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From E.T.Net and nrsing-l to Facebook and Twitter:
nurses' changing use of global online communications for
improving healthcare

Peter J. Murray, W. Scott Erdley




     Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Peter J Murray PhD MSc RN CertEd, FBCS CITP

CEO, International Medical Informatics Association (IMIA)


W Scott Erdley DNS RN

Special Projects Simulation Educational Specialist,
Behling Simulation Center,
University at Buffalo Academic Health Sciences Center


                     Disclaimer: views expressed are generally personal; and
                      should not be taken to be any official IMIA view or policy

  Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Content outline/format

Presentation and discussion on following key areas
and others from participant interest/experience:


  Looking back – it was 20 years ago today

  The 1990s – from text, Telnet and green screens,
to the rise of the Web

  The 2000s – from Web 1.0 to Web 2.0 and beyond

  Looking forward – what do being 'always on' and
  'always online' mean for interaction?

 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
My aim is to agitate
                  and disturb people.

                I’m not selling bread,
                   I’m selling yeast.

         Miguel de Unamuno, writer and philosopher (1864-1936)




Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
The early 1990s




 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
The early 1990s

Listservs:
- launched 1991 - Nrsing-l, the first listserv solely devoted
to nursing informatics

- others, eg NURSENET, NURSE-UK

Mainly email-based interactions


The (very) early Web - the limitations of slow, text-based
browsing

Example: Virtual Nursing College (Jack Yensen, Canada),
1993
 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Nrsing-l

- the first listserv solely devoted to nursing informatics
- the first nursing listserv (with global membership)

- launched in 1991
- mid to late 1990's had >1500 members


- topics covered wide range of nursing IT issues from
training to systems support




 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Nrsing-l

- founded by Gordon Larrivee


                      (Photo from NI94 – in Linda Goodwin's NI history at
     http://www.duke.edu/~goodw010/SAVE_HxFiles/NI-Hx/NIhistory.html)


- Scott Erdley took over late 1990s
- hosted via AMIA NIWG from 1999

- list retired in early 2012 due to low levels of use

- archives available for research via
scott.erdley@gmail.com
 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
The early 1990s




Tim Berners-Lee at his desk at CERN in 1994. On Aug. 6, 1991, the
physicist and engineer invited participants in a Usenet discussion group to
access the first-ever publicly accessible Web server hosted by his
employer, the CERN research center in Geneva.

The day marked the beginning of the World Wide Web as we know it today.

  Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Early browser screenshot - © Board of Trustees of the University of Illinois
http://www.computerhistory.org/revolution/the-web/20/388/2129

  Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
What if the technology had not changed?




 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
The mid to late 1990s


Growth of World Wide Web

Commercial Internet Service Providers

Access increasing outside academic settings

Nursing moves onto the Web, but continuation of
listserv discussions and other newer forums




 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
My interest in nurses’ use of CMC
(computer-mediated communications)
MSc research 1993-95 (discourse analysis of NURSENET
list; what was said, how, why, by whom)

PhD research 1995-2001 (reflection on practice in informal
list discussions)


Evidence of some interactions, discussions around and
reflection on practice issues.

Many lurkers/readers, few frequent and consistent active
contributors to discussions.


 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
My interest in nurses’ use of CMC
(computer-mediated communications)

Moved more to use/development of online communities of
practice and virtual interaction around conferences (eg via
blogs)

What more/different could be offered?

Collaborative models of blogging (international group) and
readership – virtual participation in events.

Latterly, more use of Twitter than blogs (many archived).



 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Into the 2000s – the growth of interaction(?)

Blog (weblog) - emergence and growth of blogs in the
late 1990s coincided with the advent of web-based
publishing tools that facilitated the posting of content
by non-technical users
- term coined late 1997 – widely used from around
2002/03.

Web 2.0 – coined late 2004
Twitter – launched July 2006
Facebook – launched 2004
LinkedIn – launched 2003


 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Where are we today?


Social media growth

Smartphones and tablet devices

The move to mobile

A golden age of communication and interaction – or
not?




 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Claims for social media and Web 2.0:
Applications will provide benefit to the international health,
biomedical and nursing informatics communities

- will allow users to interact with a dynamic, multimedia, and
engaging Web platform

- will foster interaction, communities, etc.

- will change the way we work

- will change healthcare, medicine,
nursing, informatics, etc.


   Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
The 1% Rule

The 1% rule - if you get a group of 100 people online
then one will create content, 10 will "interact" with it
(commenting or offering improvements) and the other
89 will just view it.


How much is REALLY interaction via social media, as
opposed to continuing to broadcast/consume?

- is this a real problem/dichotomy?



 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
http://www.ihealthbeat.org/data-points/2012/
what-social-media-websites-are-health-care-providers-using-for-professional-networking.aspx

 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Which do you use? - and why?



