Christian Veillette M.D., M.Sc., FRCSCChristian Veillette M.D., M.Sc., FRCSCAssistant Professor, University of TorontoAssistant Professor, University of Toronto

Shoulder & Elbow Reconstructive SurgeryShoulder & Elbow Reconstructive Surgery

Toronto Western Hospital University Health NetworkToronto Western Hospital University Health Network

Email: orthonet@gmail.comEmail: orthonet@gmail.com

How Web 2.0 is Changing How Web 2.0 is Changing OrthopaedicsOrthopaedics

ObjectivesObjectives

• Understand the difference between Web 1.0, Understand the difference between Web 1.0, 2.0 and 3.02.0 and 3.0

• Understand the factors that Web 2.0 Understand the factors that Web 2.0 technologies enable between patients, technologies enable between patients, professionals and researchersprofessionals and researchers

• Define Health 2.0 Define Health 2.0

• Understand the 4 C’s of knowledge creationUnderstand the 4 C’s of knowledge creation

• Describe the benefits of wiki collaborationDescribe the benefits of wiki collaboration

• Describe the 3 components of the open Describe the 3 components of the open access advantageaccess advantage

Quick PollQuick Poll• BlogBlog

• Tagging/Social Tagging/Social bookmarkingbookmarking

• WikiWiki

• RSSRSS

• PodcastsPodcasts

• Video sharingVideo sharing

• Social networkingSocial networking

Web EvolutionWeb Evolution

Web 1.0 - World Wide WebWeb 1.0 - World Wide Web

• information is communicated from information is communicated from company to individuals (i.e. your company to individuals (i.e. your basic website). The web becomes basic website). The web becomes one big encyclopedia of sorts.one big encyclopedia of sorts.

Hyperlinked information, Static content

Hyperlinked information, Static content

Web 2.0 – Read/Write WebWeb 2.0 – Read/Write Web

• information is communicated information is communicated between company and individuals between company and individuals AND between individuals. This is the AND between individuals. This is the Post a Comment/Start a Post a Comment/Start a Blog/Skype/YouTube web. If web 1.0 Blog/Skype/YouTube web. If web 1.0 is a book, web 2.0 is a live discussionis a book, web 2.0 is a live discussion

Dynamic information,Social content

Dynamic information,Social content

Defining Web 2.0 – Core PrinciplesDefining Web 2.0 – Core Principles

• The Web as PlatformThe Web as Platform

• You control your own dataYou control your own data

• Services, not package softwareServices, not package software

• Architecture of participationArchitecture of participation

• Cost-effective scalabilityCost-effective scalability

• Remixable data source and data Remixable data source and data transformationtransformation

• Software above the level of a single deviceSoftware above the level of a single device

• Harnessing collective intelligenceHarnessing collective intelligence

What is Web 2.0 . http://oreilly.com/web2/archive/what-is-web-20.html

Web 3.0 – Semantic WebWeb 3.0 – Semantic Web

• it's not information anymore, it's it's not information anymore, it's intelligence, artificial intelligence. intelligence, artificial intelligence. You'd interact with it almost like You'd interact with it almost like another person. The web won't just another person. The web won't just blindly do what we tell it to do, it'll blindly do what we tell it to do, it'll think for you.think for you.

Organized information, Content + meaning

Organized information, Content + meaning

Medicine 2.0Medicine 2.0

Eysenbach, http://health20.org/wiki/Health_2.0_Definition

Medicine 2.0 applications, services and tools are Web-based services for health care consumers, caregivers, patients, health professionals, and biomedical researchers, that use Web 2.0 technologies as well as semantic web and virtual reality tools, to enable and facilitate specifically social networking, participation, apomediation, collaboration, and openness within and between these user groups.

Health 2.0Health 2.0

Health 2.0 is participatory healthcare. Enabled by information, software, and community that we collect or create, we the patients can be effective partners in our own healthcare, and we the people can participate in reshaping the health system itself.

Eytan, http://www.tedeytan.com/2008/06/13/1089

So what?So what?

• How does health 2.0 align with the Obama How does health 2.0 align with the Obama administration's larger health reform goals?administration's larger health reform goals?

