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Craig Stoltz from the Health Care Blog writes:

There are many good reasons to deplore Wikipedia, not the least of which is its authors’ cultish smuggery about the righteousness of their cause and the rightness of their content.

Of course there is also its internecine complexity of processes. The documentation tracing the petty bitchery about an entry is often longer than the entry that is produced. The international collectivist negotiation over matters of “fact” is beginning to remind me of the United Nations, but without the fancy New York headquarters.

A brief diversion from usual topics, but I too have been listening to the “wisdom of crowds” nonsense for long enough.

Wikipedia is great, but it has a limited ability to do a few things well: reign in pop culture to a reasonable degree and make anyone with an iPhone at a cocktail party the final arbiter on any topic.  (Full admission: I am an iPhone user.)

But even their model has broken down.  To wit, there is a long and extensive series of gatekeepers who review articles and decide if they are worth keeping.  As Craig writes, much of this reasoning is circumspect, and now, Wikipedia is going to make it even harder to publish on their site.

What you talking ’bout, Wikipedia?

As much as they might downplay it, there is still a chain of human command laboring behind the curtains of Wiki.   The crowd wisdom has little to do with the success of wikipedia; what’s truly amazing thing is that by appealing to basic emotions of all humankind — the need for fame, the need to judge others — most of these writers and editors do work for free.

You could get the same results if you dumped a series of photos, videos, ancient texts, etc. that were all authored by a small group and set the wiki admins loose on organizing it.   See Amazon.com and their wishlist series – it’s a neat way for me to bring order to a disordered set of data; Amazon provides an incentive for me to do so –small amounts of fame and the hope that someone might buy me a gift. 

I’m curious, didn’t we use to call this job “being a librarian?”

What I find increasingly strange about the Wiki-universe is how distrustful it is of its own fans.   There is now a sniff-sniff, Wikipedia is too good for that kind of attitude regarding certain types of content.   Articles that are not “relevant” or “news-worthy” — again, decided by the overly-invested, unpaid admins – are deleted.  So what if the article on historical Christian hairstyles wasn’t good enough to make the grade, isn’t the point that Wikipedia has no limits — that because it is the very antithesis of an encyclopedia set, which once bound and printed is limited — so it should be able to encompass all kinds of knowledge, however random?

But here’s the last laugh.  Wikipedia is now authoring an encyclopedia.  (One wonders, Will they e-mail out updates?  Will digital ink self-correct?) 

Such a move is proof that the printed word — the book that you can hold in your warm, Kindle-less hand — is still something the crowd aspires to, whether ’tis wise for the Wiki franchise or not.

Of my last post about open source food, Jeff Jarvis commented:

I wasn’t suggesting that the kitchen should be turned over. I’m exploring the ideas of openness even in restaurants. For example, I’d like to know which dishes get ordered more so I can use that in my decision. Or perhaps diners can suggest improvements in recipes. And so on.

Next I’m tackling health. Since that’s your expertise, how do you think Googlethink could come to health care? Could it? Can doctors and health institutions be more transparent? What would we learn from aggregated and open data? Would there be value in a social relationship among patients? And so on. I have some ideas but I’d love to hear your thoughts.

From my point of view, the biggest challenge in healthcare institutions is the institutional thinking that goes on behind the scenes. Many good hospitals are trying to keep it all together, given the unfair hand they’ve been dealt: price-setting from insurance payors, even lower price-setting from the government, and the legal responsibility to treat anyone sick enoug to walk through their ER doors. Add in overall costs of service delivery increasing at a time when the costs of insurance are biting Joe Q. American’s pocketbook and Michael Moore’s Sicko… well, it’s a rough time right now in healthcare.

This leads to institutional thinking: how do we keep this boat together? And the simplest answer is command and control leadership. Don’t take risks, don’t innovate, trim costs wherever possible, etc. That’s not a critique — I’m sympathetic to the challenges here — but it does mean that providing patient access to data inside of a hospital is risky because it opens the hospital up to more risk.  Patient benefits be hanged!

I have been point-blank told, at more than one hospital, how much they’d like to get rid of system X or software Y, but they can’t. Even though it doesn’t work and there are better products available, they just can’t. It would be too costly — politically or capital-wise.

From an infrastructure standpoint, most hospital software is cumbersome, expensive, and (let’s face it) old. The sales cycle for a hospital engagement is often 18-24 months — contrast that to a Google service: free, immediately available, updates whenever you want! As good as the technology is, each hospital technology infrastructure is a jigsaw puzzle that barely fits together as is, never mind inviting a behemoth like Google into the mix.

