1. How web 2.0 is changing medicine* Dean Giustini UBC Biomedical Branch Librarian Vancouver General Hospital April 12 th, 2007 *A presentation at the 2007 Emerging Trends in Scholarly Publishing seminar, National Press Club, Washington, D.C.

2. Outline Discuss types of social software use in medicine How do doctors communicate? Evidence-based medicine Trends to watch Open access (OA) Medical publishing 2.0 Web 2.0 & medicine, Giustini – April 2007

3. Talking medicine How do physicians communicate? Formally  Journal articles, print and e-books, conferences Informally  Conversation, ‘on the wards’, online, with residents Community of practice (Lave & Wenger) Web 2.0 & medicine, Giustini – April 2007

4. Doctors are social Web 2.0 creates conversations Tools, ‘social-software’ Blogs, wikis, podcasts, video, RSS feeds Socialization Conversation, ‘on the wards’, online, rounds with residents Knowledge begins with conversations* * Kenneth Megill. Thinking for a living: the Coming Age of Knowledge Work. 2004 Web 2.0 & medicine, Giustini – April 2007

5. Key tools in the knowledge economy Blogs, wikis… Is a medical wikipedia the next step? Podcasts & vodcasts Do physicians listen and/ or watch? RSS feeds “push” content Other tagging, photo & slide sharing Web 2.0 & medicine, Giustini – April 2007

6. Blog discourse in medicine Blogs stimulate discussion, self-directed learning & reflective practice Useful educational tools Clinical Cases & Images, Ves Dimov, M.D. Kidney Notes blog, Joshua Schwimmer, M.D. Over!My!Med!Body!,  Graham Walker, Stanford medical student Medical librarian search blogs To help find medical information, rapidly Web 2.0 & medicine, Giustini – April 2007

7. Clinical Cases & Images blog Web 2.0 & medicine, Giustini – April 2007

8. Good medical wikis AskDrWiki.com FluWikie.com Ganfyd.org Just The Facts PubDrug Wikisurgery.com Web 2.0 & medicine, Giustini – April 2007

9. Ganfyd wiki AskDrWiki Web 2.0 & medicine, Giustini – April 2007

10. Doctor-moderated - AskDrWiki Web 2.0 & medicine, Giustini – April 2007

11. Content development @ AskDrWiki  Credentials needed to become an editor or contributor  Transparent editorial policy with contributors and credentials listed (Name, degree, location)  RSS feeds to notify editors of content changes/ additions.  New clinical domains:  General Surgery, ENT, Vascular Surgery, Hospital Administration, Bio Informatics, Dermatology, Emergency Medicine, Orthopaedics and Basic Science Editors.  ‘Lock down’ of some content pertaining to medical/ drug dosing.  Additions can be made, but not until approved by editors. Web 2.0 & medicine, Giustini – April 2007

12. Post-textual web Podcasts, vodcasts New England Journal of Medicine MEDLINE/PubMed indexing Trend is toward integration; ‘mash ups’ Web 2.0 & medicine, Giustini – April 2007

13. Post-textual web Podcasts, vodcasts New England Journal of Medicine MEDLINE/PubMed indexing Trend is toward integration; ‘mash ups’ Web 2.0 & medicine, Giustini – April 2007

14. Post-textual web Podcasts, vodcasts New England Journal of Medicine MEDLINE/PubMed indexing Trend is toward integration; ‘mash ups’ Web 2.0 & medicine, Giustini – April 2007

15. Virtual, social reality Immersive, gaming environments Tools for facilitated conversation? MMORPGs  Role-playing games, Second Life Simulated medical services Medical librarians 2.0 ‘avatars’ Web 2.0 & medicine, Giustini – April 2007 Second Life – secondlife.com ‘Goodwillstacey’ medical librarian in Second Life

16. In summary: Web 1.0Web 2.0 Proprietary, closed accessOpen access, data liberation Yahoo, Google, MSNSocial search ie. Google health Static websites; hierarchiesParticipative, non-hierarchical “wisdom of crowds” Standalone, firewalls“The open web as platform” Sticky sites “Pull” information Syndication, RSS “push” Information comes to you E-mail alerts, listservsBlog posts, RSS readers Medical directories, bookmarks, favorite sites Social tagging ie. Connotea, del.icio.us Disparate piecesIntegrated, virtual, mashed Web 2.0 & medicine, Giustini – April 2007

17. Open Medicine www.openmedicine.ca * a new peer-reviewed, independent, open-access journal  launch is imminent (next few weeks)  physician-created, many former CMAJ editors  editorial independence, scientific integrity as core values  Open Medicine blog A new medical journal

18. Web 2.0 & medicine, Giustini – April 2007 In conclusion Physicians should learn about the vast ecosystem of the web Web 2.0 is not a fad, but is changing the way patients and physicians interact Wikis and blogs help doctors to communicate, collaborate and participate more Software tools help physicians to form digital communities of practice In the future, physicians will publish in the absence of associations or affiliations.