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Archive for Social Objects

Healthcare – the new frontier for Social Media

by Rob Paterson

Macys
Once upon a time there were department stores that sold everything. They hardly exist anymore. Why? because we get a better deal from specialty stores. Once upon a time there were record albums where many songs were in one package. We don’t buy albums anymore. If we buy any music we buy songs.

We used to rely on advertising. Increasingly we use our trusted personal networks to help us navigate the market.

It used to take millions to make complex things but more and more we are seeing new tools that can do big things for very little cost.

3dprint

The world of Macy’s and Mad Men is over. But not in health care

Dallas-va-hospital

Today we have a department store model for healthcare. Today we use all the old models of business in healthcare.

So what might a truly modern view of health care look like?

This is where Clayton Christensen’s new vision for Healthcare makes so much sense to me.

Clay c's business models for medicine

Here in one page is the guts of CC’s case. All of these models are combined today in the healthcare model and are rooted in the most expensive part of the system – the doctor’s office and the hospital. It’s all Macy’s in the 1950’s. It’s big and aggregated into one high overhead system that has massive organizational friction and so low quality.

Clayton Christensen is advocating that we break this up as happened to the department stores. Then each part of the mix woudl get the best deal!

Imagine each part of this mix being pulled out as CC suggests:

  1. Fee for Service – Here you pay a lot to get the best shot at finding out what the problem is when what is wrong is not clear. ”House” on steroids. The McKinsey model.
  2. Fee for Outcome - Specialized units that focus on doing one proceedure well – we see this already with hernia operations – you are much better going to a specialist clinic – lower overhead – better operational process – better outcomes.
  3. Membership as the Model – A social network aggregated around similar issues. Such as Type 2 Diabetes etc. Here prevention and living with a diease or the life changes needed to cure us will take place. None of these tasks can be done by a doctor as we currently organize health. Nor should they. They can best be done by us the pubic. For here the issue is how we live and of course getting off our addictions.

How to do this?

CC offers the playbook here too. It is very unlikley that the system will reform itself to do this. Systems don’t do that. The system will have to be disrupted from below.

Diagnosis – Most GP’s refer complex cases of all kinds up the line as it is. They are in reality traffic directors. They can treat only very minor problems. Most of the time they simply write a prescription. They are so time pressed that they cannot help with prevention. They are not paid for that anyway. The real issue for most of their patients is that they have a chronic disease such as heart disease or type 2 diabetes. All of these diseases are based on lifestyle. Not the Dr’s forte. Drugs are the proxy for health.

CC is suggesting that we see high end diagnosis as a field in itself. This does not have to be based in one hospital.

Just as a hospital or a Dr’s office has low skills and high overheads – Specialty Clinics have high skills and low overheads.

In Canada we have a start here in specialty clinics such as the Shouldice Clinic – If you have a hernia you would be silly to go anywhere else. This is what CC means as fee for outcome and this type of clinic can generate such process expertise as to all but guarantee a good result. The Shouldice is the specialty retailer that replaced the department store.

Changing all this above is hard work as it involves changes to the system as it is.

What interests me the most is the largest group at the bottom where groups of people with say Type 2 Diabetes can get together an help each other.

The new frontier for health that can grow up in spite of the system is “Community Health”. Where you and I take charge of our health and use simple and powerful tools and each other to stay healthy, get healthy and help each other at rock bottoms costs.

  • In using diagnostic and measurement tools – as with all other tools more and more diagnotic tools that used to ve expensive and hard to use are available at prices and levels of complexity that you and I can use.
  • In learning more about their condition – as with the publication of the bible in the 16th century, information that was restrricted ony to Dr’s is widely available to all of us now. Many know more about their condition that theur GP who has to be so broad.
  • In learning about diet – we are learning that diet is at the heart of most of the diseases of medern life. Dr’s know nothing abut this. Changing our diet is often beyond our power alone.  We need the help of our peers.
  • In helping each other makes the hard lifestyle changes they need to take back control. No expert can help here – only peers.

Here the skilled part is in Facilitation. This is where 85% of the system will reside.

Here is I think where the power of social media combined with what we are learning about the true causes of most modern disease offers us so much.

We could all get more healthy at a fraction of the cost of the current system – cost to us as individuals and as societies.

This is the revolution that is ahead.

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Measuring Influence and so Attention – New York Times

by Rob Paterson
description

Cascade allows for precise analysis of the structures which underly sharing activity on the web.