A typical patient experience, from a hospital standpoint, goes as follows:

1. I’m healthy.
2. I’m worried I’m sick and go online to get health information.
3. I see a doctor/RN for diagnosis.
4. I go to a hospital for treatment.
5. I am discharged.

Being a patient in a hospital is a terminal experience: it ends in discharge or death! The medical systems were created long before Starbucks convinced every industry that consumer relationships were what mattered (thank you, SB, for getting the stinky breakfast sandwiches out; here’s a to a $30 stock price again.)

Google Health might end up being a great tool for diagnosis but hospitals can’t embrace it… unless so many the physicians demand it for their patients.

The churn and noise about hospital transparency is basically saying, “Here’s proof we don’t kill that many people.” Transparency = quality of outcomes for a hospital. But in 5 years, that won’t matter. Once the measures of quality are open to the public, the payors and Medicaid/Medicare will use it as an excuse to stop paying hospitals with lousy outcomes. So, overall, the healthcare experience should get better. But that doesn’t mean we’ll know any more or less about the process.

I place much more faith in the power of patients to self-organize in a way that wasn’t possible even two years ago. With sites like PatientsLikeMe, patients in recovery — discharged, perhaps from a hospital — are about to connect about their quality of treatment in a real-time, clinic study fashion. Sites that provide disease/condition/treatment communities will be where hospitals can knock it out of the park. Imagine if every cancer patient in your town heard that XYZ Hospital was the best — from the site moderator!

That’s where the openness will come from: empowering patients who had great experiences to market the hospital with a level of authenticity not possible any other way. We just ran a few webinars on this topic — so popular, agencies and competitors showed up in droves to hear what we had to say. That tells me we’re striking a chord.

But, as I always say, the nice thing about talking about the future is that it’s difficult to be proven wrong.

And by way of continuing the conversation from yesterday, Jeff Jarvis wonders if Google ran a restaurant, who would do the cooking?

Besides the silliness of open source restaurants as a concept — technique matters far more than recipe — the NY Times contrasted that notion with the need for efficiency in dining, noting that too many choices killed the Manhattan diner.

But art demands risk and taking a step forward into the unknown.   Asking your customers to make all the choices — which, one might argue, is an artistic choice in and of itself — is not the same thing as crowdsourcing.  For example, Threadless.com has plenty of folks vote on the best designs, but still maintains final creative control on which t-shirts to send into production. 

Even Wikipedia, famed for its “wisdom of crowds,” has become more bookish and patroling than in the past.  Giving an example at a client site, we created a page for their hospital… and then they got banned.   For copyright infringement. 

I think the point of the restaurant was “Can we imagine Google mashups working in a world outside of technology?” 

Sure, go to any jam band or jazz pickup group.  The improvisational talent is found plenty of places.   But if you don’t share a common level of expertise, you can’t play along.

I read an excellent post on Mashable today,  about how less is more and how to unlock the web.   Much of the post concerns Twitter, an application so sublime, it’s hard to put into words what it does for you.   (But you can follow MedTouch on Twitter here.)

The power of simplicity can’t be understated.  By example, I had a microwave/toaster oven for a brief period of time.  It was left by the previous residents of the house.  Wonder why?   Because I’m sure they found it difficult - as I did - to determine how long to cook something (no numerical keys; just dials) and to take items out when it was a toaster (you needed tongs) and why you couldn’t leave things on top of it (much surface area hotter than a microwave).

In short it was a “time saving” device, but only if I could adapt to it. I couldn’t.  I had a solid understanding of a Platonic microwave and toaster oven ideal.

Twitter is an excellent example of an application that is so simple, you know we are still working to understand and appreciate its value.   In that sense, adding more features to something we are still in the process of discovering, robs that experience of joy.

Now, not everything can be Twitter, but this certainly explains why we prefer a conversation rather than an RFP.  There’s a joy to the creative process that comes out in conversations in way over-processing never quite gets at.

I’m back from the AMA Houston SIG meeting on healthcare and technology, presented by:

Plus Katie Laird, from Schipul, moderated the panel.  

We had about two hours to present, take questions, and wrap it up.  I felt the Q&A could have gone on for another two hours, the audience was so engaged.   The most helpful aspect was that each presentation built on the previous.  Ours was focused on why healthcare was changing due to social media and then Chris and Jennifer followed up with the successes and challenges of from an inside the hospital point-of-view.  (Chris does it because it’s a clear passion, in the midst of other jobs; Jennifer is fortunate enough to have this be her full-time position.)  Jay, from CareFlash, finished up with a demo of sorts to show the benefits of social networks to the caregiving community.

