Health 2.0 : No Website is an Island

I like the film 'About a Boy', based on the book by Nick Hornby, not because it is hilariously funny, gripping to watch or beautifully directed (I actually found it somewhat amusing and enjoyable), but because I took away from it a contemplation of the meaning behind John Donne's famous words 'No man is an island'.

I now often hear Hugh Grant's protest at the back of my mind as he tries to argue the case that he is an island (which he comes to realise during the course of the story that he could not actually continue to be), and also the dialog from the young boy in the film as he comes to the conclusion that one parent is not enough - you need backup (his point not being that you need two parents, but in fact a whole network of people to give you the support you need if you are to be happy in life).

I am by nature an extremely independent person, always someone to try and work something out myself before asking for help – in fact, I could probably count the number of times I have asked for help in this life, and each time it was a difficult thing to do. I'm the type that will always look to the map rather than ask for directions and finds it incredibly difficult to admit when I don't know something, much preferring to quickly dig deep into a manual somewhere to find the answer myself. I guess I am also a bit of a perfectionist and probably am reluctant to delegate a job, especially when I think I can do better myself. And because of these traits, I guess I also could easily fall into the trap of arguing that I too, and my work, is an island - I don't need anyone else because I can do it all on my own - in fact, other people would probably slow me down.

Add to this character another trait that is fiercely competitive. If anyone has the same ideas as me, does something similar, or worse still, better, I can't help but fume inside - something close to hate, or envy, maybe some feeling of inadequacy - I simply have to be the best, or at least hold within me the belief that I am the best, or else remain ignorant of the reality of the situation - maybe that is why I sometimes don't like to look at competitor sites, for fear that they might be better than mine!

But all these sentiments are strictly not Health or Medicine 2.0

Health 2.0 in my mind is all about forming relationships in order to build a framework that might release the full power of the internet (3.0!) and take us that step closer towards the healthy utopia of which we all dream. This takes some courage when many entrepreneurs are often by nature both independent and competitive. It means opening up a little, sharing ideas, looking at building partnerships and new ways of working with other people and other websites, some of whom may be considered potential competitors and others that you may never have considered as relevant to what you are doing at all. Any websites that follow this ethos I believe will grow - those that hang on to their NDA's (non-disclosure agreements) as some kind of armour in an attempt to keep their company ideas under lock and key I do think will likely wither over time and die. Sure there has to be a little balance - I'm not talking about broadcasting your 5 year business plan to the world - but I am talking about throwing a little caution to the wind and saying 'what the heck - maybe this other person/website might be competing with me somehow somewhere in the future? (especially since we all have similar ideas about what we should be building – honestly, there really isn’t much in the way of original ideas), but if we can find some way of helping each other out, chances are we can actually help each other get to where we want to be a little faster, and build something much more powerful than we originally thought'.

Think about relationships with other websites, and relationships with your site visitors - who may not always be who you think they are - think relationships both vertically and horizontally - near and far - outside the box - functional and philosophical. Remember that the Internet is a web and I think you'll be keeping on the right track.

Health 2.0 - Love it or Hate it?

David Rothman dislikes the phrase "web 2.0", and the terms "medicine 2.0" and "health 2.0" bug him even more. Why? Because he is just too cool!

I used to be cool once - in a younger life I owned a 'way cool' clothes shop. I was the ultimate trend setter. I took pride in spotting trends way ahead of their time. The downside of this was that as soon as something became mainstream, I would hate it - which meant I was never going to earn my fortune in the fashion industry. Now my daughter tells me I am 'past it'. I'm not, honest! (I'm trying to convince her that I am even cooler - I just don't care any more!)

Now David is a cool geek - he saw the phrase "Health 2.0" coming way before the rest of us - and now everyone is using it he has to hate it. This dislike I think started back when he first added the category 'Web 2.0' to LibWorm over a year ago, and has been simmering ever since, until it reached boiling point a few weeks ago.

Hey David - you know I'm only pulling your leg ;)

Now, in order to make amends for my tomfoolery David, please let me agree with you. I think that the term "Health 2.0" is not helpful for medical librarians or other information specialists when trying to promote the use of internet technologies amongst physicians and other medical professionals.

The majority of doctors do not care and simply could not care less about "Health 2.0 ".
They may be interested to know how the Internet can be of use to them in their work, but mention "Health 2.0" to them and generally the response you are going to get is Health What??? followed by very rapidly increasing disinterest (trust me, I've tried it, on my nearest and dearest!)

