Skip Navigation
Department of Health and Human Services www.hhs.gov
 
 

Back to "About This Webcast."

Innovations in Stakeholder Engagement Conference, Urban Interactive Studios

Webcast Transcript, November 3, 2011

Speaker:  Chris Haller, Founder and CEO, Urban Interactive Studios

(JOINED IN PROGRESS)

HALLER: ... and, with that, I want to dive right in. As I mentioned, this is going to be more sort of an overview, just to set the stage for all the great people that are gonna be talking about their experience with their particular project afterwards.

And as part of this overview, I just want to set the stage real quick. As -- as you all know, I mean, I see a lot of people with computers here and I'm sure that most of you have checked their emails today while you are here on your phone.

So this is -- when we were talking about research and about including stakeholders in engagement and research, we can't ignore the web(any longer.

I think that it's something that we've learned. I think it's a point that we've come to. There are still issues with the digital device but it has moved on from the haves, have-nots, to how are we using sort of the different communication tools we have now.

What are people's preferences? What are the skills et cetera?

And so that -- I'm a big fan of info-graphics and found such great info-graphs by the- project, the Path of the Blue Eye, who put together sort of this idea about what the e-patient looks like today, the informed online patient.

And obviously you can't see much so I'm gonna zoom in a little bit and just sort of focus on a couple of quick areas just to give you an idea and set the stage for what we were talking about.

So their findings are -- their findings are drawn from their own research and from the Pew Research Institute. They're a little bit older. They're from 2010.

And they, for example, found that 61 percent of American adults have gone online to find information about their -- about health issues and find health information online and that number's actually up from 27 percent in just 2006.

And so we see this e-patient as the new informed patient that uses the web to access information and learn more about health issues.

The next part of this graphic that I find interesting is sort of how are modern, or the e-patient, how are they using social media to access information.

And I found that of those e-patients, they want -- 60 percent want news and information about medical conditions via social media. So social media really has become a way to access news, of sharing news with peers, of -- of learning about things and sharing information.

So it's a new word-of-mouth in -- in a sense and has become a lot more important to share information and do outreach.

And 38 percent of the -- those e-patients are interested in two-way dialogue. And this is really what we're here today to talk about, how are we engaging stakeholders and citizens in -- in research and decision-making.

And to show that there's a new culture on the part of the patient where people actually expect that we not only provide them information but that there's a channel to contribute back, to contribute ideas, to contribute feedback.

And last, I want to highlight that there's a growing user rate that -- that uses the cell phone to access information. We're living in an age where a lot of groups or ethnic groups and minority groups are actually using the cell phone as their primary way to access the web, to access information, to access email.

And even though this is just at 17 percent of the overall population that has used their cell phone to look up health and medical information, I think this is something that we're gonna see growing rapidly over the coming years.

So with this, I want to jump right into talking about a couple of examples. And really, this is to set the stage. I picked out a couple of examples that I thought were applicable and interesting to this -- to this group. This is by no means sort of an expansive list or a complete list.

And just to dive in to talk a little bit about different technologies and the techniques or -- that go with engaging citizens and engaging stakeholders in research and participation.

So the first thing I want to highlight as a technique, is ideation platforms or online idea brainstorming. It's -- it has become really sort of popular with, sort of in my field, with this sort of government 2.0 movement where the idea is we don't want to have only experts come up with great ideas and plans that are then contributed or -- or passed down to the public.

But instead, we want to do crowd sourcing and we want to pick citizens to provide information and ideas and provide a platform that typically looks like this, where you can login, you submit an idea, other people can review and comment on those ideas and rate them up and down. And at the end of the day you have sort of a prioritized list of ideas.

And so maybe a quick show of hands -- who has submitted an idea into such an ideation or online brainstorming tool? So I see one, two -- yeah, that's a handful.

So I want to show, the first project I want to just quickly introduce is a great project put together by CEOs for Cities. It's called Give A Minute and was organized in a couple of major metropolitan areas around the country.