My favorite thing about speaking at conferences — aside from my desire to one day be a talking head over a blue screened city backdrop on CNN – is that it’s a rare time when I can be completely honest with my opinions since the room is not full of clients at varying stages of engagement with what we’re doing.   That resulted in a neat exchange with an attendee (Richard Laurence Baron) on his blog over his concerns that I predicted the death of the written word (I didn’t, but you could take some comments that way) and what it meant for his life as a freelancer (hopefully, more work for more innovative.)

Most of all, this conference forced me to examine our embrace of social media for the company — we now have a MedTouch Twitter page; thank you Jennifer — and our clients.   For example, I’ve had this blog sitting outside our main site because I wanted to make sure that I’d write enough to keep it up (it’s been a year!) and also, I wasn’t sure our point of view would warrant exposing it to every visitor to our site.  Thanks to this conference, I’ve figured it out, so in a few weeks, we’re going to tear this down and rebuild it stronger.

Until then, feel free to talk to us about your hospital’s social media needs.

Kudos to the NY Times for an engaging piece about infertility.  With bright, compelling photos of the women in their homes and an audio accompanyment, it’s remarkable how well the piece works online.  After all, aren’t they a newspaper?

This is exactly the kind of content health consumers want to read — real stories, decisions, and backgrounds of people making healthcare decisions.  How easy would it be for your hospital to do this?

People are coming to the web like never before to find out about their health. They look to hospitals for this type of information, but usually walk away feeling discouraged and even more nervous about their health situation. This has caused an increased rise of people talking to each other online through social media sites such as FaceBook, MySpace, RevolutionHealth, WebMD and other health related sites, to get the information they need and want. It is time for hospitals to join the conversation, and begin to support patients through social media applications. Many people consider hospitals as their community’s healthcare experts, so it would behoove hospitals to step up to the plate and provide the services expected by patients.

Check out our press release about an upcoming social media panel Paul, our CEO, will be on in Houston June 20th.

Paul, our CEO, will be in Houston June 20th presenting on social media, and how to use this new phenomenon when communicating with patients and potential patients. I guess this is what happens when you provide too much information on your Facebook profile.

Social media—including blogs and interactive websites—is the future of marketing. Other industries have adopted Web 2.0, but the healthcare sector has been slow to engage in social marketing as a strategy.

Our panel of experts will attempt to demystify Web 2.0. Using case studies, they will explain how to get started harnessing social media in order to reach various healthcare audiences: patients & their families, doctors, nurses, clinical and non-clinical caregivers. They will explain how to take your website to the next step and utilize interactive web feedback to market your practice or product.

If you are an AMA member, and happen to be in Houston that morning, go check it out. It will be entertaining…

One of Cambridge’s finest CEO’s, Paul Griffiths CEO of MedTouch, was mentioned in an article in the Boston Globe this morning. Read what Paul is most likely to do to based on his Facebook profile.

When CEO’s Provide TMI

I’m convinced that all media will soon be social — that is, nearly all content we consume will be recommended to us rather than programmed at us. Stay tuned for more on that.

But I was fascinated by Facebook’s new ad system and the data I was able to find. For example, you can now target ads based on gender, location, and employment info — pretty slick for an online yearbook site.

Here’s some data I collected first hand about the demographics of who is on FB:

50 years +: 478,640
40-49 : 613,600
30-39 : 1,979,320
23-29 : 6,594,820
18-22 : 11,062,560
under 18 : 4,129,040

For those playing at home, that’s 24 million people total, with 87.5% under 30 but less than half “college-aged” — the population the site was due to serve.

Project the data 4-5 years from now, and you’ll have a population more like 50 million, with a larger chunk of 20/30’s graduates:

50 years +: 1,092,240
40-49 : 1,979,320
30-39 : 6,594,820
23-29 : 11,062,560
18-22 : 22,125,120
under 18 : 8,258,080

Estimates (obviously) 

But that’s assuming they do no aggressive advertising amongst AARP members.
So while I’m sure the general ads for skateboards, Mountain Dew, and Noxema will continue, my guess is each population will soon be getting their own targeted ads. And this is the genius of social network: the growth rate is exponential, but predictable. In 10 years, who knows — 100million? 200million?

NBC would kill for that kind of market share.