Instant Is Not Real-time

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Should Enterprise software be like Facebook? That’s a question Salesforce CEO Mark Benioff recently raised. While reading Dennis Howlett’s analysis, Dennis makes a very simple but easy-to-overlook point about the difference between instant media and real-time media. It’s an important point, one I believe gets lost in the noise and hype about social media.

INSTANT CONFUSION

One of my main focuses is health care adoption and employment of software for improving collaboration and communication among patients and doctors and nurses. It’s important, therefore, to understand the property differences between media and the different contexts, conditions and processes needed for successful deployment. What works for consumers (Facebook) doesn’t necessarily work for business.

One of the properties of media like Twitter and Facebook has to do with time. Twitter and Facebook statuses are instant (at least when there are not server errors). Instant is exactly that: immediate, without regard to relevance. Real-time, however, has to do with relevance. In an enterprise, what matters are information flows – and without context and relevance, information is just data.

Real-time is more than just anytime (which is what instant is) – I need the right information delivered at the right time within the right context throughout the right process.

This distinction between instant and real-time is critical because any software developed must take into account the purposes and needs and contexts in order to ensure proper user experience and appropriate results.

So no: I don’t believe Enterprise software should be designed like Facebook. It follows then, that any software designed for patients and hospitals and doctors and nurses must not confuse themselves with consumer applications.

BUILD IT RIGHT AND SPEAK CLEARLY

Therefore, any healthcare enterprise analogues of media like Twitter, must take into account the difference between instant and real-time. The applications must take into account the sociological and informational needs of clinical processes. Otherwise, disaster is certainly built-in.

Software lock-in is a huge problem in technology. I fear that philosophical lock-in of social media philosophy may be one our time’s greatest threats. (As an illustration of what I mean, the Privacy Is Dead mantra is, I fear, just one self-fulfilling instance of social media fallacy – it’s one of the most dangerous myths propounded and accepted by superficial thinking these days – it’s a dangerous mind-virus.)

We need a clear language when discussing technology – especially media technologies. Confusing instant with real-time is sloppy thinking. In a health care context, it’s downright dangerous.

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Healthcare’s Google-Facebook-Twitter Platform

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Can’t we just have one place on the web where all of us around the world can congregate to acquire reliable health care content, connect patients with each other, have conversations, trade experiences and otherwise partake in the vastness of health care?

That certainly is a dream – an idea which many patients and families and professionals ponder. After all, Google, Facebook and Twitter respectively demonstrate the power of Search, Social Media and Real-time Connection to accomplish a whole host of objectives. What if we had a health care version of such a triad, unified into one platform? Is it do-able? Or, perhaps more importantly, is it necessary?

A GINORMOUS WEB WITH NO CENTER

As tempting as it may be to have a mega health care social platform, I think such a hope is wrecked by the reality of the Web. The Web is an ever-expanding confluence of machines and people and protocols and media. Like a consciousness, it has no Center, no single brain cell that we can point to and say Here it is, the center of our mind! And yet, like a consciousness, it produces the seamless experiences of awareness and connection and action which we view through our browsers and mobile devices and wherever else the Web infiltrates.

Perhaps the very model for any Web platform for health care communities of content and people lies right in the artful sciences beneath health care itself: the evolutionary underpinnings of networks of the tiny cellular gadgets that supply our lives. Yes, our bodies do have central nervous systems, but life owes itself to the vastly distributed cascading of events which aren’t necessarily centrally-controlled. That is, after all, the wonder and power of our universe’s serendipity. The web of life may be metaphor for the web we started spinning years ago.

So I wonder if our primary challenge in weaving a Health Care Web is understanding the nature of evolutionary systems. That perhaps we need to overcome our linear and strict architectural ways of thinking and building, and seek organic views of the Web.

Historically, in our efforts to wage war against dangerous bacteria and viruses, we have taken a decidedly mechanical approach: discover a vulnerability and attack it. It works, for a time. But then subtle mutations succeed and replicate and the vulnerabilities of our tiny enemies become strengths and we start to lose the war again.

So just as we may need radically different approaches to infectious diseases – approaches which advance natural processes versus stemming them – so too may we need a radical re-think in how we work with the Web. Rather than hoping to overlay a single giant complex that dominates the landscape like a Big Mother, we aught to consider the power of local networks and communities, learn to harness de-centralization and discover how to cull order out of chaos.

In many regards, we already are doing these things. Those of us who use media like Twitter have learned to appreciate the value of curation and we’re always seeking out and playing with toys which help us streamline and enhance our consumption and production of information. Patients seeking health-related content or community similarly need ways of finding the right channels.

Perhaps, then, a key feature of health care online is providing media which improve the skills of patients in how to best derive order of out of chaos and separate verifiable fact from dangerous idiocy. How to accomplish such feats? One way is through individual, localized efforts on the part of patients, providers, technologists, librarians, entrepreneurs – charged with large boluses of initiative and courage.

ALL HEALTH CARE IS LOCAL

What we may need at the large scale isn’t a giant Google-Facebook-Twitter mashup for healthcare. Maybe what we need are media and tools which connect social graphs of people and databases and communities; which enable face-to-face communities which can be weaved back into the Web; which give permissions to patients and family members to port their data however they see fit; which enable providers to be bright facets at the critical nodes of key connections; which integrate emerging technologies and re-mash them into usable interfaces for expedient and curated information.

The fact about online health care communities is that they are, well, communities. Which is to say that their success depends on the particular dynamics and values of the communities. A service which offers forums for different health-related topics may house an amazing Diabetes group but fall short on Schizophrenia. Furthermore, patients and family members experience illnesses in their own unique ways: what may be a great community for someone with breast cancer may be ineffective (or even dangerous) for another.

We have many ways to go with the Health Care Web. We can’t necessarily busy ourselves with one silver bullet. So I offer one tip to the general public: advocate for change at the local level, using public social media to inspire passionate tribes of talented change agents. We can do that much now, without having to wait for the FDA or some other governmental agency to figure out how to hit the update button on Twitter, let alone how to piece together a Health Care Web.

If we can’t get our own family physician to connect with us on just one social medium, how can we connect the multitude of patients and providers globally?

What do you think? Is a Google-Facebook-Twitter Platform of Health Care achievable? Is it even necessary? Perhaps most importantly: is it something we should even desire, or fear?

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Google Reader Gets More Social: Here’s Who to Follow

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Just days before Facebook acquired FriendFeed, I talked about why FriendFeed is (was) an important tool. Either I was completely wrong or prescient – you decide. FriendFeed.com’s future may be in question – but the social mode it brought onto the web will likely become more ubiquitous as the social web continues to evolve. Which is why I still believe it’s an important tool.

Enter Google Reader (GR). I’ve always thought that RSS could become a powerful social tool if the right features were added. It seems that the Google Reader team is doing just that. Perhaps we’ll see a more FriendFeed-like Google Reader evolving. We will just have to see. The Google Reader team ( @GoogleReader) has its work cut out, but I suspect they’re working towards turning Reader into a powerful social informational tool.

For now, if you’re interested in “following” some smart people in your Google Reader, here is a real-time list of Google Readers from FriendFeed:

Oh, and you’re certainly welcome to follow me on Google Reader :)

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