The Democratization of Health Knowledge by Steve Denning, Guest Contributor

April 21, 2008 at 9:13 pm 2 comments

Steve DenningSteve Denning wrote previously about The democratization of knowledge: anyone can know anything:

“This phenomenon is particularly notable in the spontaneous formation of global communities of interest in the field of medical problems. Patients who were once at the mercy of doctors who had unique access to esoteric medical knowledge now find themselves able to contact other doctors and patients and explore their particular subject, gather new data, discover new leads for treatment, and learn how to cope with side effects. The emerging communities are global in nature. A patient in the US may be able to learn from a doctor in China or a suffering patient in Argentina and vice versa. The sufferers of rare diseases, where perhaps only a few victims exist around the world, can now make contact with each other and share experiences…”

I had an email discussion with Steve yesterday, in which he provided the following update on the Democratization of Health Knowledge:

Some more recent themes would be:
  • the rising resentment of some “experts” to the re-emergence of amateur knowledge, and a certain degree of unwarranted elitism involved in such “expert” attitudes. This resentment seems most marked in fields where the expert’s claim to superior expertise is most shaky e.g. political journalists.
  • the reluctance of some “experts” to share if they feel that the knowledge risks being misused or abused.
  • the gratitude of other “experts” who often see the amateurs as helpful partners.
  • the risk that a little knowledge is a dangerous thing. Alexander Pope: “Drink deep or taste not at all from the Pierian spring.” (That risk is however not limited to amateurs. The radical specialization of medicine means that someone can be an expert in a tiny field, but a real ignoramus in areas of their expertise and make egregious blunders.)
  • the reduction of such risk in cases where people have taken on the task of lifelong learning. They become adept at getting up to speed in a completely new field and remain curious, open-minded, imaginative, and rigorous in their exploration of a new field of knowledge. This is important both for amateurs and experts. Atul Gawande’s books document some of these issues in the medical field.

My more recent work has tended to move towards the area of things that are already very well known but are not acted on: what can be done about this?

The irony is that the larger knowledge problem since time immemorial has always been one of demand for knowledge, rather than one of supply of knowledge. Unless this is addressed, increased supply of knowledge doesn’t change things all that much. We don’t need a lot of esoteric web research to know that diet, exercise, smoking, or substance abuse are critical determinants of health and well-being. Yet how many people fail to act on this knowledge?

In organizations, people often know all too well what needs to be done, but often they can’t get others to listen and act. (In the medical field, you don’t need to be a genius to see that the overall cost-effectiveness of the US health system is far from optimal. So why hasn’t change happened?) My work is now aimed mainly at helping people overcome resistance to obviously needed change. I’ve spoken on occasion at medical conferences and discussed the issue with dentists.

I’m also working now on what’s involved in getting people working together at high levels of effectiveness, in high performance teams, networks, communities, and even political movements on a large scale or families and marriages at the opposite end of the spectrum. Within these “hot spots” of collaboration, knowledge transfer happens a lot more rapidly. I’m working on what’s involved in establishing and sustaining those environments.
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2 Comments Add your own

  • 1. Bernard Farrell  |  June 23, 2008 at 8:28 pm

    There are definitely cases where the quality of online information is suspect or of questionable use. That’s probably the biggest challenge. When I read online information or advice, how trustworthy is it? Newly developing standards like the Healthcare Blogger Code of Ethics can help here. I expect these 3rd party evaluations to increase in the coming years.

    In my opinion an obvious place where online community is of most use is in improving the quality of life when dealing with chronic diseases (pick your favorite one).

    In those cases healthcare providers can really only act in a consultative way – though some like to be more dictatorial. They’re not living with the illness 24 hours a day. Online communities (for example, TuDiabetes) can provide useful ways for dealing with challenging situations. I’ve also found that the best news about interesting developments almost always comes from an online source. Doctors are often too busy working with their patients to take time to learn about all the new stuff.

    A friend pointed me to your blog, I look forward to reading more about this important field of online health communities and information sharing.

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Lisa Gualtieri, PhD, ScM

Lisa GualtieriLisa Gualtieri is Assistant Professor at Tufts University School of Medicine in the Department of Public Health and Community Medicine. She teaches Online Consumer Health, Social Media and Health, Mobile Health Design (online), and Digital Strategies for Health Communication (1 week summer institute). Contact Lisa: lisa.gualtieri@tufts.edu

@lisagualtieri


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