Health 2.0 Liveblog: Clay Shirky

Author of “Here Comes Everybody,” NYU Interactive technology/culture prof: Health 2.0 keynote address.

“More is Different”: As groups aggregate, they create not just more knowledge, but a different, more valuable kind of knowledge….this affects healthcare innovation in three ways:

Information: Most valuable aspect of the Internet: “people.” Those who think about health information think of individual transactions–but the value is when people share this information. Yahoo Groups, “the first social software,” illustrates tremendous public demand for collaboration with others. “Wherever people trust each other, the information will flow.”

Coordination: Example of how institutions are losing centralized control: Vatican 2, 1970s:, premised on “The People are the Church.” But in the 70s, people couldn’t do anything about it. . .until 2001. Then the abuse scandal broke–and by then, technology enabled “word of mouth at the speed of light.” The church was powerless to control the information–incidents were transparent, individual episodes became aggregated.

Parallel: In healthcare, the standing command-and-control structure sees “healthcare” as the sum total of providers, payers, etc.–the established institutions. But the patients are healthcare too–and they outnumber professionals by 100 to 1. Once they collaborate, the central institutions lose power–and have to change.

We’ve always had informal conversations in healthcare, among each other–but now they are visible, global and immediate. Doctor-patient relationships, by contrast, are very few.

Collaboration: A doctor finds a problem with a knee joint; the company says it’s a practitioner problem, not a device problem. They will deal with doctors one by one to solve it. The doctor posts an open letter on the web about the device’s problems, which immediately gets distributed within weeks to patients and doctors. Within weeks the company has a PR disaster, and class-action lawsuits.

So: Some medical institutions are trying to prevent health 2.0 from occurring. Doctors can now get patients to sign a contract which prohibits them from discussing their care. They are trying to regain power, prevent the transparent conversation among patients.

Ending quote:

“Things get really weird when you give people access to tools of collaboration.

“Things are getting really weird in healthcare.”