brown2020

This is a short blog post on the way home from Connected Health 2009. I’m in the air on Virgin Atlantic typing on my iPhone connected to the web with inflight WiFi — that’s why it’s short and may have some typos.

First of all, Connected Health is a much bigger idea than the original idea of telemedicine, which was all about laying the painful last mile of technology to finally reach those with the greatest needs to communicate about health.

Connected Health, in contrast, is not about devices, sensors and gadgets. It is about the idea that how people connect with each other has a profound impact on health.

As Nicholas Christakis, author of “Connected”, reiterated in his keynote speech, our connections to each other, probably even more so that our connections to our doctors and nurses, has a measurable impact on our health.

Despite the big idea of connected health, too many of the Connected Health sessions followed the same format:

1. Most of the trillions in health spending is the result of chronic illness which in turn is the consequence of our lifestyle and behavior.

2. There is compelling evidence that connected health can improve quality and reduce the cost of care, referring to proactive care models that coach and monitor patients at home.

3. The only barrier to widespread adoption of a more rational model of connected care that will save our health system from impending collapse is Medicare coverage of remote health monitoring technologies.

This is the same conversation we had six years ago when we introduced the first connected health ideas as part of the Medicare Modernization Act of 2003. Six years later, it seemed like nothing had changed.

In fact, much has changed, and the next few years will be profoundly different than the past six. The fact is, we are all becoming connected in a tighter web of relationships enabled by technology. 300 million of us are on Facebook, maintaining a constant awareness of how our social network is faring. Soon we all will be able to keep tabs on our most important relationships on our smartphones.

When Grandma is also on Facebook, and her friends and family know how she is doing and she knows they still care, do you think there will be fewer crises that lead to hospitalization? I think so.

In a world where we can blog and tweet from an airplane while watching satellite TV, we surely have the tools to create the kind of connection that will improve healthcare. It’s going to happen, not because of policies and reimbursement, but simply because connected health is far better for everyone than isolation.

The “Share To Win” Experiment

Last month, my company sponsored a “crowdsourcing philanthropy” experiment in which we offered to donate money to causes based on their ability to rally supporters online. Our premise with the Share To Win challenge was that a cause needs two ingredients to be successful in the modern world: An idea worth spreading, and a core group of passionate people to light a fire online.

A recent Harvard study found that just 10% Twitter users generate more than 90% of the content on the popular and fast growing microblogging service. The numbers must be even more skewed when it comes to the much more involved act of traditional blogging. If you have an important idea that you want to spread, and especially if you are a non-profit cause that relies on the generosity of others to back your idea, you are going to need to have some of those Internet extroverts on your side.

The methodology of our challenge was straightforward: Anyone could nominate a cause by creating a note on 3banana.com describing why people should support their cause, and then share that note through social networks like Twitter and Facebook. The five causes that attracted the most endorsements – as measured by unique visitors who left a comment – would win our donations, a total of $10,000. The challenge would give champions an excuse to spread the word about their cause, but without asking for money – which tends to reduce the virality of any idea online.

To encourage participation, we reduced the barriers to posting content online down to a minimum. The first tactic was simply positioning: Asking users to share a note was less formal and less work than authoring a complete article for a blog or website. The second tactic was to further reduce the actual effort required. Users could sign in with their existing Google account, and then type their idea freeform into an input field atop a notes page, without worrying about titles and categories. Press save, and you have created a private but sharable webpage with full functionality for threaded discussions. We were soliciting raw input of thoughts and ideas with as few barriers as possible.

Then we worked on increasing the fluidity of sharing these freeform notes with Facebook and Twitter. We just launched Facebook Connect and Twitter OAuth integration with 3banana Notes, enabling direct connections to those services so that users could share notes a with just a couple quick clicks. As a business, 3banana justified the cost of sponsoring the project as a “Beta That Gives Back”, creating an incentive to use the new sharing functions and giving the money we might have otherwise spent on traditional testing methods to some good nonprofit causes.

What Happened?

