Thursday, January 17, 2008

Web 2.0 for the CIO

You may have heard the term Web 2.0 and been unclear what it means. Then again, you're reading this blog, so chances are you're part of the enlightened who have already embraced blogs, which are part of Web 2.0.

Web 1.0 was all about web pages maintained centrally. Content was published by corporate communications/public affairs.

Web 2.0 is all about collaboration, everyone as publisher and complete interactivity with networks of associates. Here's a brief primer on Web 2.0

A blog is a specialized form of web-based content management specifically designed for creating and maintaining short articles published by anyone who wants to be an author. Although blogging is not a real time collaboration tool, it is a remarkable way to spread information. For example, my blog had 7,429 views by 4,611 visitors over the past week. As an external relations tool for communicating information, proposing an idea, or marketing a concept, blogs work extremely well. Blogger, WordPress and TypePad are leading blogging sites.

A wiki is software that enables users to create, edit, and link web pages easily. Wikis are often used to create collaborative websites and to power community websites. They are being installed by businesses to provide knowledge management and are extremely useful for a community of authors to create shared documentation. At Harvard Medical School, we use open source wiki software called Twiki as an enterprise application.

A forum is a threaded discussion with multiple participants that is not real time. Entries can be read and responded to at any time. At Harvard, we created our own threaded discussion forums and these are used for strategic planning activities by a diverse group of geographically dispersed participants. There are variations on forums such as Dell's IdeaStorm (a Software as a Service application hosted by, which Dell implemented to get input from customers and employees about new strategic priorities. Users post ideas and anyone can vote to support the idea, raising its score/relevance in the forum.

Chat is a real time, synchronous discussion group with many participants. Old fashioned Internet Relay Chat has been largely replaced by group Instant Messaging chat. Although Instant Messaging is often a 1 on 1 conversation, most IM clients support inviting multiple participants to message as a group. For example, Google's Gmail includes Instant Messaging chat and Apple's iChat works well with AOL Instant Messanging to support group Instant Messaging. Chat requires that all participants must be online together. Forums, as described above, can be more convenient because not all parties involved in the discussion have to be online at the same time.

A unique collaboration tool called Gobby, enables multiple authors to edit text together in realtime. Document respositories such as Microsoft Sharepoint, Documentum and many content management systems (CMS) support sharing of documents. I've used Sharepoint as a document repository to coordinate the nation's healthcare data standardization process at HITSP.

Social Networking tools include sites such as Facebook, LinkedIn, and MySpace . Most social networking services provide a collection of various ways for users to interact, such as chat, messaging, email, video, voice chat, file sharing, blogging, and discussion groups.. To test the value of these services for collaboration, I established a Facebook, LinkedIn, and Second Life account. I currently have 30 friends on Facebook, 78 Contacts on LinkedIn and a Second Life Avatar named Geek Destiny.

Facebook is great for building collaborative groups. LinkedIn is great if you're looking for a job. Second Life is a fine virtual reality environment , although its business applications are limited . Here's a great article from the UK Guardian about Social Networking tools.

Everyone who knows me understands that I'm very transparent about my successes and failures. I want to admit publicly that I did not embrace Web 2.0 fast enough. At Harvard, we do provide easy to use content management for departmental websites (not individuals), online document sharing, calendars, news and forums. We also host dozens of Wiki sites. However, we do not provide web-based IM and we're just starting to deploy social networking. As part of the new Dean's strategic planning process, I have recommended an immediate, wholesale adoption of Web 2.0 throughout Harvard Medical School. My report to the Dean notes:

"Immediately expand our enteprise intranet sites ( and to include collaboration services, instant messaging, Webex meetings, CONNECTS (a match making service for equipment, techniques, and scientists), SHRINE (a means of data mining across all Harvard affiliates), and web content management that enables anyone in the Harvard community to be a publisher."

At BIDMC, I'm relaunching our intranet using a commercial Content Management System called SiteCore which includes numerous Web 2.0 collaboration features such as Wikis, Blogs, Forums, Project Rooms, Collaborative Project Management, Quick Polls, and Project Rooms with Whiteboards.

I spent the last year focusing on integrating our web-based applications and achieved a number of important benefits, including single sign on for all clinical applications. My mistake was in not also focusing on the individual as content publisher. 2008 will include a major push to catch up and broadly deploy Web 2.0 collaboration and publishing tools throughout all my organizations.


Kevin said...

Have you had any success or experiences using a WIKI within your IT organization(s)? -Kevin

Mark Pollard said...

Rather than using the existing social networks (Facebook et al.), have you considered building out your own social network that is healthcare / Harvard / IT specific using a build-your-own tool like Ning?

Mark Pollard @ PanGo

John Halamka said...

At Harvard, we host numerous wikis for departmental and enterprise knowledgebases. They've worked extremely well

We are examining the possibilities of using toolkits to implement internal social network applications so that we support single signon as well keep our intellectual property within our firewall.

Gunther Eysenbach MD MPH said...

Medicine 2.0 call for papers:

Adrian Gropper said...

What about the patients? Check out this post about a new study of consumer use of social media. She comments: "What we're seeing in the pioneering excellent examples of
chronic condition sites such as DiabetesMine and PatientsLikeMe is the
duality of info AND support. In the case of info for PatientsLikeMe,
the database on drug dosing, quality of life and outcomes throughout
the MS cycle is probably richer than any other single source on the

John Halamka said...

I completely agree that social networks for patients are very important and we've included these in our new Patiensite design specification.

Unknown said...

Good doctor, I am just in time to save you from being late again :D

here you go..,1759,2102852,00.asp

Web 3.0 Can you believe it. And this no doubt, if it takes off , will impact a care setting in a big way.

John Halamka said...

The good news is that we're already far along the Semantic Web journey since most applications at CareGroup and Harvard Medical School use a service oriented architecture. I'll be ready for 3.0

Bernard said...


I've been in the center of several wiki deployments within organizations. These are generally well accepted and widely used.

They suffer from two problems typically. First, the search facilities can be limited. "I know the thing I want is in here...somewhere."

And secondly they can degenerate into a mess of outdated pages. My advice is to consider having a part-time information architect on board to help design the information architecture. At the very least, consider a good librarian with a digital background. I believe constant tuning and pruning is a necessary part of wiki success.

Regarding blogs: would these be for internal consumption only? We've had limited success with these. Because of our distributed offices worldwide, it's hard to let other offices into the network to get to the blogs. And some folks still don't understand the value of them.

Best of luck. If you succeed I'm sure it will make HMS a better organization and a more interesting place to work and study.

Unknown said...

SOA in healthcare..
The amount and size of data for each transaction in healthcare is quite large. To move such huge masses of data through SOA enveloped in bulky xml markups at times does not seem like the brightest idea around to me.

NO doubt SOA is a better way to share data than overnight synching of databases..but it does come with its own share of pains esp in provider apps.

Anonymous said...