We like many features of this tool. Most important is the automation. As the venture capitalist Roger McNamee likes to say, 'anything that saves time is worth investing in.' HealthLoop has the potential to facilitate a huge amount of data-collection quickly. It is particularly time-saving for physicians.

Here's how it works. Doctors subscribe to the service and use it like any other web-based application -- off a command "dashboard" that is private to them. When sitting with a patient, doctors must request that the patient agree to register as a HealthLoop participant. (That's for HIPAA.)  From then on, whenever a patient comes under the doctor's care for a specific purpose, over the duration of the treatment prescribed, the patient receives a daily, automated message to the email account of their choice. The message includes one simple, multiple choice question: 'Are you Better? The same? Worse? or Much worse?’ Patients respond with a single keystroke, merely clicking the link that best fits their condition. (Screenshot below, left).

Responses feed into the doctor's private HealthLoop dashboard; a single daily reply for each patient under the doctor's care. Responses are color coded: red for "worse"; green for "better." It produces a landscape of visual cues to indicate how the entire patient panel is doing that day. A lot of information, digestible in a glance. (Screenshot below, right.)

Other than in a large-scale clinical trials, doctors are typically limited to following the progress of their patients in a series, visiting with one after the other in the tradition of 'rounds.' 

"HealthLoop gives you the opportunity to follow multiple patients in parallel. I've never before been able to follow more than one patient at time," says Dr. Shlain.

According to triggers in HealthLoop set by a doctor, including triggers that might consider a patient’s personal history, or concurrent conditions and therapies, HealthLoop can alert the physician if a patient's script needs to be changed, or a house call needs to be made, or if the patient needs to be referred to the ER.

"Two 'worses' in a row -- and I get a page," says Dr. Shlain.

This has obvious clinical and economic value: doctors can do a better job of minimizing unnecessary office or ER visits,  as well as track how patients handle particular drugs or treatments.  

In its current iteration, HealthLoop offers summaries of a "treatment loop" in pdf format, which a doctor could upload into their EMR. Dr. Shlain says his software tool will eventually support  open API’s, so HealthLoop can integrate into most any proprietary EMR system. Overtime, he adds, the HealthLoop engine will "learn," meaning it ought to be able to begin predicting best practices -- like a mini Archimedes, but based on medical outcomes that are also specific to the subscribing doctor's practice and patient panel. Predictive models are more valuable when they can be made more situationally relevant. 

Patients can also login to HealthLoop.com and use a secure messaging  function to communicate directly with Dr. Shlain, if they wish. However, patients are limited to a "Twitter-size" message of not more than 140 characters.  The benefit? "They can't write the two to three paragraphs that they'd write in an email. They have to think about what is the most important information to share with me. It requires them to work at it a bit," adds Dr.  Shlain. That's a good thing, he says. It demands sharper attention from patients -- and so really, a deeper level of participation from them in their care. This, even as it offers an easier way to communicate with their doctor. Less is more.

A case in point: Last week Dr. Shlain had an existing patient call in a massively herniated disk. Dr. Shlain prescribed her a medication for pain, then used HealthLoop's secure messaging to send her the names of two neurosurgeons. She has, in turn, kept Dr. Shlain informed of her progress with the other physicians, via HealthLoop. Dr. Shlain has been able to track her progress all week, first with the HealthLoop messaging, and then the automated 'Same, better, worse' emails.

"Without every laying my eyes on her, we got all the feedback, and she's doing much better. It was this weird virtual story," concludes Dr. Shlain. "Now, she's an existing patient. For a new patient that wouldn't work, but for the established patients in my practice, this is the power of technology in its purest form. We had one phone call to open the loop, and the Internet closed the loop."

In our view, it is the fact that HealthLoop lives on email that most advantages its business prospects. We know of other communications tools that offer comparable functionality, but they are internal channels on custom-built platforms, and therefore, require users to migrate and learn something new.  That is a barrier to entry, no matter how low-cost the tool might be. Since the key to HeathLoop's usefulness for doctors is patient-participation, building HealthLoop on the back of email, a platform patients use all the time already, only increases the likelihood that patients will play ball. We like that.