My understanding is that the majority of doctors also have not heard of and do not care to hear about mashups, aggregators, folksonomies, AJAX, widgets, the semantic web, RIAs, or for that matter, 'Really Simple Syndication'. They want to know where to click to get to the information they need, quickly, and that's about it! I know there are exceptions to this rule - in fact, there is quite a big group of technically savvy doctors out there - but in terms of world wide health care professionals, this big group is really tiny and in no way representative of the majority. When talking to my target users on a daily basis about MedWorm, I often drop the term 'RSS', since it usually isn't necessary, and I find that 'newsfeed' works better.

But I do think, as much as it annoys me also, that the term 'Health 2.0' has its uses:
1. It helps money makers to exploit the health internet business as much as possible by whipping up frenzied interest from venture capitalists.
2. It gives previously disheartened American citizens some hope that there may be some solution to the disjointed health care provision in the US (hee hee! now I may complain about the NHS and its failings, but it is with some pride that I hold on to this national institution!).
3. It brings me more visitors to my blog - which is great for MedWorm.
4. (The only use that I believe is honest in its application.) It helps me, and I am sure others, conceptualise what has happened/is happening/will happen in regards to communicating and sharing (health and medicine) information on the internet, and helps bring like-minded individuals sharing this same interest (and excitement) together, to discuss how we can push ahead with such progress.

Let me elaborate point 4 a little further, for it is the reason why I can continue to justify my blog dedicated to this topic.

Sure we all know that in real terms there is no second version of the Internet. But thinking about 2.0 helps me to stand back and see the wood for the trees. I started MedWorm really by chance - probably jumping from one lily pad, to another that was bigger and greener, to another and another, until I found one that suited me just fine - the biggest and greenest in the pond - my destination - how nice! But I hadn't really stood back and looked at the pond as a whole, to see what else was growing there - I hadn't really given a thought to its ecology and how we all depended on each other for our future growth and success.

An example of my ignorance at that time was when David suggested that I might think about inviting people to give their comments and suggestions about MedWorm, and possibly writing a blog. My immediate reaction was that I was just too deep in code to have time for such activities. I've come some way since then! Not only do I love to hear about what people have to say about MedWorm and get feedback (and more), I realise that MedWorm's growth absolutely depends on such relationships, both with its users and with other compatible websites.

Thinking about Health 2.0 and the coming Health 3.0 (sorry David! and yes the dreaded 3.0 posting is coming!) has made me realise that not only is investment in communication with both users and what could actually be seen as competitors, both enjoyable and helpful, it is actually MedWorm's destiny - and I can run ahead with it, or fall by the wayside and let MedWorm slowly die.

So to summarise my opinion on the term "Health 2.0" - do I love it or hate it?
1. It annoys me, because I am cool like David - honest!
2. It helps me conceptualise health developments on the Internet and form my plans for the future.
3. It helps bring together like-minded people to discuss such developments.
4. It does not help when trying to encourage the majority of physicians and other health professionals to try out MedWorm and other emerging Internet technologies.

I guess therefore that I am 50/50 - some may say sitting on the fence!

And what about you? Health 2.0 - do you love it or hate it?

Wanted - Medical Professionals with an Interest in Health 2.0 / Medicine 2.0!

Are you a doctor, or other health professional, with a particular interest in one or more of the following?:

1. Health 2.0/Medicine 2.o


2. Blogging


3. RSS


4. The Internet

If you are, please drop me a line - I'd love share ideas with you!

If you are reading this and are a physician, probably you are one of a minority. You take a keen interest in IT. You like reading medical blogs and maybe you have one of your own. You probably know a bit about RSS and are even familiar with Health 2.0.

Do you realise that if you are one of these unique people, you have a responsibility to share the good news of the coming Health 2.0 revolution with your colleagues, who may not be so technologically inclined? Without your encouragement, it will never really happen. You are bridges. You are champions!

There are many people excited about Health 2.0, but I increasingly find myself asking the question: How many of us enthusiastic people are really 'in' medicine, and how many of us are just technology medical wannabes like me? I'm an IT professional that would love to be able to cure the sick, but sadly can't, so spend my days dreaming up and building an infrastructure to help medical professionals, but the problem is this big gulf between IT and medicine. How to make that leap? How to convince my husband that RSS really is the best thing since sliced bread?

If you are really 'in' medicine or medical research, and have an interest in Health 2.0, please get in touch. Maybe we can work together to convert the masses? Maybe you might even me interested in becoming a MedWorm Associate?

Health 2.0 is all about finding new ways of working together, so drop me a line and build another link in the big brain.

What is Health 2.0 / Medicine 2.0?

This definition is written for two purposes:

1. To clarify what Health 2.0 / Medicine 2.0 is for myself. I figured that if I was going to make a contribution to discussions in this arena, I had better first make sure I had my facts straight - this is a chance for me to say what I think I know, and then for all the Health 2.0 Seasoned Veterans out there to correct me/argue with me where any inaccuracies are identified.