This first-of-its-kind tool links browsing behavior on a site to sharing activity to construct a detailed picture of how information propagates through the social media space. While initially applied to New York Times stories and information, the tool and its underlying logic may be applied to any publisher or brand interested in understanding how its messages are shared.

Cascade was developed by R&D using open source tools including Processing and MongoDB.

videos

Better measurement is coming – I really liked this video that shows how the NYT is looking at how their content is shared.

It offers of course an “organic” perspective – reinforcing for me that new reality that is based on the model of nature rather than on the mechanics of a machine.

Already it is showing the importance of influence nodes – we see this is the spread of disease as well – the Typhoid Mary issue. Understanding this then enables us to understand where the systemic leverage comes from.

This I think takes us back to the math of Magic Numbers – a very few people count a lot. Their influence and how they get this is then central – that brings us back to the work of Klout.

We are getting there.

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Boingo Part 2 – Using the power of the network effect – Superfans

by Rob Paterson

What would it be like if your business had a sales, marketing and support force that was 1.3 million strong that you did not have to pay for? What if you could source this leverage with a tiny central force? Sounds impossible? Do you have any idea of how this could work?

Now that everyone is using Social Media – what I am seeing mainly are people who using the new tool in the old way – trying to shout above the noise – “Look at ME!” “Aren’t I cool!” “Aren’t we good!”. I am seeing a Dilbert approach – “Let’s have a Facebook site” “Let’s get on Twitter”.

Most do what most do when a new technology arrives – they apply it in the old way and so get nothing in response.

So what then is the power and leverage that you can harness by using social media well?

Boingo are on their way to finding out how to do this. Oh yes and I am one of the people that are part of this and oh yes I am not being paid and nor do I in any way work for them. I am living the theory.

So how might this work and so how might you do this too?

Boingo have a class of people that are deeply committed to the enterprise that Baochi calls her “Super fans”. They and why they are connected to Boingo and each other is the core of the leverage potential. We will meet 4 of them in this post who agreed enthusiastically to be interviewed by me. As you will see, these Super Fans are attracted first of all to Boingo by the obvious:

  • The service – easy one stop access to Wifi in Airports and Hotels – is now no longer a nice to have for travellers but an essential
  • The support for the service is outstanding – got a problem – you get instant personal help

But a great product is not enough. Nor is good service. What is the differentiator for Boingo is the human nature of the relationship that Boingo has with its customers. Most organizations do not allow their people to be human. Service people are often ciphers working from a script. Boingo have set up an environment where their key point of contact is a real person who is allowed to be herself.

She has a name and a face and we are all in awe and a bit in love with her. We all feel her presence watching over us. It is way more than getting her help when we can’t sign on. She watches out for us. Have a problem – A quick tweet. In minutes she is there. She is like the guy who runs the old corner store who holds your keys when you go away, keeps an eye on your kids in the street, helps you find a new roommate.

As Nuno Montegro, a customer in Portugal says – It is not what she says but how she says things that is the difference.

Nuno is like me, a customer who actively refers others to the service.

Most of Social media is all about Weak Ties – They are very useful but Weak Ties don’t get people to do much – or risk much – or commit much – that is why they are Weak – they are easy.

If you want to do something – Civil Rights in the US – you need Strong Ties. (Nice new piece by Malcolm Gladwell that explores Weak and Strong Ties in depth)

The key to attracting Strong Ties is being human. It is NOT PIMPING your product. It is instead to show that you really do care about ME. It is instead to show that you can indeed be trusted.

How do you show this? Nuno makes the point that every service and product fails at times. The key is to offer the best possible response to the inevitability of a problem. The best possible response is to know from experience that if there is a problem, you can reach a real person quickly and that they will go the distance to help you get it fixed. “I felt as if I was the only customer in the entire world when she was helping me” Nuno told me. I had the same experience.

Attracting Strong Ties is all about “Giving”.

Aaron Strout is the CMO at social media agency, Powered Inc. and is also Super Fan. “Boingo is proactive and they don’t expect a direct return – they are not selling all day – so if they want an inch, I go the mile back. It’s Karmic! I know if I have a problem that they will look after me. If people are good and do good, then good comes back. Not necessarily directly but good gets attracted back. We talk about a wide range of things that affect me not just the product – which is great too – have to have that – they listen.”

What Aaron is talking about here is a very old model for an economy that was the centre of all tribal economies – the Gift Economy. In the Gift Economy, the Big Guy is not the man who has the most stuff but the person who gives the most.

