainment?

Actually, it's both. There's nothing boring about health, especially when you're in charge, you ask the questions, and you find the answers about your own life and health, whether you're worried about getting pregnant, want to know how to treat tennis elbow, or would like to talk to other people with breast cancer. According to Deryk Van Brunt, Vice President of Windom Health: "Early experiments with on-line health education show not only that people use it with growing enthusiasm, but that it is highly effective: it improve people's health, at the same time that it lowers healthcare costs. People make better health decisions, and they tend to use the healthcare system only when they actually need it."

According to studies at the Centers for Disease Control and the National Institutes of Health, fully 50 percent of our healthcare dollar is spent on problems caused by unhealthy behavior, from alcoholism and smoking to drunk driving and violence. Michael McDonald, President and CEO of Windom Health, says, "As a nation, we need better ways to help people change their behavior, and interactive cable is a very important delivery system."

Who's building it?

Windom Health has assembled a team that brings together three different capabilities: health and medical expertise, technological integrity, and entertainment creativity. Windom Health is coordinating the work of the development team and two advisory councils of industry leaders, one from the world of technology, the other from health and medicine. Former Surgeon General C. Everett Koop is the proposed chair of the health and medicine council. (McDonald, Windom's President, also serves the C. Everett Koop Institute as senior advisor on health and telecommunications)

Who's working with you?

Numerous local and national partners will be working with Windom Health in a wide variety of ways, from providing the content to becoming sponsors or financial partners. For instance, one national partner will be the American Self-Help Clearinghouse, the country's largest database of self-help groups, which will enable Windom to assemble the information necessary to guide users to resources in their own area. Local partners might include health maintenance organizations, major employers, business alliances, healthy cities efforts, insurance companies, and local governments.

Has this ever been done before?

Windom Health has conducted trials in conjunction with Pacific Telesis (the ISDN videotext Project Victoria), TeleGuide (a kiosk system) Bell Atlantic, and Prodigy (WISA Wellness Information System). To date, we know of no full-scale interactive personal health information systems, either announced or in actual use, on cable.

Background: Health and the New Media

The average American's view of health and the body is changing rapidly. So is healthcare. These changes work together to create an enormous need for information. At the same time the changes in healthcare are creating large incentives to provide that information. Among these changes:

Healthcare is becoming integrated. Clinical operations (such as medical practices, clinics, and hospitals), payment mechanisms (such as insurance carriers), and ancillary services (such as long-term care, ambulance and home care services) are becoming increasingly amalgamated into larger structures variously called systems, networks, or health maintenance organizations (HMOs).

Healthcare is becoming managed care. Rather than simply treating the cases that walk in the door, healthcare and insurance managers will increasingly intervene to move patients to the appropriate level of care.

Healthcare is moving upstream. This means moving decision-making, information, and technical capabilities from the hospital to the clinic, to the doctor's office, and to the home. It means shifting attention from the critical acute phase of disease, to the earlier or chronic phases, and to prevention and education.

Expanded access is considered likely in much of the country by most health futurists, whatever the legislation that makes it past the Beltway. Many major states (including Florida) are adopting their own reforms. This could be a disaster for healthcare unless the industry is able to move massively upstream to stanch the flow of inappropriate use.

Each of these trends increases the interest both of the industry and of the public in more and better health information. They give healthcare a major interest in bringing this information to as wide a population as possible.

The most powerful tool for holding healthcare costs down while improving health outcomes is the rapid and powerful dissemination of information.


Excerpts from:

"The Other Revolution In Health Care"

by Joe Flower

Wired, 1/94

(International Copyright 1994 Joe Flower All Rights Reserved)

The coming American healthcare system has everything to do with smart cards and dumb terminals, big bandwidth and micro-probes, genetic markers and info-markets. And it doesn't look like anything you've read in the paper. . . . Healthcare will shift its center of gravity away from last-minute, traumatic, intensive, expensive, short-term hospital-centered care, and toward early-as-possible, preventive, long-term, intimate, inexpensive application of information in the community and the family. . . . The fact is, of all the actions that make up this vast humble-jumble we call health care, the great majority are already transfers of information rather than shots, cuts, and pills. . . .

In healthcare, you can cut costs, and do a better job at the same time, if you help people learn how to improve their health, if you catch disease as early as possible, and if you take care of people at the lowest appropriate level of intensity - keep the colds and the aching backs out of the Emergency Room; don't tie up Intensive Care with something that a little prevention could have caught.

Telecommunication, especially a two-way, digital, switched broadband network that extends into people's homes, has powerful potential to help. . . .

A few read-'em-and-weep statistics on our $1 trillion-a-year bankrupting-the-country healthcare industry (from "Health in the Information Age," by Michael McDonald, President of Windom Health):

Prognosis? We could save money in big buckets if we gave people an easy way to grab good information about their own health at home. . . . Picture the kind of TV/telephone/computer information appliance that people widely expect will a big part of the home in the future. Give it a home version of a medical "expert system," fitted with a highly interactive graphic interface. It can ask the kind of questions, and give the kind of answers, that the doctor at the clinic would: "No, if the boy didn't pass out, it's not a concussion. Here's what to watch for . . ." Or: "If it's round and has definite edges, it's not skin cancer. Here's what skin cancer looks like . . ." Based on what you tell it, the system can triage the cases you can take care of yourself from the ones the require a doctor's care ("Better make an appointment") and the ones that require instant attention ("Dial 911.")

Such a system would know you. You would give it your digitized medical history and answer its questions. It would ask you different questions, and give you different advice, if you were a 48-year-old woman with a family history of breast cancer, than if you were a 28-year-old gay male, or a black man thinking about getting married.

Or this system, with all its interactivity, could be put online. According to McDonald: "Part of the reason self care, prevention, and health promotion are so undeveloped is that traditional print and mass media do not allow the individual to access health information when they need it in a form that aids appropriate decision making. Health-oriented telecommunications are likely to revolutionize this part of the health system by making available anything a person needs or wants to know about their health 24 hours a day, seven days a week in the home, school, workplace, or through public terminals." . . .

In many ways the most revolutionary part of all these ideas is the part that allows sideways, many-to-many discussions, just as today seniors can talk on SeniorNet, homeless people can tap into HandsNET, and MCHnet deals with matters of maternal and child health. One bulletin board system, CHESS, was designed solely to deliver information to people with HIV - but the people with HIV wanted more than access to the latest information. They wanted to talk to each other. And the people who ran CHESS changed the system to meet the demand.

Many of the factors that can actually build healthier communities - factors such as diet, street crime, environmental problems, access to information, good child care and housing, and substance addiction - can be most powerfully affected at the community level, but the energy has to come from the community. Systems that allow open "forums" provide a matrix on which this kind of community energy can grow.

Developed and used properly, health-oriented telecommunications carry possibilities that go far beyond gee-whiz Buck Rogers romanticism, and even beyond more toys for the big boys. They carry the possibility of providing a major assistance in revolutionizing health care, making it both cheaper and better, spreading it wider, involving people in making decisions about their own lives, helping America (and eventually the world) build truly healthier communities.

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