Health 2.0 is a key pillar of where we believe innovation will take place in the nation's health care system. As we look to shape the market conditions -- the incentives to reward wellness and prevention -- I have great confidence that the health 2.0 community will rise up to the challenge and engineer game-changing ideas to deliver the results our policymakers in Washington are keen to deliver.

Aneesh Chopra, Chief Technology Officer of the United States, @ Health 2.0, October 2009

Embrace health 2.0 technologiesEmbrace health 2.0 technologies• What would you say to health care What would you say to health care

providers who are reluctant to embrace providers who are reluctant to embrace these health 2.0 technologies?these health 2.0 technologies?

I understand and can sympathize with their lot in the current environment that does not reward them for the adoption of these capabilities, but I hope as we proceed with health reform that the stakeholders -- mainly the hospitals and physician groups -- will be very active participants in delivering health 2.0 only because it's in the best interest of the patient.

Aneesh Chopra, Chief Technology Officer of the United States, @ Health 2.0, October 2009

Doctors are social and the practice of Doctors are social and the practice of medicine is inherently socialmedicine is inherently social

• Web 2.0 creates conversationsWeb 2.0 creates conversations• Tools facilitate socialization (Tools facilitate socialization (social-software)social-software)

• BlogsBlogs• RSS feedsRSS feeds• WikisWikis• PodcastsPodcasts• Video sharingVideo sharing• Social networkingSocial networking

• New generation of tools in the medical New generation of tools in the medical knowledge economyknowledge economy

What is a blog?What is a blog?

• Web publishing toolWeb publishing tool

• Typically a single ownerTypically a single owner

• Utilized to convey Utilized to convey information & express information & express opinionsopinions

• Content published in Content published in chronological fashionchronological fashion

• Readers can leave commentsReaders can leave comments

• Content is syndicated via Content is syndicated via RSS feedsRSS feeds

• Blogrolls and trackbacksBlogrolls and trackbacks

Growth of BlogsGrowth of Blogs

Impact of blogsImpact of blogs

http://technorati.com/blogging/article/day-5-twitter-global-impact-and/page-2/#

Academics #9 #6Health #12 #7Academics #9 #6Health #12 #7

Blogs in Healthcare/OrthopaedicsBlogs in Healthcare/Orthopaedics

• Clinical EducationClinical Education

• ResidencyResidency

• HospitalHospital

• Physician ExperiencePhysician Experience

• Patient ExperiencePatient Experience

Clinical BlogClinical Blog

http://orthopaedicsmadeeasy.blogspot.com

Clinical BlogClinical Blog

http://orthopeadicsurgery.blogspot.com

Orthopaedic Residency BlogOrthopaedic Residency Blog

http://Orthopaedic-residency.blogspot.com

Physician BlogsPhysician Blogs

Hospital MicroblogsHospital Microblogs

http://twitter.com/SunnybrookHSC

Patient BlogsPatient Blogs

http://blog.estellahom.com/

RSSRSS

• Really Simple SyndicationReally Simple Syndication

• RSS is a standard for RSS is a standard for publishing regular updates publishing regular updates to web-based contentto web-based content

• RSS Readers allow you to:RSS Readers allow you to:• Stay up to date Stay up to date • Share itemsShare items• Comment on itemsComment on items

RSS Reader – Google ReaderRSS Reader – Google Reader

Google Reader – http://www.google.com/reader

Social NetworkingSocial Networking

• Collection of people Collection of people tied together by tied together by their relationshipstheir relationships

• Ideas, friendships, Ideas, friendships, kinship, authorship, kinship, authorship, mentorship, alumnimentorship, alumni

• Social mapSocial map• visual representation visual representation

of a social network, of a social network, depicting nodes and depicting nodes and tiesties

Social networking for PatientsSocial networking for Patients

Social Networking for PhysiciansSocial Networking for Physicians

Asklepios.caAsklepios.ca

Social Networking in OrthopaedicsSocial Networking in Orthopaedics

Wikis in Medicine/OrthopaedicsWikis in Medicine/Orthopaedics

• Collaborative contributionsCollaborative contributions

• List of Medical WikisList of Medical Wikis• Over 50 catalogedOver 50 cataloged

http://davidrothman.net/list-of-medical-wikis/

Orthopaedic ResourcesOrthopaedic Resources

What are they missing?What are they missing?