2. To explain in simple terms what Health 2.0 / Medicine 2.0 is to the medical professional who does not have a special interest in technology. I figure that if I can write one simple definition/explanation, I can save myself having to construct a comprehensive answer each time the question arises - I'll just reuse this one.

I understand that there are plenty of definitions/explanations already out there, so I ask for you patience whilst I take this opportunity to reinvent the wheel (and sorry if I may seem to be stating the obvious to some of you - the real target audience here is the doctor without much knowledge of IT terminology).

The Background - Web 2.0

Both Health 2.0 and Medicine 2.0 are derived from the term Web 2.0, which implies a second generation/release of the Internet.

The '2.0' part is based on computer programming - as a new edition of a an application is released, it is common practice for the programmers to add an incrementing number at the end of a program's name, to label the new version. A completely new release would see the increment of the whole number, and any intermediate releases (often referred to a 'patch', as it may be patching up problems with a previous release) would see an increment to the decimal number. An example of this is Internet Explorer 7.0 - there have already been small patches to fix Internet Explorer - mine currently says that I am on version 7.0.5730.11 - I guess if there is a substantial release that enhances IE 7.0, but is still fundamentally the same program, it may be called IE 7.1, 7.2, etc - a new generation of IE could for example be called IE 8.0

Web 2.0 implies the 'second release' of the Internet - which of course is not based on anything concrete - the Internet being made up of millions of interconnecting computers running lots of different programs - but is more of a concept to describe the type of programs/applications/functionality one can now find on the Internet.

The Internet was originally based on mostly static pages of information. Soon to follow were email, web forums and chat rooms where discussions could take place. Web 2.0 refers to a trend on the Internet that saw a step forward in the way we communicate on the Internet, which includes the use of blogs, videos, podcasts, wikis and online communities where people with common interests get together to share ideas, media, code and all types of information. RSS (really simple syndication) is a format/method to help pass around updates about all this new information we are now broadcasting.

Think of the Internet like a big brain - there is no 'central repository' of information - it is stored in lots of different locations, but each part of the brain has its own important part to play. Web 1.0 was a bit like the brain cells developing and Web 2.0 is what is happening now that communications are taking place between those cells.

Health 2.0 / Medicine 2.0

So now you know what Web 2.0 is, the rest is easy. Health 2.0 is the application of Web 2.0 technologies in the area of health, whilst Medicine 2.0 is the use of Web 2.0 technologies in the area of medicine. Some examples can be seen in the Medical 2.0 Directory. I have come to think of Health 2.0 websites as being those that provide services geared towards the consumer, and Medicine 2.0 those geared towards services for the medical professional - although I am sure there will be those who will debate this with me. Regarding my own website, MedWorm, I decided that it was MedHealth 2.0, since it was providing a service equally for both consumer and professional alike.

The Future - Web 3.0 / Health 3.0 / Medicine 3.0

Of course many are now speculating ... (to be continued)

Just realised that the future - Health 3.0 - would make a better post of its own.

RSS 2 Email - Progress or hindrance?

Subscription to TOCs via email has been a popular method amongst physicians of keeping up to date with their favourite medical journals for some time. I was hesitant to provide such a service on MedWorm since I wanted to introduce physicians to the benefits of RSS.

My reluctance to provide an alternative to an RSS aggregator was based on experience in rolling out new systems in large companies. There are always a core group of pioneers that are eager to try out the implementation of a new system, but the majority will need 'cajoling' and there will always be the 'die hards' that need forcibly removing from their old ways of working. The final solution, if management really want to see a new system take off, is the turning off, or outlawing use of, a previous system.

My reasoning, therefore, was that if doctors are going to really embrace RSS, an alternative, such as subscription via email, should not be made available. If I did not provide a subscription via email alternative, doctors would have to, at some point, make use of an RSS aggregator if they wanted to benefit from the information that was available.

However, this argument was flawed by a few factors. Firstly, an email alternative will always be available. Doctors can usually go directly to a publication to subscribe to a journal's table of contents or can use a third party RSS 2 Email service. Secondly, my argument was assuming that the use of an RSS aggregator in place of email was in fact progress and a better way forward.