And I chose this because there's a little bit of a twist that I'm gonna show you in just a second.

But basically, their web interface that you see right now is very visual. It's kind of built around the idea of post-it notes. And they ask the question, it's all structured around simple answers and short answers to one central question, which is what would encourage you to walk, bike and take the public transportation more often?

And so you could either use the website to have with 140 characters to -- to give a quick sentence of what you think should be done so you would take it more often. And that's why it's called the minute because it doesn't really take longer. And -- and that's just sort of very much sort of a micro-participation effort where you don't have to take a lot of time to participate.

But I think what they did, what was really effective, is that they had advertising in public transportation, in buses and subways, and people were actually using their cell phones to submit that idea while they're on the go, while they're traveling.

And I think the brilliant part that they got right about this is that people have time to spend when they're on the subway. They might have 15 minutes, half an hour, while they're commuting to participate and provide their feedback.

And I think that that's something that has worked very well in that context because everybody has their cell phone with -- with them these days as well as actually driven by text messaging, which pretty much any cell phone can do.

And so I chose this example because I think there's a lot of time that patients and -- and people spend in waiting rooms. And I think that's something that -- that might be really effective and that I, every time I'm at a -- at a doctor's office that I'm looking around when I'm figuring out if I want to grab a magazine or if I actually look around at what the posters are.

None of them actually engage me in any way. They're usually just sort of information passing down. So anyway, that was just a -- food for thought.

The next part, sort of taking this a step further, online dialogue, sort of larger efforts to -- to have a back and forth conversation and discuss ideas.

And who here has participated in some sort of forum or temporary online dialogue -- so, a couple.

The example that I want to highlight is -- was done by the National Administration for, or Association for Public Administration Professionals in -- with America Speaks.

And they, during the last presidential election, held this online forum on -- that they called a national dialogue on health information, technology and privacy.

And it was an open call. They did a really great job of doing outreach to industry blogs and through bloggers in the field and newspapers and had sort of shareable videos and really drummed up a lot of interest to this website where people were able to login, submit their ideas and then have a dialogue about what should be done to improve health I.T.

And over the course of the project, which was really open for one week, a very focused dialogue. They collected -- I think they had something like 4,000 people come to the website, check it out. I think 400 of those logged in, submitted something like 200 ideas and more than 500 comments on those ideas.

And so they packaged the results of it, the report that they then handed over to the incoming president.

And I think it's just sort of one example how the web can be used as to have an open dialogue where you don't have to have people come in to one place, obviously, to have a face-to-face meeting and -- and talk about these issues and come up with ideas, but a way to brainstorm online and -- and have a dialogue about what can be done.

The next thing that I want to talk about quickly is our prediction markets. Has any of you heard of prediction markets before? OK, there's just two or three.

It's a model that has been made popular by James Surowiecki in his book, "The Wisdom of Crowds," as a way to actually -- or what he finds is that it's -- typically if you want to sort of find out what the outcomes of future events are, it's not a good idea to ask a couple of experts to come together, sit at one table, and sort of come to consensus what that future might look like.

What he found was more -- was more effective is to actually have a large group of people from all kinds of different backgrounds, with all kinds of different sources of information, come to a market and actually bid or bet on those outcomes.

And without them actually talking to each other, you'll get a better picture of what that -- what those outcomes might look like. And it's a lot easier to sort of aggregate information that way and make sense of that then if you actually have to talk them up, where you use sort of a hierarchical structure to have sort of ideas -- those ideas sort of simmer up and then be condensed at the top.

And so this, the Iowa Electronic Health Market is actually an example that the University of Iowa is putting together where they bring together a large group of different experts in the field and practitioners and give them fake money and -- and they bet on questions like, how many cases of dengue fever will be recorded in the 50 United States in 2011?

As you can see, I mean, it's a little covered up, but you'll get a sense of what that might be. And ultimately, you can do it. There's examples where this works with real money or there's examples with fake money where it's actually about reputation.