• Social TechnologiesSocial Technologies

• Collaboration & CommunityCollaboration & Community• Who are your people?Who are your people?• Who do you want to tell what?Who do you want to tell what?• Who do you want information from?Who do you want information from?

Web 2.0Wikis

Sharing OpennessUser Generated

Content

Social Networks

Personal Knowledge ManagementPersonal Knowledge Management

““Knowledge is created by people”Knowledge is created by people”

… … through …through …

CComparisonsomparisons

CConsequencesonsequences

CConnectionsonnections

CConversationsonversations

Power & Opportunity of Wiki TechnologyPower & Opportunity of Wiki Technology

What is a Wiki?What is a Wiki?

Web site + Word documentWeb site + Word document

Epit

Edit

Edpit

What’s so great about wikis anyway?What’s so great about wikis anyway?

• CollaborationCollaboration• Create, edit, discuss, share in one placeCreate, edit, discuss, share in one place

Before WikiBefore Wiki Using WikiUsing Wiki

What’s so great about wikis anyway?What’s so great about wikis anyway?

• Knowledge ManagementKnowledge Management• Single, searchable, structured repositorySingle, searchable, structured repository

Before WikiBefore Wiki Using WikiUsing Wiki

Power of Wiki CollaborationPower of Wiki Collaboration

http://www.wikipatterns.com/display/wikipatterns/Email+to+Wikihttp://www.wikipatterns.com/display/wikipatterns/Email+to+Wiki

US National Geospatial Intelligence AgencyUS National Geospatial Intelligence Agency

Using Wiki in EducationUsing Wiki in Education

“The one-to-many model of knowledge transfer can be transformed into a collaborative, many-to-many network where every voice contributes to the knowledge of the group; the sum becomes greater than its parts.”

-Mike Cannon-BrookesAtlassian Software Systems

“The one-to-many model of knowledge transfer can be transformed into a collaborative, many-to-many network where every voice contributes to the knowledge of the group; the sum becomes greater than its parts.”

-Mike Cannon-BrookesAtlassian Software Systems

What is Orthopaedia?What is Orthopaedia?

Orthopaedia.comOrthopaedia.com

Power & Opportunity of Open AccessPower & Opportunity of Open Access

What is Open Access?What is Open Access?

"copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship....“

"copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship....“

Bethesda Statement on Open Access Publishing. June 20, 2003. <URL: http://www.earlham.edu/~peters/fos/bethesda.htm>

The Open Access AdvantageThe Open Access Advantage

1.1. Citation Citation countcount

2.2. End user End user uptake uptake

3.3. Cross Cross discipline discipline fertilizationfertilization

Eysenbach G. The Open Access Advantage. J Med Internet Res 2006;8(2):e8 <URL: http://www.jmir.org/2006/2/e8/>

What About Copyright?What About Copyright?

http://creativecommons.orghttp://creativecommons.org

Creative CommonsCreative Commons

Web 2.0 – Hype vs RealityWeb 2.0 – Hype vs Reality

• Overly enthusiastic acceptanceOverly enthusiastic acceptance

• Overpriced purchasesOverpriced purchases• Google purchase of YoutubeGoogle purchase of Youtube

• Quick shifts in popularityQuick shifts in popularity• MySpace MySpace Facebook Facebook Twitter Twitter

• Market not yet consolidatingMarket not yet consolidating

A ‘revolutionary, new’ practiceA ‘revolutionary, new’ practice

Web 2.0 as a disruptive technologyWeb 2.0 as a disruptive technology

Health Care Values Web 2.0 Values

Risk adverse Risk taking

Information comes from authoritative sources

Information judged based on social networking/community acceptance

Privacy and security are regulated Anyone can create an account

Long lead times for deployment Quick deployment (Beta release)

Controlling data Information contributed by and distributed to all

Intellectual property closely guarded Follow existing standards, use licenses with as few restrictions as possible

Thank YouThank You