Knowledge prostitution in healthcare

Danny Lieberman, founder of Pathcare, considers whether there is a conflict of interest and violation of privacy by healthcare communities that sell data mining services to pharmaceutical companies and healthcare providers.

A medical device vendor client recently told me that they were considering using  social networks for healthcare  to help market their products.

After some discussion   about privacy, data security and the advantages of private social networking for healthcare versus closed physicians portals, I got thinking about the current business models for healthcare communities.

I started by looking at physician portals and came across a fascinating post from Dr. Scott Shreve - Knowledge Prostitution enabling Aggregated Voyeurism: Is this a Business Model?

Voyeurism (voi-yûr’ ĭz‘əm) n.

1. The practice in which an individual derives pleasure from surreptitiously observing people.

2. Derives from the French verb voir (to see); literal translation is “seer” but with pejorative connotations.

The business model used by closed, advertising-free, doctors portals (Sermo.com in the US or Konsylium24.pl in Poland) involves paying for market intelligence data collected from the “user generated content” in the community.

The tacit assumption is that physicians will talk freely inside a gated, advertising-free community.

It seems the patients community patientslikeme.com has taken the same business model of data mining user conversations as a way of generating revenue without charging admission to their gated community.

Sermo.com kicks some of the revenue back to the users but the precision and recall of this market intelligence is not clear to me, considering the amount of noise in vertical social communities like Sermo and Konsylium24.pl and open social media like Facebook, Twitter and LinkedIn.

What is clear to me – is that there are data security and privacy implications when the community operator data-mines user-generated content for profit.  As a concrete example – a recent thread on Konsylium24.pl went something like this:

Doctor Number 1:

You know – Professor X is the KOL (key opinion leader) for company Y’s drug Z.  He says that drug Z is extremely effective for treating the indications of infectious disease Alpha.

Doctor Number 2:

Of course – Professor X is an acknowledged expert on infectious diseases, but he is also an expert on cash and knows how to do the math and add up the numbers…

I asked my client - “and for this kind of data, your parents sent you to medical school?

This took me back to the days of Firefly, Alexa, Hotbar and use of personal information as currency – collected with “collaborative filtering” and “automated inference” from people browsing the web.

Dr. Shreve wrote this post 5 years ago and opined that “voyeurism is both a viable and sustainable business model.“. He may be right, if only because people enjoy the idea of someone doing something useful with their conversations.

On the other hand, I am not sure this is a long term sustainable business model. Let’s look at the trends in the light of history of the Internet.

Web 2.0 and social media are going through the same evolutionary process as Web 1.0 – trying to monetize content by  data aggregation and analysis using “collaborative filtering” techniques.  This was a sexy looking business model for Venture Capitalists during the dot.com era, but in 2009 (5 years after Sermo.com launched) and a few months after their well-publicized breakup with the AMA; automated inference, knowledge prostitution and aggregated voyeurism are  yielding to direct communications between people in B2B communities, social and professional networks.

Why peep through a window when you can just knock on the front door and ask?

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