Watching the uptake of RSS by doctors over the past year has been frustratingly slow. I just have to look at my husband (a doctor) to realise what a big problem this is, and will continue to be. He has RSS forced on him every day. He knows what it is, how it can benefit him. He has an RSS aggregator installed for him and a personal tutor breathing down his neck. I have even been offering to install some feeds for him on his mobile phone - an offer which he hasn't yet taken me up on. Now my husband is young and technically savvy. He loves technology and the latest gadgets. Often it is him who points me in the direction of the latest advances. But does he use an RSS aggregator? Well, not exactly I would say; occasionally; at a push. Why not? Well, it means either opening another application, which takes a fair few seconds, and then waiting for those feeds to refresh, which takes some time more, and having an RSS reader running in the background does seem to add to the performance hit on his computer.

The alternative, an online RSS reader, also has its drawbacks. First you have to open a new web browser. You have to navigate to your online service and then you have to log on. Before all of this, you first have to find a service that you like, add your feeds (which will often fall over for a variety of reasons) and familiarise yourself with how the service works.

Either solution does not qualify with motivational criteria by which my husband operates:

1. Things that are essential, or time saving, in order to complete his work.
2. Enjoyable and absolutely nothing to do with work.

Some would argue that using an RSS aggregator is time saving and would actually help him complete his work (as indeed would I), but the problem here is that the time saved is indirect. In trying to write a report, or find the best treatment for a condition, or pass an exam, RSS would not often be a tool to which one would turn.

Others would argue that using RSS is enjoyable. But for my husband, and I guess the majority of doctors, his idea of enjoyment is something that helps him forget everything that is medically related (although I have noticed that he particularly enjoys watching House, which is a bit of an anomaly).

Now time for a confession. Quite shocking really. I don't really use an RSS aggregtor that often myself. At least not on on the face of it. Ouch! That hurt! Why don't I? And how can I expect others to use it if I, who has realised that RSS is the Bees Knees, don't make full use of it?

I don't often use an RSS reader for a few reasons. Most of the online RSS readers I don't like that much. Google Reader is the most accessible, especially since I have a reminder that is is there whenever I log on to my Google account, which I do for emails, AdSense and my blog. But I find it a little clumsy and wastes a lot of screen space. When starting out on my RSS adventure I tested every aggregator I could find on the market. My favourite was the free, somewhat 'amateur' FeedReader which I really liked for its simplicity. I found that its navigational tree and three window layout enabled me to scan through hundreds of articles in seconds without any clutter. But its disadvantage was the time it took to load and refresh all the feeds, and unless I kept on top of the data and cleared it out regularly, I found that it was slowly filling up my hard drive with thousands of cached items.

The other reason I don't use an RSS aggregator that often is that I am quite lazy in keeping up to date with the latest advances in, well, just about everything, hence just 'can't be bothered'. Regarding technology and Web 2.0, I tend to leave it to David to do the research and let him point out to me if I am trying to reinvent the wheel. I find myself far to preoccupied with my own work that I forget to look at what other people are doing (yes to my own detriment I am sure - something I am currently trying hard to change by spending/wasting a lot more of my time reading other people's blogs).

But hang on a minute, it's not that bad after all, since MedWorm is actually one big aggregator in disguise. Even without bothering to log on I find I can easily keep a track on the latest ideas in which I am interested. I like to keep a watch on the Blog Cloud, in particular items tagged RSS, Health 2.0 and Medicine 2.0, as well as keeping an eye on the Information Technology section of the publications directory, the Technology Consultant and Medical Librarian section of the blogs, as well as the Cancer section of the blogs (which I find keeps me a check on reality and the priorities in my life). And then when I want to pay particular attention to my reading list, I do log on, which enables me to read items I am really interested in via my River of News, keep a track on my reading history and easily save items that are of particular interest to me.

Excuse-me, I digress. The topic was RSS 2 Email. I knew that people wanted this. A medical librarian from down under was specifically looking for such a service which prompted me to finally give way and implement this functionality on MedWorm. The design of the service was tweaked by valuable input from medical technology analyst, Dr Sheela Sharma, who very kindly provided me with the following feedback:

"RSS is a great idea, but I just don't have enough time in the day to look at both my e-mails and RSS feeds. So the service that you are providing is ideal!"

Funnily enough, even though I was dead against the idea in the first place, I'm actually finding I really like receiving RSS 2 Email myself. I don't think I would want to receive hundreds of updates from lots of feeds to my email, but for my favourite, carefully selected feeds, having a nicely formatted email conveniently land in my inbox with the latest updates is working really nicely for me and has given me some ideas on how I might further develop this area, to incorporate the best of both worlds - RSS and email working together - in perfect harmony - maybe that's what would really bring RSS to the masses.

MedWorm - Medicine 2.0 or Health 2.0?

I've been sitting on the fence for a while reading about Medicine 2.0 and Health 2.0. Now I'm the kind of person that really hates hype and likes to go against the trend, and see myself as a 'doer' rather than a 'talker', so up until now I've resisted getting involved in this 'idle chit chat' and laid low whilst I spend my days building MedWorm.

