good bye old economy, welcome economy created by people participating in flows of information!


Today, I would like to write about the unconventional paths that the internet  takes to get the information we need on our screens and the unexpected ways it takes to reach us, when we need it, even if we had not ask for it.

Last Monday night, I was in Brussels to present at a meeting, and late at night, while checking my mail and social media accounts, I found this post on Facebook from @epatientDave:

New post, tying together a BUNCH of thoughts: http://epatientdave.com/2012/11/12/knowledge-is-leaky-now/

Knowledge is leaky now. Farewell to centralized control; hello to rapid spread and discovery. « e-Patientdave.com
Yesterday I postedabout discovering a really good year-old video about something I’ve often blogged: the importance of letting people see the prices of what they….
As the title of the post sounded promising, I clicked on the link. I found another fine post of @epatientDave, that I quote below because it gives a new perspective on how knowledge and information may be obtained today. It tells the story about Dave, in the US and me, in Greece tweeting about a seminar on  #right2health at the  Salzburg Global Seminar , in Austria, that took place from Friday, Nov. 9 to 13. I brought it to his attention as it covered some common interest areas, we commented on it,  linked it with our participation in a previous session, two years ago, on Shared Decision Making in Health Care,  and offered some outsider thoughts to the online conversation. During our conversation Dave had some thoughts about complementing the online convo in Austria, but he did not have a clear idea of them. Now, see what happened:
Yesterday I posted about discovering a really good year-old video about something I’ve often blogged: the importance of letting people see the prices of what they buy, in healthcare.

The process by which I found it is a crystal clear illustration of a profound change in how information moves around today. It’s totally different from before the web, and anyone who wants to understand the present and the future needs to understand how it works now. Because as hard as it may seem – especially to a trained scientist – the path to finding the best information is no longer through a methodical, linear, step by step process.

This drives some people insane, but it’s true. In the past year I’ve found four major publications about this from three unrelated sources, and I’m convinced.

First, the story; then about the books. (If you don’t know how Twitter works, ignore the jargon; it’s just a way of messaging, and this story isn’t about Twitter itself.)

How I ran across the video illustrates how the network of social media works, and how centralized control is becoming impotent:

  • Sunday morning I was up early – 4:30 a.m. – because I’m still adjusting to time zones after 2 weeks of travel.
  • Twitter buddy @kgapo, in Greece, has been monitoring the #right2health tweets coming out of a conference in Salzburg, Austria, Realizing the Right to Health. (She and I met there two years ago at another event.)
  • To address an issue we thought the conference might be missing, I wanted to find a quick summary of an important principle, “the social determinants of health.” I tweeted a request, expecting an answer in the next day or two.
  • Instead, 18 minutes later a guy from Illinois, Ross Silverman (@phlu), tweeted a link to a great 2-page piece!  By this time it was about 5 a.m. for me, 11 a.m. for Kathi (and Austria), and 4 a.m. for Ross.
  • I tweeted it to the conference, and within minutes the organizer had retweeted it so anyone following him would see it.
  • Then, idly exploring Ross’s Twitter feed, I found that he’d recently tweeted that video.

Look what happened: I went looking for something, wasn’t sure exactly what it was or who would know, and found it.

Book 1: That’s part of what’s described in The Power of Pull, written by three guys at Deloitte, the big consulting firm. In short, the forces that used to bind valuable knowledge within institutions have come apart at the seams: hyperlinks and social links enable all kinds of connections, and things like this can happen.

Book 2: The “coming apart at the seams” aspect is the core of Eric Topol’s phenomenal book last year, Creative Destruction of Medicine. I don’t like the “destruction” term because I don’t think it’s about destroying hospitals, but the term comes from the 1940s and describes the same effect: as knowledge is no longer bound in the institution, its particles can leak out and get recombined in many new ways. This enables innovation in ways nobody could have imagined.

(It closely parallels part of Clayton Christensen’s “disruptive innovation” idea, which among other things involves recombining parts of an old value system, in ways that don’t hew to the old system itself. My favorite example is that thirty years ago fonts existed only in typesetting systems, and now they’re on your computer and sometimes even your phone. That’s creative destruction.)

Book 3: Shift Index. Strictly speaking this isn’t a for-sale Amazon book, it’s an annual report (again from Deloitte), tracking how major shifts in our infrastructure are changing how value arises and moves around: we’re switching from a economy (in all senses) where people hoard info and extract value by selling it, to one where people create value by participating in flows of information. Can you see that – the flow of information – in the story above?