This is the power in networks – this is how Open Source Works too.

Cliff Bremmer is a programmer who works for a company called Carley Corporation that bids on government contracts to develop instructional CD base/computer based training for the US military.  ”In my spare time I help companies understand and navigate the social media spectrum in a professional yet interactive way.  The company I’m currently helping is the one my father works for called the Jamaica Pegasus Hotel“.

The Gift?

Not only is he a fan but in interacting with Boingo he has learned a lot about how to use SM media well. “If there is anything I’m proud of lately it’s that I helped the Pegasus Hotel promote their brand with the help and support of @Boingo and other companies to become one of the most popular brands in Jamaica.” Boingo is  not only helping him with his travel and Wifi but is talking with him and helping him help his dad in his business with advice and Tweet Up prizes such as free access and bag tags. The Gift in action!

He can see the flaws of how most use SM – “They are stuck in self promotion versus communication. I can see through it all – it’s all about them.”

In the Gift Economy that drives Trust and so Strong Ties, the starting point is YOU. In the non network economy the starting point is ME. No small difference!

Shelby Rogers is a flight attendant, a serving soldier (in the active reserve) and the wife of a serving soldier. Travel is her life. When she is not working, she travels. Access to Wifi has made her travel better – “I now know more than the Gate Agent does about my flights!” and it has taken away much of the loneliness that travel brings with it. Who has not been alone eating room service and watching TV in our room? “I can stay in touch with my husband on Skype and every city seems to have a friend in it.”

For Shelby, Boingo is a service that truly meets her needs. But it is how Boingo is connected to her that has transformed a pleased customer into a Super fan.

How often has your service provider taken you out to dinner? “We have even had dinner recently. I am now a walking billboard for Boingo with winking bag tags!”

So what does this mean? What are the lesson for both Boingo and for you?

  • Baochi is no accident – the Boingo senior leadership have created the role and given it the space to enable someone who is naturally humane to be herself inside it. This new way of using Strong Ties to be the centre of a network is all about culture. In most cases senior leadership is too scared to let go. But if you do let go and create this safe place then the power of the network effect can be yours
  • A really powerful network has to have an inner core bound by Strong Ties. This is where the leverage is. One staff person like Baochi can without too much trouble have close ties with 34 people. That gives her an outer network of 1.3 million. If she can handle the Dunbar limit of 144 that creates an opportunity of 400 million! You can see that with the right person, you can have a vast reach – provided you realize that your goal is not to have thousands of relationships but a few Strong Ones
  • The secret is the math of social leverage. Many of you know about the “Dunbar Number”. Some of you know about “Magic numbers – the hierarchy of trust in human groups. If you don’t here is a quick primer.

So what now?

I think that the next stage would be this:

  • At the moment all the Super Fans have a strong relationship with Baochi – I think that the best next step might be to find a way to connect them to each other
  • At the  moment most of the dialogue is still about the obvious and excellent service that Boingo provides – I think that some of the work that the Super Fans could do might be to deepen the conversation – Shelby touched on this in her interview with me – What is it that being easily connected while travelling does? In her case it helped her deal with isolation and loneliness – it helped her do her job better – it kept her in touch with her husband – these are deep issues that I think connect all of us who travel a lot

As I think about networks, I think about the laws of physics. All systems have order and attractors. Some force is needed to keep systems coherent.

Think of the Sun in our own local system. It has mass that provides a gravity that holds all the planets and asteroids and stuff in a pattern. It has energy that creates life in the system. I think that any healthy human social system has to have gravity and light.

At the very centre is the “Right Space” a Trusted Space created by the leadership. In this Space, the Right Person – Right being a person who as part of her natural persona truly cares about others. Connected to her is the fuel and the mass that makes up the Sun – the Super Fans. The closer they are to the centre and the closer they are to each other – the more mass and the more energy. The more mass and energy, the larger and more healthy the network of Weak Ties that form up around the Sun.

What gets in the way is our fear about losing control.

mickey_mouse-7771

At Disney the surface of the Brand Icon never changes but inside the mask is a person who changes all the time and so is never allowed to speak.

But in the new world we have to take off the costume and let the person inside have conversations with the public – HARD to do.

