I was having dinner with a group of friends about a month ago, and one of them was talking about sitting with his four-year-old daughter watching a DVD. And in the middle of the movie, apropos nothing, she jumps up off the couch and runs around behind the screen. That seems like a cute moment. Maybe she’s going back there to see if Dora is really back there or whatever. But that wasn’t what she was doing. She started rooting around in the cables. And her dad said, “What you doing?” And she stuck her head out from behind the screen and said, “Looking for the mouse.”

Here’s something four-year-olds know: A screen that ships without a mouse ships broken. Here’s something four-year-olds know: Media that’s targeted at you but doesn’t include you may not be worth sitting still for.

The other snippet of media that’s worth your time is this Deloitte podcast (ignore the narratrice’s intro — the actual researchers are genuine & full of insights):

Embracing Disruption: How Consumers Are Transforming the U.S. Health Care System

There remains only one universal internet-based application and it is not web-based. Email remains the only way anyone can communicate easily via the internet. All the smartphones can now deal with it in simple and usable ways, unlike the still-clunky mobile web-browsers and their inability to universally render a given web page.

All of this explains why we have constantly tested many very exciting web-based services over the last 15 years and have consistently decided that ACOR remains firmly email based. I am sure that in the future we will add many mashups and innovative services to our offerings but they will not replace the practicality and universality of email -mediated exchanges.

We are proud to use the simplest technology to help patients become educated and empowered. As Clay Shirky so rightly says: “Communications tools don’t get socially interesting until they get technologically boring.” Just remember that email was revolutionary and deemed a modern gadget just a few years ago. Like the telephone before: “The telephone is little better than a toy, it amazes ignorant people for a moment but it is inferior to the well-established system of airtubes.” Saturday Review, 1878.

We also consistently notice that the quality of exchanges taking places through many of the ACOR email communities seem to be at a far higher health literacy level than what can be found in many web-based social networks. Of course there is the famous exception, the patientslikeme.com communities, where the health literacy level is very impressive. But there is a lack of validated data to confirm what we, the people managing email-mediated medical communities for 15 years, know to be true. Maybe we should do a better job at explaining the depth of the knowledge present in many of them.

From my experience you’re certainly right about the value of having a support community. The Feb 19 post about friends, family and surgical outcomes illustrates it too.

I suspect, too, that this is a big part of the value of having continuous care from a primary physician we feel we can depend on.

I wonder if we can evolve a model (a diagram of some sort) showing the aspects we see: the collective wisdom part (fostered by broad access to others’ experiences, via the read/write web), the documented value of connectedness, the (documentable?) value of feeling we have access to our physicians outside of the appointment room.

But I’m not so sure about your suggestion that developments like going mobile being just same-old same-old. Sure, in the world of Web 2.0, that’s routine – but health IT is positively *crusty* compared to modern uses of the web. That will eventually change, but from what I see, the vast majority of (for instance) patient interfaces are far from being accessible by mobile.

Good post – provocative, as they say.