There are multiple/duplicate channels


Often many used for same purposes - eg reposting
from Twitter to Facebook or vice versa




 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Observations over the years (from Scott)

A few thoughts:

- Initial communication was either receive (aka 'listserv') or go
get (BBS)

Listserv - user passivity
BBS - user active

Now: social media
    Twitter, FB, de.li.ci.ous, etc.
       User activity req'd to make work
       Frequent lurkers as well (aka 'passivity')

Not much has changed - just the tools

 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
The challenge is not only to anticipate
      the future, but to create it



                  Motto of Institute for Alternative Futures




Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
http://thecourse.webicina.com
Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
Please feel free to follow up with us

                      peterjmurray@gmail.com

                               @peterjmurray


                       scott.erdley@gmail.com

                                @scotterdley

                   Final version of presentation:

           www.slideshare.net/drpeter/rutgers30

Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference

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Murray Rutgers30

  • 1. From E.T.Net and nrsing-l to Facebook and Twitter: nurses' changing use of global online communications for improving healthcare Peter J. Murray, W. Scott Erdley Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 2. Peter J Murray PhD MSc RN CertEd, FBCS CITP CEO, International Medical Informatics Association (IMIA) W Scott Erdley DNS RN Special Projects Simulation Educational Specialist, Behling Simulation Center, University at Buffalo Academic Health Sciences Center Disclaimer: views expressed are generally personal; and should not be taken to be any official IMIA view or policy Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
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  • 4. Content outline/format Presentation and discussion on following key areas and others from participant interest/experience: Looking back – it was 20 years ago today The 1990s – from text, Telnet and green screens, to the rise of the Web The 2000s – from Web 1.0 to Web 2.0 and beyond Looking forward – what do being 'always on' and 'always online' mean for interaction? Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 5. My aim is to agitate and disturb people. I’m not selling bread, I’m selling yeast. Miguel de Unamuno, writer and philosopher (1864-1936) Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 6. The early 1990s Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 7. The early 1990s Listservs: - launched 1991 - Nrsing-l, the first listserv solely devoted to nursing informatics - others, eg NURSENET, NURSE-UK Mainly email-based interactions The (very) early Web - the limitations of slow, text-based browsing Example: Virtual Nursing College (Jack Yensen, Canada), 1993 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 8. Nrsing-l - the first listserv solely devoted to nursing informatics - the first nursing listserv (with global membership) - launched in 1991 - mid to late 1990's had >1500 members - topics covered wide range of nursing IT issues from training to systems support Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 9. Nrsing-l - founded by Gordon Larrivee (Photo from NI94 – in Linda Goodwin's NI history at http://www.duke.edu/~goodw010/SAVE_HxFiles/NI-Hx/NIhistory.html) - Scott Erdley took over late 1990s - hosted via AMIA NIWG from 1999 - list retired in early 2012 due to low levels of use - archives available for research via scott.erdley@gmail.com Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 10. The early 1990s Tim Berners-Lee at his desk at CERN in 1994. On Aug. 6, 1991, the physicist and engineer invited participants in a Usenet discussion group to access the first-ever publicly accessible Web server hosted by his employer, the CERN research center in Geneva. The day marked the beginning of the World Wide Web as we know it today. Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 11. Early browser screenshot - © Board of Trustees of the University of Illinois http://www.computerhistory.org/revolution/the-web/20/388/2129 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 12. What if the technology had not changed? Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 13. The mid to late 1990s Growth of World Wide Web Commercial Internet Service Providers Access increasing outside academic settings Nursing moves onto the Web, but continuation of listserv discussions and other newer forums Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 14. My interest in nurses’ use of CMC (computer-mediated communications) MSc research 1993-95 (discourse analysis of NURSENET list; what was said, how, why, by whom) PhD research 1995-2001 (reflection on practice in informal list discussions) Evidence of some interactions, discussions around and reflection on practice issues. Many lurkers/readers, few frequent and consistent active contributors to discussions. Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 15. My interest in nurses’ use of CMC (computer-mediated communications) Moved more to use/development of online communities of practice and virtual interaction around conferences (eg via blogs) What more/different could be offered? Collaborative models of blogging (international group) and readership – virtual participation in events. Latterly, more use of Twitter than blogs (many archived). Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
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  • 18. Into the 2000s – the growth of interaction(?) Blog (weblog) - emergence and growth of blogs in the late 1990s coincided with the advent of web-based publishing tools that facilitated the posting of content by non-technical users - term coined late 1997 – widely used from around 2002/03. Web 2.0 – coined late 2004 Twitter – launched July 2006 Facebook – launched 2004 LinkedIn – launched 2003 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 19. Where are we today? Social media growth Smartphones and tablet devices The move to mobile A golden age of communication and interaction – or not? Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 20. Claims for social media and Web 2.0: Applications will provide benefit to the international health, biomedical and nursing informatics communities - will allow users to interact with a dynamic, multimedia, and engaging Web platform - will foster interaction, communities, etc. - will change the way we work - will change healthcare, medicine, nursing, informatics, etc. Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
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  • 23. The 1% Rule The 1% rule - if you get a group of 100 people online then one will create content, 10 will "interact" with it (commenting or offering improvements) and the other 89 will just view it. How much is REALLY interaction via social media, as opposed to continuing to broadcast/consume? - is this a real problem/dichotomy? Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 25. Which do you use? - and why? There are multiple/duplicate channels Often many used for same purposes - eg reposting from Twitter to Facebook or vice versa Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 26. Observations over the years (from Scott) A few thoughts: - Initial communication was either receive (aka 'listserv') or go get (BBS) Listserv - user passivity BBS - user active Now: social media Twitter, FB, de.li.ci.ous, etc. User activity req'd to make work Frequent lurkers as well (aka 'passivity') Not much has changed - just the tools Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 27. The challenge is not only to anticipate the future, but to create it Motto of Institute for Alternative Futures Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
  • 28. http://thecourse.webicina.com Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference
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  • 31. Please feel free to follow up with us peterjmurray@gmail.com @peterjmurray scott.erdley@gmail.com @scotterdley Final version of presentation: www.slideshare.net/drpeter/rutgers30 Rutgers College of Nursing - 30th Annual International Interprofessional Technology Conference