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Breaking through the Social Media Culture Barrier in Government – Canada’s Veterans Affairs is the Wedge

by Rob Paterson

I think it is a given that Culture is the main barrier for most large organizations as they look at how to use Social media. As my colleague Joe reminds us there is real hesitancy in the mainstream. No large bureaucracy can be so bound by the fear of losing control than government. So it is interesting  - to me anyway – to discover a Canadian Federal Government Agency, the Department of Veterans Affairs, that has got more than a toe in the water. They are well engaged in an area where it is relatively “safe” to find out how to do this. I think that their experience here will give them the right and the know how to expand this into their operational area and to give others in Government the experience-based confidence to follow.

When the public think of Veterans Affairs, many of us think of Battlefields and Memorials. I was one of many thousands who returned to Vimy Ridge for the 90th anniversary in 2007.

memorial1

Like many who visited, I blogged about my experience and posted a lot of information. Of course in these days I was not alone. Today thousands of us post material. Many people are exceptionally knowledgeable. There is enormous wisdom and energy embedded in those who visit.

One of the first ahas of Keith Hillier and his team Teresa MacLean and Joey Mokler – was that they could enhance the experience by bringing the Battlefield to the public rather than focus only on bringing the public to the Battlefield.

This recognition that there could be a “safe” way to bring the public in had very early roots in VAC. Today “silverorange” is a global leader in designing social media platforms. They have sites designed for leading entertainers such as Feist and Sloan, have added design to Firefox and Ning, have leading edge sales sites and so on. But few know that silverorange got its start with Veterans Affairs. A long time ago when many who are now old men at silverorange were in their early teens, VAC put out a tender for kids to create a Virtual Memorial for all those that had died in Canada’s conflicts.

Screen shot 2010-07-08 at 9.11.00 AM

This is the entry for my wife’s uncle Bill.

Screen shot 2010-07-08 at 9.12.23 AM

These are the entries that I made on his behalf. So even before “Social Media” was a buzz word, VAC had created a site, using kids, where the public could find out about their loved ones online and where the public could not only look but participate.

The key issue here in terms of culture and barriers, is that this is quite real – the public are really contributing and the service is authentic and valuable – but that the risks are low. Above all that VAC is learning by doing how to get a start.

They are much further along now. When I first started work with VAC about 10 years ago, they had this wonderful archive of film that they had made of interviews with Vets from WWI, WWI and Korea. The question back then was what were they going to do with this.

Ytvacmain

The answer of course has been YouTube!

Over time this invaluable archive is being made available for all of us. Not just in a static way but in a way that we can all use and share.

So what about today? Canadian Forces have been in action for many years in Afghanistan. What about their story? What about their families?

FBmainvac

The answer is of course Facebook! There are over 200,000 members right now. Much of this is very personal and touching.

fbdetailvac

Here we see a film made by young Canadians about what Vimy meant to people in New Brunswick followed by a piece on the Highway of Heroes – the route taken by our fallen as they return from Afghanistan.

So what is really going on behind the scenes at VAC and how can what they are doing help you? Here are a few “Tips” that I can see now after nearly a decade in this work.

1. Leadership - First of all the work is being lead by a very senior and trusted executive – Keith Hillier ADM. My experience is that skunk works don’t work. At VAC as at KETC and before at NPR – having the most senior executives as the real champions is essential. For there are organizational risks and there is big push back and fear. Having a very senior person lead the charge enables you to extend your reach.

2. Use Projects – Don’t try and change the world in one go. Have a real project that you can use to find our by discovery and trial and error that will not get people fired if things don’t go well. At VAC this began with the Virtual Memorial and then has been extended into putting the film archive online on YouTube and now with asking the public to participate on Facebook. Teresa told me of their fears of trolls on Facebook. Conventional wisdom is that if the community is sound enough, they will control the trolls. But of course you don’t know that for sure. The war in Afghanistan is a tricky topic right now and sure enough some came to the site to talk about this. But the community – who are there to support the troops and their families asked them to go away and they did!

3. New actions lead to new thinking not the other way around - You can plan for ever, you can imagine for ever but it is only when you do that you learn and by learning your mind gets changed. By choosing small projects that could be made “safe” VAC is doing the doing and so all at VAC, not just the members of the team, can experience the new for themselves.

4. Start small - The team behind Keith includesTeresa MacLean and Joey Mokler. The money behind this is tiny. But the support is big. I think this is the safer way ahead. Jesus was born in a manger. Moses was found in the Bullrushes. You keep the organizational risk and the naysayers quiet by not announcing the second coming up front.

