Geoffrey Moore (author of 'Inside the Tornado') would say that we are in the 'chasm' between early and mainstream adoption of connected health technology. The Partners 2006 symposium showed that changing the way that government funds healthcare from fee per service to fee per outcome is key to crossing this particular chasm. The symposium also showed that the US government is listening and is prepared to act subject to evidence - which they will need to amass themselves. So we have a two or three year window during which, if you follow Mr Moore's diagnosis and treatment plan, the connected health community will need to focus on clusters of applications (in what Moore calls 'the bowling alley' phase of market development) that are closely linked so that when one skittle falls, it has an impact on the others.

Chronic disease management is an obvious cluster. My bet is that this will lead the way towards changing government reimbursement strategies leading to subsequent and more or less predicable technology adoption by existing providers.

What is not so clear is what will drive us beyond the 'bowling alley' and into Moore's 'Tornado' with attendant exponential market growth. In this we will see applications that surpass current healthcare imagination. Body Media have pointed the way to the use of lifestyle databanks as new sources of 'vital signs' information. MySpace has yet to make an impact on healthcare - but it or something like it will in due course play a role in helping connected health to cross the chasm, pass through the bowling alley and then enter the amazing tornado of connected health.

I am heartened by all of the experimentation that CMS is doing with respect to risk-based contracting and pay for performance. These changes will encourage adoption of connected health. I want to call attention to the other major payment force in US health care, the large employer. This group is very creative (some would say desperate) and will adopt solutions ahead of the government. We just have to present them with solutions that are ready to go.

Thank you for starting this forum. I'm very interested in how people think about their health (worried, engaged, in denial, etc.) and how that impacts their interaction with health-related technology. Can you point me to any literature or other references that talk more specifically about human factors and product design in relation to health self-perception?