But now I'm thinking, what the heck? Just so long as I don't get drawn into the ongoing debate between Sermo and Medgadget regarding security/privacy loop holes in social networking models ;)

To begin my debut into the 2.0 arena, I have been looking at the difference in usage between the terms Medicine 2.0 and Health 2.0 From what I understand, Medicine 2.0 is used when referring to Web 2.0 sites primarily for medical professionals, whilst Health 2.0 is a term used for sites geared towards health consumers (a term that I find somewhat strange coming from the UK - here we don't really consider patients as 'consumers', probably due to the provision of the NHS - health is considered a basic right, not really something that we buy/consume).

So is MedWorm Medicine 2.0 or Health 2.0? Is it for the doctor or the patient? My original intention was that it would be for the doctor (and other health professionals) with articles grouped by medical speciality. But then I realised that a lot of people assumed it was actually for the patient, since it was providing a user friendly way for people to find the latest information about their particular conditions.

I was sent a kind comment by another webmaster who is using a MedWorm feed to help populate his own site with relevant new content for a particular condition:

'Medworm fits in a sweet spot between medical professionals and the lay public.'

It was at this point that I began to clarify my vision for MedWorm. It would provide a forum for understanding and discussion among both medical professionals and consumers. Note that I say discussion 'among', rather than 'between'. A lot of Health 2.0 sites are providing an extension of service between doctors and their patients - patients ask questions, doctors give answers, which is all well and good.

However, as I see it, for Medicine/Health 2.0 to take that real leap forward (to dare I say it, Medicine/Health 3.0?) I don't see an automation of services being the end result as some might (for example, the diagnosis of a patient by computer - input all the information and the computer tells you what the problem is, and the cure/medication). I believe that computers will never replace man's intelligence, rather assist it. The Internet opens up new lines of communication that before were never possible. Like the building of roads, the invention of the automobile, the aeroplane, the telephone - all of these things opened up new ways of communicating and hence working.

In today's society, patients now want to know much more about their conditions (and rightly so!) Many want to know all there is to know, will read all the latest research, and will often know more (about their particular condition) than their physician. Not that I think the physician has any less an important role to play than before - their medical education and experience will always be vital in guiding the patient down the right path of thought, to put their limited understanding into a wider medical context - but this for sure will become increasingly a different role than previously understood, whereby almost everyone followed the doctor's instructions without question.

The Internet provides an amazing opportunity for medical professionals and health consumers to unite in the battle to solve many of life's ills. I'm talking here about truly working 'together', not just side by side. Think about it - patients, and their families, have motivation that a physician never could. Often their lives are at stake. Patients will go to extraordinary lengths to raise money and awareness for their cause. Increasingly, this is becoming the same for research. Look at the advances in Aids/HIV research that were made in the 1980s - wasn't this due largely to the patient led Aids awareness groups that were busy raising the public profile , drilling up funds and even getting personally involved with research into this devastating disease? But without the knowledge and firm grounding in science that a medical professional holds, this enthusiasm can be easily misdirected. I think that patients, physicians and medical researchers working together is vital if real advances are to be made in solving some of life's' biggest problems.

Already we are seeing a move towards this new way of communicating, with patient blogs being increasingly subscribed to by physicians, and vice verse. It is my hope that MedWorm can help facilitate the opening of such lines of communication. First off, by ensuring that the right people get the right information - both patients and physicians want to read consumer style health news and the latest research. Secondly, it now provides a forum for discussion centered around the latest publications - it does not matter whether you are a professional or a consumer - MedWorm is visited equally by both and the ultimate objective between these two groups is the same. For this reason MedWorm does not have any issue with identifying who is a professional and who is not - all are welcome, and since discussions are centred around professional publications and authentic news sources, and are moderated, this helps to keep discussions focused on MedWorm's objective - the advance of medical knowledge. Thirdly - well, watch this space - don't want to give too much away about my plans for the future!

As for an answer to my question, is MedWorm Medicine 2.0 or Health 2.0? It is neither, or maybe it is both. It is Medhealth 2.0.

RSS Reader in my Mobile Phone

I've just bought a new phone. It is a Sony Ericsson K800i
What a pleasant surprise to see it includes a pre-installed RSS reader!
This will surely increase the take-up of RSS, as people scroll through the available functions on their phones they are bound to ask 'what is RSS?' when they see 'RSS Reader' with its little orange icon listed. And what better a way for busy doctors to receive all the latest news updates on their speciality than directly to their mobile phone/Blackberry?