A Different Real-Time Web

I've often thought it strange, when watching a TV medical drama, to see amazingly realistic shots of surgical procedures, followed by scenes of what must be pure fiction, where the doctors are spurred into action via a page, from one of those 1980s pager things on their belt.

Come on, nobody these days actually uses a pager, do they?

Well, I learned today from an expert in medical informatics that pagers are alive and well in hospitals because they so effectively reduce the latency between when a message is sent and when it's received. "In patient care, a minute will make a big difference", he said.

Ironically, this came up in a conversation about how his hospital could extend their existing social networking implementation into the realm of patient care, in particular the possibilities for using internal micro-messaging tools (a secure internal Twitter-like app) to improve communication between the people treating each patient.

In the long term, hospitals will embrace such tools for the obvious patient benefits. Patient care teams provide an excellent use case for micro-messaging, because team-wide status updates enable faster, more error-free transfer of patient information from one team member to another. In an ICU (intensive care unit), for instance, a technician signaling that a patient's respirator had exceeded some limit would enable the nurses, residents, and attending physician to more quickly assess and treat the patient's emergent condition.

Why in the long term? Because people in medicine are not eager to adopt new technology. As a patient, I can understand why. Would you want your doctor treating you with some new but not thoroughly tested device?

And that's why pagers persist to this day. In a clinical context, a page may carry less information than a micro-message or an email, but it's less risky.

Only some of this is due to its lower latency; the cultural practices that grow up around a technology are also important. Email, for instance, is such a bullying time-suck that many people let their inbox become a "to-do" list that runs their lives. By contrast, a page is culturally understood to have immediacy, which frames the timeline in which you're expected to respond.

Social media will eventually have a deep and profound impact in the health care sector, as elsewhere. But don't be surprised if the medical community takes a lot of time to apply these new tools, operating as they do from a prime directive – first, do no harm.

Twitterville: My Kind of Town

Shel Israel's new book Twitterville has modest ambitions – providing an overview of how Twitter is currently being used for business. It's a quick read that doesn't attempt the impossible task of cataloging all of Twitter's enterprise possibilities, or spend much time comparing Twitter with other kinds of communications and collaboration tools.

But it's precisely for these reasons that I liked Twitterville; instead of blathering on about theories of social networking, it simply presents anecdotes about how companies large and small are using Twitter to respond to complaints, improve their products, and in a few cases, measurably increase sales.

I appreciated the author being up-front about how the book was written – he tweeted his few thousand followers asking for suggestions for each chapter, then captured and edited the best responses. I'm relatively new to Twitter, and had used a similar process of asking the people I trust for advice when taking my tentative first steps with this new but undeniably powerful communications medium.

Most of Twitterville documents the way Twitter has spurred the growth of different kinds of what the author calls "global neighborhoods":

1. Large consumer-oriented companies: these arguably have the most to lose by ignoring the rise of social media, such as Twitter. There are already many examples of major consumer brands (including Amazon, United Airlines, and Motrin) that have damaged themselves by responding slowly, ineffectively, or not at all to consumer complaints distributed via social networking. At the same time, companies that proactively use Twitter to listen for and respond to customer mentions of their brands are getting disproportionately positive press, just for doing something they should have been doing all along.

2.  Business-to-business: not many B2B companies have leveraged Twitter effectively to date, though some have gone beyond standard sales and marketing tactics and started using Twitter as a recruiting tool. As Twitterville points out, any business seeking to gain a competitive advantage via Twitter, whether globally or locally, needs to look carefully at the issue of identity. For instance, @comcastcares is the Twitter handle for a real human being, Frank Eliason, who has more than 30,000 followers and has tweeted more than 35,000 times. By contrast, @timewarnercares is being followed by more than 500 people, but has yet to issue a single tweet.

3.  Small business: for many small companies, Twitter provides a better ROI for sales and customer service than any comparable expenditure of time and money. Twitterville documents a number of exemplary small businesses, from coffee houses and pizza joints (and a popular San Francisco crème brûlée cart) to Web 2.0 companies such as Seesmic (which makes the Twhirl Twitter client). In particular, it describes how the entrepreneurs behind these companies are breaking the traditional customer / vendor boundaries that until very recently governed business, replacing them with a model in which customers aren't just consumers but are actively courted to co-define a brand and thus have an active stake in its success.

4.  Personal branding: Using Twitter (and comparable internal micro-sharing tools) is the fastest way to build your professional identity, whether you work in a global corporation or as a freelance contractor. But you need to have a very clear career mission in tweeting, focusing on what you're solving for your customers or employer, says Jeremiah Owyang (now of the Altimeter Group, formerly an analyst at Forrester Research). "Don't focus on the minutiae of tools; instead, think of the greater problem and solution you'll provide."

I found the second half of Twitterville especially interesting, as the author goes beyond commerce to look at how Twitter-based communities can be further the growth of philanthropy, government 2.0, and what Israel calls "braided journalism". Of these, journalism is the first to experience gut-wrenching change as a result of the explosion of information sources on the web, a trend that can only get more severe as "the web" evolves to become "the real-time web". Recent examples include the US Airways flight that landed safely in the Hudson River, and the worldwide push-back against corrupt elections in Iran, both most effectively reported via Twitter.

These are early days for the 140-character phenomenon of micro-sharing, but savvy companies and individuals are already staking out turf in the neighborhood.

If you've been tweeting for a while, Twitterville isn't likely to rock your world. But if you're new to Twitter and want a quick overview of the commercial possibilities, a visit to Twitterville is a good place to start.