I’ve been thinking about web 2.0, health care and health policy a lot these days since I’m trying to meet an offline writing deadline for a chapter on this theme.   As it happens, John Podesta (of the Obama campaign now transition team) still has my email and continues to update me on how things are going. Serendipitously, Podesta sent out an one of those email updates that was all about web 2.0 and health policy in the new administration.   Here’s what they’re doing (emphasis added):

Transparency and engagement are priorities for the Obama-Biden Transition Project. Our success depends on not only opening up a process that has historically been inaccessible to most Americans, but also encouraging citizen participation.  Last week, we took an important step towards these goals by asking the public to participate in a discussion about health care on our website.  The result was fantastic. Started by a question from our Health Policy Team, thousands of comments poured in over a few days. Some people answered the initial question, but others engaged with one another debating and developing new ideas and approaches to health care reform. Members of our Health Policy Team, including former Senator Tom Daschle, read through these comments over Thanksgiving weekend.

Pretty cool, I thought.  And, at end of the email there’s a link to the video response from Dashcle and Lauren Aronson.   As an online video, it’s not dynamic enough to go viral, but it as governance, it’s fairly impressive.   It’s also encouraging to listen to the actual content of the suggestions from the public which included a range of ideas from basic public health (e.g., focus on prevention to lower costs of chronic diseases) to relatiavely left-of-center suggestions like a proposed “health corps” similar to the Peace Corps, where people would volunteer for two years of service in health-related fields.   (All of the above is good news for schools of public health, so young sociologists would be wise to take those medical sociology courses and brush up on their knowledge of all things health-related.)

The central feature of what’s exciting and innovative about web 2.0 as it relates to health care and health policy is summed up nicely by blogger Jen McCabe Gorman who writes at Health Management Rx:

Like this year’s presidential election, social media and networking sites are breaking down some siloed barriers in the healthcare strata. On Twitter, I chat with docs, nurses, med students, marketers, health executives, entrepreneurs, analysts, etc. Would I ever have the opportunity to find and initiative conversations in the brick-and-mortar delivery world with such a diverse group? Not bloody likely.

New forms of communication that are based on the many-to-many style of distribution (rather than the top down, one-to-many style) are making conversations possible now that either didn’t exist or were very unlikely in the past. And, as anyone knows who has read any the literature on the mystification of medical (and scientific) knowledge, that’s a pretty dramatic shift.

Tim O’Reilly saying interesting things about Twitter:

In many ways, Twitter is a re-incarnation of the old Unix philosophy of simple, cooperating tools. The essence of Twitter is its constraints, the things it doesn’t do, and the way that its core services aren’t bound to a particular interface.

It strikes me that many of the programs that become enduring platforms have these same characteristics. Few people use the old TCP/IP-based applications like telnet and ftp any more, but TCP/IP itself is ubiquitous. No one uses the mail program any more, but all of us still use email. No one uses Tim Berners-Lee’s original web server and browser any more. Both were superseded by independent programs that used his core innovations: http and html.

What’s different, of course, is that Twitter isn’t just a protocol. It’s also a database. And that’s the old secret of Web 2.0, Data is the Intel Inside. That means that they can let go of controlling the interface. The more other people build on Twitter, the better their position becomes.

O’Reilly also talks about how a large number of Twitter users use Twitter to update their Facebook status, which is exactly what I do. In fact, if you just look at my Facebook page, it looks like I’m fairly active on Facebook, until you realize that almost every thing in my profile is pulled into Facebook from other services like Twitter or this blog (via Wordbook). Thanks to the demise of Scrabulous, I pretty much only go to Facebook any more to approve friend requests and respond to people who comment on my Twitter status inside of Facebook instead of in Twitter.

I’m not sure what a Facebook that tried to untie its data from its interface like O’Reilly recommends would look like though. But an even more interesting thought experiment is this: what about a Facebook-like social networking system that works like laconi.ca, a Twitter-like piece of software where the data itself is decentralized on individual instances of the software but where the social networking & communication can occur across each instance. This gets around both the centralization of interface, but also the centralization of data, which is really a much bigger problem!

I’m sure you’ve already voted or you wouldn’t be reading this, so I won’t nudge you about that. Onward, then, to all things digital and how it’s changed presidential campaigns. On Sunday, the New York Times has an interesting piece by Daniel Carr and Brian Stelter, called “Campaigns in a Web 2.0 World,” that explores how the 2008 presidential campaign has blurred the lines between old (broadcast) media and new (Internet) media. The authors remind us just how much has changed in four years:

“Many of the media outlets influencing the 2008 election simply were not around in 2004. YouTube did not exist, and Facebook barely reached beyond the Ivy League. There was no Huffington Post to encourage citizen reporters, so Mr. Obama’s comment about voters clinging to guns or religion may have passed unnoticed. These sites and countless others have redefined how many Americans get their political news.”

The article goes on to note how Obama’s campaign has made savvy use of social networking sites, such as Facebook. Yet, this has not meant usurping the importance of traditional networks in breaking election news, here they site the Katie Couric interview with Sarah Palin.

I’ll be part of this blending of old and new media today, as I take photos of various polling places, share them through Flickr and Twitter, and then attend a party hosted by NPR tonight in Harlem, where lots of other people will be blogging and sharing election-day photos. What about you? How is Web 2.0 changing the way you relate to this campaign?