Book 4: Too Big to Know lays out how it’s no longer possible to get on top  of everything. And even if you could, it says, the facts themselves are no longer where the real value is – the greatest value is in their connection to each other through links and social connections, and to other people’s comments and related links. More on this book below.

The full title is Too Big to Know: Rethinking Knowledge Now That the Facts Aren’t the Facts, Experts are Everywhere, and the Smartest Person in the Room is the Room. That sounds stupid but believe me, if you want to understand how to get information to where it needs to be, you need to understand this book.

Get a Clue(train): If you find this hard to imagine, consider that Too Big is by David Weinberger, one of the authors of the landmark 1999 book The Cluetrain Manifesto, which I often mention in speeches. Written by four gurus of marketing, just five years after the Web came alive, it correctly foresaw that marketing had already been forever changed: “Markets are conversations,” it said – marketers no longer had control of what customers could hear – or think, or say – about their products.

It was modeled after Martin Luther’s 95 theses, which he nailed to the cathedral door, starting the Reformation; and Cluetrain was just as revolutionary: both said “We can read it ourselves, now – we don’t need you to control us anymore.”

Cluetrain was visionary and hard to imagine. Can you remember how long it took some companies to adjust and get online?  Even today some don’t participate in social media, user ratings, blogs, etc. And now, Weinberger, who foresaw that world (about connections), writes this, about knowledge itself. And I’m listening.

From all the conferences I’ve been attending I can see the parallels to medicine. I expect this industry will be slow to change – but, tellingly, patients aren’t waiting. As internet guru Clay Shirky said at Connected Health in 2008, “The patients on ACOR don’t need our permission and they don’t need our help.”
_________

Look what happened in my Sunday Twitter anecdote: with no centralized control, someone in Greece connected with people in New Hampshire and Illinois, and got a paper written in New Jersey sent to a conference in Austria. All within 30 minutes, and without knowing who had the paper or even knowing that it existed. (Power of Pull talks about being able to go looking for something without knowing what it is – and find it.)

For a final bit of frosting on the cake, Kathi says she’ll use that two-pager in a presentation she’s doing at the European Union this week.  A totally unexpected, unplanned discovery of value, ultimately connecting people, needs, and events in very different places.

Knowledge is leaky now. It doesn’t stay in boxes. Build your network, and listen to others’ networks!

Now, listen to what followed: not only Dave offered new content to the #right2health online tweet stream but the link to The Social Determinants of Health  from Ross Silverman (@phlu) in Illinois, a person totally uknown to me till then, was exactly what I needed at that particular time, on Sunday, Nov. 10, approx. 11 a.m. in Athens, Greece, 5a.m. in US for Dave and  4 a.m. for Ross!

Why? I was working on my presentation on The impact of Austerity Measures on Disability Benefits in Greece  and I wanted to show how the health care status of a country is influenced by the way people live and by the income they earn. In other words, The Social Determinants of Health was the missing piece of my presentation. Indeed it refers to USA but the important thing is not the numbers in it but the concept of social determinants, that I was able to adapt for our situation in Europe.

This is the tweet  exchange with @epatientDave:

Dave deBronkart @ePatientDave

@jrlumpkin @Risalavizzo For a conf going on now (I’m not there) I need clear 1-pager on Social Determinants of Health. Got one? cc @kgapo

This post remained unfinished, last week as I thought about closing it with some other examples of how knowledge is available on the internet, when on Sunday, Nov 18, going through a paper.li (mine, somebody else’s, I cannot trace it now) I found an interesting tweet on Twitteracy: Twitting as a New Literacy Practice.The tweet was about a paper of @chrisgreenhow, Dr. Christine Greenhow, Assistant Professor at the University of Michigan and Benjamin Gleason. This is my 5th addition to the resources suggested by @epatientDave.
I went through @chrisgreenhow twitter timeline and I found the following tweet which I re-tweeted:

Kathi Apostolidis ‏@kgapo

@chrisgreenhow Christine Greenhow: Help from Friends: Social Network Sites & the Future http://youtu.be/zk9GA1KErc4  cc @epatientDave #twitteracy

Illustration Banner.jpgIt’s a tweet about the (youTube video) presentation that Dr. Greenhow made at the Cyberlearning Research Summit in January* this year! and yes, social network sites do play a role in learning! So, closing this post I would say that with help from friends and same minded people out there, social media are a great learning tool with knowledge coming from very unexpected paths and that as tools the results you get depend on the use you make of them.
*the other cyberlearning videos are available online
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