5. Partner – The early partnership was with a group of local teen nerds – what a gift to them and what a gift to PEI. You will not have the skills inside when you start. Now VAC wish to extend this to their service delivery for Vets. They do not have the resources for this. So the plan is to Partner – Partner with other agencies that can help them build a robust service delivery platform.

6. Have a clear vision for the future where social media gives you the win – The vision for “Commemoration” (Memorials etc) was to bring the memorial to the Public. The Vision for “Commemoration” – offering meaning for the sacrifice and the lives of our vets was to give this to the public. The new service delivery goal will be to shift the web from being a big pamphlet to being the place where the services of VAC are enacted – where a vet can get what he or she needs. Finally the visions for the social needs of the vets – which in most cases exceed the program needs – is to use the web to help vets get connected to others like them so that they can help each other. So far so good!

I think that VAC have earned the right to go for the service goals now – don’t you?

I think that they offer us a process that any large organization can follow too – don’t you?

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Have books been bad for us?

by Rob Paterson

A really weird thought has been building in me for months. Have books been a bad thing?

SCA-campfire

Is this better?

If so – why?

If so – Is this the campfire of all campfires?

Internet Graph

So what’s my argument?

Many people are convinced today that the birth of the web is making us stupid. That the web is only superficial. That only dense books can contain and spread real knowledge.

I am coming to the conclusion that the opposite is true. That books make us stupid and that the web, like the campfire and for the same reasons as for the campfire is what makes us clever.

So here goes. All our foundational knowledge was discovered around the campfire. Imagine you a hominid sitting around the fire at night. You are awake. You are looking at each other. I would imagine that at first, before we could speak, we sang or made music together. The fire elicited a social dance of interaction and community.

I think we can surmise that the campfire helped us speak and so it helped us become conscious. Something like this happened about 100,000 – 60,000 years ago. For suddenly our tool development, art and technology took off. All the foundations of our world today were discovered in a 10,000 year period. Tools had been the same for a million years. Within a 1,000 years they were completely different. We invented pottery. We invented metallurgy. The wheel. Everything we depend on was discovered then. Not only discovered but widely disseminated in a short period of time.

How did this occur?

My bet is that it happened because of the social process created by the campfire and by our hunter gatherer culture of equality. Such an environment extracts order from chaos. Design from intuition. It is ideal for the exploration of implicit knowledge. It is ideal for discovering things that we don’t know exist. It is ideal for taking half baked ideas and refining them. Let’s use a thought experiment.

How did pottery get invented? Surely no one said “Let’s have a project to invent Pottery!” How can you invent something that had never existed? No it must have happened like this – The People stopped for the night after a rainfall. The next morning, as they prepared to leave, the fire keeper noticed that beneath the coals that she was harvesting, the ground had baked to a crust. Maybe she could carry the fire in this thing – this bowl. That night as they shared the food around the fire, she told the people what had happened and showed them the “bowl” that she had lifted out of the earth the day before. And the conversation began – how had that been? Did it hold the fire well? What else could it hold? What if we put it back in the fire? Would it hold water? And on and on. Experiments were made. Some earth worked better than others. At the seasonal meeting with the Cousin Peoples, the People shared their story with the others and gave up a “bowl” as a gift their elder. At the next season meeting, the two tribes spent days sharing the stories of the experiments that they had been making…….

There was no peer review. There was no authorized way of doing it. No one was telling anyone. They were sharing and asking and arguing. They were having conversations!

But with the book comes authority. With the advent of the book, much of knowledge development stopped. Only the in group was allowed to play. What mattered was not observation. Not trial and error. Not experiment. Not sharing. But authority. Most of the accepted authority were texts that had no basis in observation or trial and error. Ptolemy, St Augustine and Galen ruled.

Worse because of the “Book” people who did observe or test were killed or persecuted. The Book stood for the ONE WAY. It spoke not you.

For a while, with the advent of the press, knowledge opened up.

But where did the great advances then come from? Did they come from the Universities? No they came from amateurs – from Natural Philosophers. Who met in clubs over dinner to talk about their work. Gradually, the “BOOK” came back. Only papers written and approved inside the authority system counted as being right. People outside the authority system were discounted.

Knowledge was seen as an explicit thing – an object. The Book was its metaphor.

But now with the web, we have a global campfire. Once again, we can play with ideas, with observations and experiments. Once again we can share with equals who will not knock us down. Even better, this time the group around the fire is not 35 people but all of us.

What new things will come from such a process? Surely amazing things. Things that could never have come from the use of books.

As a person who loves books, whose life is reading, I now wonder……

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