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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.”

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