Over 50 causes were nominated for share to win. Some organizations nominated themselves, and some were nominated by one of their passionate supporters. We also asked our friends and family to nominate causes and to spread the word. The first big surprise was how the social media platforms we had taken for granted for some time now were still quite new and fresh to many people at non-profits. We found many causes to be extremely eager to figure it out, while other causes felt they needed to call a board meeting before even posting a note about their mission on Twitter.

Among the causes who were nominated, over 20 of them took Share To Win as a real opportunity to spread their message to supporters through Facebook, Twitter, blogging, and email. We had suggested at the beginning of Share To win that causes should consider the prize money as a token of appreciation, while the real benefit of the campaign would be to create an opportunity to reach out to more people and to galvanize support on social media channels without asking for any money, because we were putting up the cash if they could show they had supporters.

The top two contenders couldn’t have been more different on the surface. Grand prize winner SENS Foundation supports research in regenerative medicine and seeks to end aging. Runner up Los Angeles Habilitation House helps veterans with PTSD and traumatic brain injury get back on their feet. Underneath the surface, however, these two causes both are based on powerful ideas and both are championed by passionate supporters. Each cause was able to find over 2000 people who supported them enough to sign up for an online service they had never heard of, login and post their endorsement message. Remembering the Harvard study showing that most people don’t make the leap to generate content online, 2000 content generating supporters represents a much big number behind the scenes.

We also gave prizes to the top contenders in the fields of education, environment, and health, each of which gathered hundreds of passionate supporters to comment online: Art in All of Us helps kids express and share their experiences, their passions, and their dreams with peers around the world through art. Their vision inspired supporters from 80 countries to endorse them in Share To Win. Disaster Accountability Project recognizes that the number of climate-related disasters is bound to rise. Hurricane Katrina proved that we need better ways of responding to disasters, and DAP advocates grass roots monitoring and information sharing. The HeartMath Institute sees stress as one of the most important frontiers in healthcare and their research aims to help us better measure, understand and manage this driver of so much illness.

For some of the smaller causes, even though they did not have the numbers to win a top prize, they still found a way to bring together and galvanize dozens of supporters. These people felt part of a support community, and in the future will be even less inhibited to speak out online, to Tweet, and to tell a friend on Facebook. One of these causes is Friends of Kibera, a new non-profit started by students at Notre Dame to help people in Kibera, a very poor area in Kenya. Another was a group called Magical Bridge, raising money for new and better parks for kids. These causes and dozens of others were highly diverse in their missions but very similar in their ability to use social media to rouse the passion of supporters for very clear ideas that mattered to their respective communities.

What did we learn?

The final tallies of supporters were very nonlinear. The more support a cause received, the more rapidly the cause spread. Even though 3banana is an open and free service, and there were no barriers to signing up and commenting, we found surprisingly little abuse of the process, which we were able to validate by cross referencing the results of multiple methods of counting unique users.

It was very motivating to read comments from hundreds of people about why they supported their cause. On of the biggest fears that large donors sometimes have about helping small non-profit causes is that they will find themselves alone, and what started as an act of generosity will become a guilt-ridden dependency. When you see that a cause has hundreds of supporters willing to take the initiative to endorse the cause publicly online, it creates a lot of confidence that the cause has both an idea worth spreading and a critical mass of passionate support that will sustain the group through the inevitable ups and downs of any worthwhile mission.

Based on what we learned from a whole bunch of new users, we are refining both our note-taking applications and our methods for sharing notes. Then we may do something like Share To Win again, perhaps with partners who share our passion for using social media and mobile technology for good causes. Next time around, we will focus more on mobile information capture and sharing: We hope to make the engagement in the cause even more personal, allowing users to snap photos and to link them to locations, products, or events to connect with their cause.

If you want to be notified when we launch the next Share To Win challenge, simply start a free notebook at 3banana.com, create a note about your cause and about yourself, and use the share function to send us link to your note at sharetowin @ gmail.com. You can also find me on Twitter at @brown2020. We will keep you posted!