Archive for March, 2009

Healthcare Hacks on Twitter and Friendfeed

I rediscovered this quote a few days ago, and it got me thinking about that piece of software I mentioned in my previous post.

Q. Why is the software so dang simplistic?

A. In the early days of the Joel on Software forum, achieving a critical mass to get the conversation off the ground was important to prevent the empty restaurant phenomenon (nobody goes into an empty restaurant, they’ll always go into the full one next door even if it’s totally rubbish.) Thus a design goal was to eliminate impediments to posting. That’s why there’s no registration and there are literally no features, so there’s nothing to learn.

- Joel Spolksy in Building Communities with Software

I have a few skeleton pieces of that software sitting on my hard drive right now.  While trying to figure out how to make it work like Joel’s message board, I remembered one of the other axioms of software development: The Best Code is No Code.  It doesn’t make sense to write a new piece of software and waste others time learning a new piece of software when there are very good free alternatives already out there.  They don’t even require me to futz around with servers and hosting.  So instead I’m going to put my effort into building connections on Twitter and Friendfeed.

For the time being, anything cool and healthcare related that I find online is going into one of those two places.  If I outgrow it I’ll move on, but I don’t think that’ll be an issue.  Incidentally, I think that choosing to use these services instead of rolling my own is an example of what I’m trying to learn with this blog.

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A Healthcare Hacker News?

I have to admit that I’m a bit of a news junky.  It’s not CNN that interests me though.  Instead, I’ve been obsessed with social news going all the way back to Slashdot.  I’ve been using Reddit since Paul Graham linked to them from his site way back when (2004?).  Now I spend almost all of my online time on Paul’s social news site: Hacker News (incidentally, that kinda where I got the name for this site).

Why bring this up?  Well, in my last post I mentioned the need for zero-friction ways to share information about the healthcare problem and potential solutions.  While I don’t think a social news site is the be-all end-all solution, I think it’s a great first step.  The only problem is that I’m not aware of any such sites. I may just have to buckle down and build one myself.  No promises though… If I do get something together, I’ll post it here first.

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Collaboration Means Sharing Intellectual Property

My Google vs Facebook analogy from yesterday was rhetorically useful, but I think it’s misleading.  There is way to much me-too-ism on the web right now, and I don’t want to suggest that clone of something from the pure-web world will be of any significant benefit to healthcare.  I think what I was getting at though was that the problem solvers in healthcare need their version of the Open Source, collaborative infrastructure that is currently driving the web.

A small, but very interesting, development on the web that I’d like to explore further is GitHub.  GitHub is a very niche operation that is doing something that probably would have been considered impossible a few years back: commercial source code hosting.  For a small fee, the promise to maintain the intellectual property of software shops.  For an established company, this idea is ludicrous.  They are asking their customers to move their most valuable asset outside the walls of their company and put it in the hands of this little startup.

GitHub seems to be making money so it seems that enough organizations are willing to trust their IP to this small software shop.  What really makes GitHub interesting though is how they’ve used Open Source technology to build not just a for-profit company, but a vibrant community around their service.  The GitHub website is actually a social networking site.  Instead of throwing sheep at each other though, they’re trading code.  This is one social networking site that has figured out how to enable valuable intellectual and commercial activity.

So what does this mean for healthcare?  Can their be a healthcare github?  I think sage might be on the right track.  This article from xconomy has some more info on sage.  They’ve already signed up some big names, but they’re also running into some of the same problems that you’d expect when you ask big companies to share IP.  While I hope they’re successful and I think that they’re structured appropriately for what they want to accomplish, the barriers to entry still seem to high.

I still don’t know what the right approach is to deploying mass creativity and the wisdom of the crowds to the healthcare problem.  It will, however, need near zero friction toward sharing ideas and data.

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Great Healthcare Hacks will Empower the Real Problem Solvers

My attention tends to be drawn to Open Data because I want to write code to make sense of it.  I love the thought of building a Googlesque system to crunch terabytes of data and somehow magically defeat the healthcare problem with elegant algorithms and raw computing power.  I’m not the kind of person that can really solve this problem though.

The people that are going to solve the healthcare problem are doctors and policy makers and probably even a few quants (I hear that some of them aren’t too busy right now).  Some of them are very good at what they do, but they don’t necessarily have the means (well, the quants might) to harness Open Data and really deploy the smart, data driven, solutions that I think are necessary.  So where does this leave me?

Both the promise and the problem of an Open Source solution is that it relies wholly on collaboration.  A brilliant spark by itself will flame out almost immediately, but many sparks connected by a combustible fuel can burn hot and bright.  To switch metaphors, open healthcare does not necessarily need a Google, it instead needs its Facebook.

I’m writing this blog because I’m hoping it will help me discover what I can contribute to the solution.  I like to think I can write really cool software, but I’m fully aware that even the greatest software is useless without a market or a community to exploit it.  I’m not one of the primary solution providers I listed above so what I can build won’t solve the problem directly.  My best hope is not to be the spark, but the fuel.  If someone like me wants to hack the healthcare system, I need to do it by building an open network of people that can actually solve the problem.

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