That's a great way to get a lot of experts in one place and actually give it their best shot and get a picture of what -- what those outcomes might look like, using a prediction market like this.

Another thing are online communities and we've already done this hands-up exercise so I'm not gonna repeat it again. I'm also gonna be very brief because there's gonna be great speakers later on in the next session that are gonna talk a lot more about this.

All I want to say is there's all kinds of different forms of online communities, obviously, the big ones like Facebook and Twitter. There are very -- there's, like, the open ones and there's closed ones that are used for communities of practice that we're gonna hear a little bit more -- closed ones that are -- that are practitioner networks.

And also there's forms of online communities that are used for focus groups where you don't bring people into one room for a focus group but have an online focus group. And I will leave it at that.

Another example I want to talk to real quick is m-health, or mobile health, where cell phones play a role in.

And that this is becoming increasingly popular in Africa where a lot of communities and -- and regions are not connected to the Internet.

And researchers and local health practitioners have a hard time aggregating information and getting to know what's going on in the community so they're using simple cell phone technology like text messaging.

And how many of you have used text messages before? I'm sure that a lot of you are, everybody who has voted on the next American Idol, I'm sure.

(LAUGHTER)

And so...

(UNKNOWN): (inaudible)

(LAUGHTER)

HALLER: That's not a good idea.

But the -- the basic idea is, and there's a whole community called MobileActive that are -- that shares these resources. There are a lot of initiatives and -- and technologies, that really focus on using very simple cell phone technology to have to drive health -- community health initiatives in -- in third world countries.

And use it, for example, to help patients stay on their treatment plans by sending a reminder via text messages and things like that.

And lastly, I want to just quickly talk about virtual worlds. They have often been over-hyped and then sort of gotten -- got -- forgot -- been -- been forgotten.

And who of you has accessed the virtual world before? Anybody? Well, one.

It's a little bit out there but I think there's really good use cases. One that I find -- found interesting while researching this is that there's actually major incident simulations where virtual worlds provide learning opportunities that you typically can't get in the real world and that you hope you will never have.

So this is one example, sort of my background is in urban planning, is there's actually great ways to use this to let people explore sort of what new built environments will look like and -- and explore different scenarios.

And what is really effective about this is that it can be used to do role-playing, really get your stakeholders to step in somebody else's shoes for a, maybe an hour or something like that and look at the world around them from their foot -- from their perspective.

And that, in -- in the next step, could inform their decision-making or could help them think about, or participate in a process like having just a couple of different perspectives on a topic.

And so I want to use the next couple of minutes just to talk a little bit about considerations, I think, when choosing sort of a process and platform to do this.

Oftentimes, the first thing that we think about is technologies. Like somebody told me about, we have to engage citizens on -- on Facebook.

And it's, like, wait a second, obviously that's the first thing to come -- that comes to mind but really a lot of other things have to be in place to get to this point of choosing the right technology because the technology, at the end of the day, will not make or break your project. I've seen horrible, or great processes run on horrible software.

And I think what I really like is this simple POST Method, Charlene Li and Josh Bernoff put out in their book, "Groundswell," which I can highly recommend.

The POST Method suggests you should look at the people that you're trying to reach out to and -- and interact with first. Where are they? Are they already communicating somewhere online? What are their habits for the -- using
communication tools? What are their incentives to get involved online or their capacities?

The next thing is -- and I think typically that's something that we have in place, what are the objectives? What are the outcomes we want to get from this process?

And then before you dive into technology, think about the different strategies that are involved, like to get these people involved and to get them excited about your project.

And I think, more often than not, when I look at field projects online, it's that the strategy piece hasn't been figured out and that too soon those decisions made about the technology that was used.

And so what I want to do just quickly is to just talk -- touch on a couple of different examples of what those strategy pieces are that -- and this by no means is an -- a full list, these are just some highlights to sharpen your senses as you go throughout the day.

Ask these people, all these great people, like, that run these processes, what makes it successful? What makes or breaks a process?

