This was the title of my latest article for the 26th January edition of the Irish Medical Times. You can read the full piece here (available for the next week on the IMT site).

It is one of a series of articles on Web2.0 which will suggest ways in which these developments might impact on General Practice.

Update: The full article can now be read below.

There is a frenzy working itself out in Silicon Valley that reminds a lot of people of what was happening before the dot com crash in 2000. Lots of parties with geeks; venture capital funding for barely-starting-to-shave teenagers; and optimism in bucket loads.

The reason for this is Web 2.0 – the reincarnation of the web as a place where people contribute content and don’t just read it; where they look to replace traditional desktop applications, like mail, spreadsheets and word processing, with web-based versions; and where information is shared among users and applications using simple data exchange standards.

So is Web 2.0 built on cutting-edge technologies that have emerged from the latest research from the likes of Google, Microsoft and Yahoo? Hardly. In fact, most of the workings under the bonnet are ones that have existed for a decade or so. The concept of re-invention is one that is much loved by the technology industry. Take RSS, or Real Site Syndication. This was a data communication standard initially used by a browser company called Netscape over a decade ago, and based on the syntax of XML.

Around this period, I gave a presentation at the annual conference of the Healthcare Informatics Society of Ireland, outlining how information could be “pushed” to the desktop. Little did I know at the time that it would take this long for these concepts to mature and to be put to use. Specifically, RSS – the ability to receive updates from a website without actually re-visiting the site – has only now been incorporated into the latest version of Internet Explorer, making it much easier for ordinary users.

No installing software

As broadband has finally become the default way to connect to the web, it has allowed companies to develop applications that live within the browser. Back in the late 1990s, Sun Microsystems championed the concept of a diskless computer under the slogan ‘The network is the computer’. While we are still waiting for a cheap, usable version of this device, the applications that could be used with it are beginning to roll out.

Some older examples of these types of applications, like Hotmail and Eircom email accounts, have been around for years. All we need to access these is a browser and an Internet connection.

Predecessors

These web-based email services are the predecessors of other applications that can now be used with similar low constraints. In the business world, a company called SalesForce.com has pioneered this type of software with customers paying a monthly charge. In a similar fashion, HealthLink makes patient results and other information available online or to download into their practice management systems – same concept, different information.

Over the past 12 months a slew of online services have been launched, including calendars, word processors and spreadsheets. Some are free (many of these services have been developed by small start-up companies that have in turn been purchased by Google), while others offer different levels of service for a monthly fee – typically these fees range from €5 to €15 per month.

General practice

So how might some of these Web 2.0 ideas be applicable in general practice? Ease of access to patient information in a secure and confidential manner is appealing for all staff working in a typical general practice environment. The fact that this information might be from a hospital, laboratory or even another practice becomes less of an issue when it is used to improve patient care.

The idea of sensitive patient information residing on a server belonging to a Microsoft or a Google can not be contemplated, but there will probably be services offering to host applications and back-up data in a safe and secure hosted facility.

We will also probably see more use of services that allow a bulky PowerPoint presentation, for example, to be uploaded to an online location, rather than attaching it in an email. Or what about uploading digital photographs to a service that provides prints by post, rather than using our own expensive ink cartridges or photo booths in the local pharmacy?

The first decade of the internet has shown us that the evolution of core technologies — rather than any radical new discoveries or inventions – are at the heart of Web 2.0. The first decade has been on all-fours, but now it’s time to walk.