By Jim Lefevere

"Pioneers get the arrows," as the saying goes. I much prefer: "Pioneers get arrows in their back." Being early in a market is great -- if the market is ready for you.

I have been in and around Internet and healthcare for nearly 15 years. I almost regret to say that that for many reasons, but mostly because I have been waiting that long for technology to revolutionize healthcare. That is a decade long trend in the making. I don't think there has been much transformation other than a lot of VC money has been burned and consumers and HCPs are now both online. If you go back to the start of the millennium when the "Year 2000" was the issue du jour, consumers and "silver surfers" were online then too and health information was at the top of the list for why they came online. The same is true today except the "silver surfers" are now the fastest growing segment on Facebook.

We have seen the DVR (digital video recorder) disrupt television viewing and single handily ruin Thursday's "Must See TV." We've seen the notion of watching a full-length movie on your phone become a reality and being able to watch your favorite TV shows remotely on your PC come and take hold in a shorter timeframe.

It's interesting to watch mobile health take off and the AppStore on iTunes fill up with apps. Mobile is now the wild frontier of unclaimed health space. I truthfully think everyone is, to use the expression, "building the airplane while flying it" and not entirely sure where things will end up.

But for those with short memories, the Internet has been a year away from revolutionizing healthcare for over a decade. Yes, a decade. It's almost as bad as waiting for the year that mobile advertising takes off, but I think we're actually getting closer to that year.

That's not to say that I don't think we'll get there. I think we will, but I don't think it will come immediately or easily. There are a number of issues left to resolve before we get closer to technology fully enabling healthcare, remote patient monitoring and mobile health.

I do not want to oversimplify what is really a complex issue, but I do see some major stumbling blocks to full-scale adoption in the near term.

Technology -- Let's call it technology standards for device interoperability. It's not there yet. It's coming, but it's not there yet.
Products -- In order to have healthcare you need an end-to-end solution for multiple disease states. Take chronic disease as having the highest burden on "the system" and you need to have a suite of products available to have a solution.
Privacy -- If you're 50 years old or older you probably have second thoughts about storing all of your medical records on Google let alone let someone access them.
Reimbursement -- Unless a doctor gets paid to do it, I can assure you that he/she is not going to spend his time on it-until forced to.
Fragmentation -- There are still far too many one-off, one-way and proprietary solutions available. Just Google "EMR" and tell me what you come back with. Enough said. There has to be financial incentive for a company to move to a common standard and until a solution is proved you will see lurkers but no real movement. That puts an end-to-end solution years away.
Adoption -- consumers have to embrace and demand it. Doctors need to get paid for it.
The Last Mile -- This is a term that was originally used to describe getting connectivity such as telecommunications or cable to the end-user. Same is true here for the doctor who needs to implement it or the patient who needs to use it. It's hard for a multitude of reasons. As I search for the metaphor in this I see healthcare delivery as a marathon. This is the marathons of all marathons and that the last mile is absolutely the toughest. I'd say we're at around mile four.

Do I think it can be solved? Yes. I am excited for the future? Yes. What will it take? It's pretty simple, time. Yes, time. Technology needs to mature, reimbursement needs to come into play and patients and doctors need to widely adopt. That requires time.

This will happen in time, but you need the generations (Gen-Xers, Gen-Y and Millenials) of people who are comfortable with the Internet and technology in combination with healthcare delivery before you will see mass adoption. Will President Obama push this in the right direction? Absolutely. Will we look back in ten years and mark some legislation he passed and other milestones as key events? Yes. There are some very good things going on out there. Products are becoming available, pilots are being conducted and there is progress, but I don't think it's going to happen en masse for a few years.

Before I get my email box flooded, let me stress the words, "en masse." There are very smart people and organizations trying to move this forward and there are successes and there will be many more successes, but the future I envision with full-scale connectivity and remote monitoring of elderly parents or chronic disease management is still a few years away from mass adoption.

I'll be watching and would love to have someone prove me wrong.

In the mean time the pioneers get the arrows, but the settlers get the land. Which are you?

Jim Lefevere is a global marketing and technology professional in consumer goods, health care, and medical devices. Recently named one of the Top Forty business professionals under 40 by the Indianapolis Business Journal, he has led marketing efforts for Fortune 100 organizations and fast-growth start-ups. The thoughts expressed here do not necessarily reflect the thoughts of his employer or associations. You can read his blog on digital strategy, interactive marketing, and connected health care at http://www.jlefevere.com.