And so one obvious one is duration. There's a project that might just be one day but if you have a one-day process, you really need to have the outreach right. And obviously, you would lose some of the capacity to get people to talk back and forth and to have an ongoing discussion.

And then, obviously, if you have sort of some -- some sweet spots for temporary projects -- are like a week to three weeks where there's enough time for dialogue back and forth but also sense that this closes and comes to an end at some point.

And some of the -- where -- where we've seen problems is if you go, like, beyond four weeks on a temporary process, people start procrastinating. It's like, OK, I don't have to participate in this today. I can do this two weeks from now. And if you -- like, people forget. We all forget.

So -- and I highly encourage you never to use an open-ended structure unless there's some sort of online community building involved because otherwise there's no sense of urgency. There's no sense of this is any, in any way useful for me to invest my time in participating in this so I'll move on and -- and not even worry about it.

Another thing is figuring out pre-registration. I'm sure that whatever you're doing there's gonna be a -- a marketing component to that. But if your platform's not open at that time, you ought to make sure there's a sign-up form where people can actually put their name and email address in.

So by the time, the day that your dialogue or whatever it is opens, you can reach out and say, hey, come back. We're open for business now because otherwise people forget again. Nobody puts, or barely anybody, will put that on their calendar, make sure they come back the -- the day that you're open.

So having good mechanisms for outreach is really important.

Another one is seeding a conversation. When we come together in -- in face-to-face meetings, we have a facilitator who draws upon people and make sure that they introduce themselves, et cetera, and there's a feeling that we -- we can talk now.

Online that doesn't happen. If you come to an online platform where there's a forum or some, like some of the earlier examples that I gave, if there's nothing there nobody wants to be first. There's no -- people don't know what the expectations are.

Shall I write a long article? Shall I write two sentences? What is sort of the tone of the discussion? Is this sort of a YouTube discussion where everybody yells at each other or is, are we polite?

So to make sure you, like, reach out to some people that you -- you have or that you can draw on to just, to make some good content early on so that somebody else who comes later already knows what the sort of dialogue is before. And so do that before the doors officially open.

And then, what are we rating? You don't want to have a conversation where people share their experience about sort of their own struggling -- struggling with cancer and then have other people rate that.

What does a five star rating mean on a cancer story or something like that?

Similar to that, if you have these sort of popular platforms for ideation oftentimes come with ratings so if you open a -- a dialogue on one of those sort of off-the-shelf platforms, typically they show you the highest rated ideas first.

The problem is that if a good idea comes on the first day, everybody rates it up, it's gonna sit on the top of -- that everybody sees from the beginning.

Somebody else who might come with a brilliant idea on one of the later days might sort of get on the bottom of the list and nobody scrolls through a hundred ideas so their idea never has a chance.

So make sure, like, when you select software to think about some of these things, how you want to structure the process and maybe show some random ideas first or there are other mechanisms. But again, this is just sort of -- just something to sharpen your senses to what (inaudible).

And last, this sort of onion model of -- of online participation or online communities. Clay Shirky made that sort of a popular model for understanding online communities.

And I think the -- the interesting thing here is when you think about your audience, 90 percent of your audience is sort of the outer layer, are people that come to find information. They find information. They go. They're not gonna be there to, like, to participate, to contribute.

Nine percent are sort of infrequent contributors, typically. They come. They have some sort -- maybe a temporary sickness or something. They -- they're engaged for two weeks until they're sort of done with that and then they're gone.

And then there's really only 1 percent that are -- that makes the heart of your community or the heart of your dialogue and those are the people that are your champions, that keep the conversation going, that welcome other people, that make it a success.

So keep that in mind, that you really have to find one -- it -- it -- it's important early on to focus on finding that 1 percent and to finding a couple of people to drive the conversation and then keeping them engaged and patting them on their shoulder and -- and making sure they stay because that's really sort of what ultimately...those are the people that make your community or your effort a success.

END