This online environment facilitates the potential for physical goods to become more fluid and produsers in this context are not only involved in the produsage of knowledge about and reputations for physical goods, but also, through these produsage processes, provide advertising and marketing for these products (Bruns 2008, 393). For years we have been able to locate, rate, and review movies and restaurants. Now, sites such as Revolution Healthallow members to do just this within a health context as health products are turned into artefacts in the digital environment. Patients can rate and review certain drugs and treatment, which they have been prescribed,  for effectiveness and price and this communal evaluation also extends to doctors and hospitals. Revolution Health also features applications that allow members to keep track of their medical history in a digital format. You can list your allergies, medications, and previous doctor and hospital records all in the one place. Changing doctors or moving to a new location; creating emergency information sheets; or preparing health information for that next big holiday has never been easier.

 Bruns (2008, 378-9) argues that, “The technologies of produsage… highlight the fact that the industrial process is neither the natural nor necessarily the most productive or socially beneficial approach”. In considering the productive benefits of these produsage based e-health services it is important to consider Revolution Health’s business model. The site provides mostly free services and thus, makes money from products sold through the Revolution Health store and via on site advertising. Advertising and marketing content is often widely seen as untrustworthy in an era where multiple opinions and perspectives can be presented in the light of biases. By instead using recommendations and reviews provided by produsers for produsers a more objective evaluation can be made. While Revolution Health claims that these advertisements are not an endorsement for the featured products and services, the very existence of these ads within a social network that produsers align themselves with may influence their ratings and reviews of the advertised products. As previously discussed in my blog “…produsage almost always highlights the existence of open, participatory, collaborative, communally driven and determined, consensus-based models of development and decision making” (Bruns 2008, 388). 

The Economist argued a few years ago that it was essential that the healthcare industry make patient profiles more interoperable, “out of paper files and into electronic databases”, and through a less centralised healthcare approach “enable individuals, at last, to have access to, and possession of, information about their own health.” Web 2.0 technologies are finally ensuring the emergence of decentralised healthcare and, as John Sharp of eHealth highlighted in a recent presentation, health professionals should take note of the power of produsage because produser patients already have: right now produsers are using these tools to “write about, talk about, and rank [health professional’s] performance”.

Bruns, A. 2008. Blogs, Wikipedia, Second Life, And Beyond: From Production To Produsage. New York: Peter Lang.

Consequently, individuals can select for themselves the contributions they are the most qualified or able to make and these contributions are then evaluated by the online community. These communities are often comprised of a diverse population with varying perspectives and skills. As Benkler (2006) outlines in his book,  “the emergence of new media technologies, platforms, and practices results in a hybrid media ecology, where commercial, amateur, nonprofit, governmental, and educational media producers interact in ever more complex ways”. This ‘hybrid’ of amateur and professional content undoubtedly contributes to a more holistic and balanced collective intelligence. However, there have been suggestions, as featured in a  Newsweek article titled, “Revenge of the Experts” and Andrew Keen’s book, that amateur produced content has become more prevalent than professional contributions and consequently, professional content is regaining renewed favour. However, considering the relatively new emergence and establishment of amateur content, Wharton University argues that perceptions of an increase in professional content over amateur, or user-generated, content are “misplaced”.    

In any case amateur content is still flourishing within health applications on the internet. One such example is cancerfacts.com, a web site that encourages patients to become more involved in e-health services. The site combines accurate, personalised information and current research contributed by clinical specialists, doctors and leading medical journals, with personal stories from patients. This hybrid of professional and amateur content ultimately comprises a wider information, and thus knowledge, base for produsers to make informed treatment decisions and access support networks. As Bruns (2009) indicates in his blog, these hybrids have evolved in response to “increasing health service costs, an increase in chronic diseases, the perceived need for more participation of patients, and the opportunities offered by e-health systems”.   Amateur content provides namely a more personal viewpoint and in-depth knowledge of daily life with cancer; whereas, professional contributions present analysis and a consistent, reliable quality. Both forms of content are indeed valuable and have the equal potential to enhance the collective intelligence of online communities. As Bruns (2008, 215) concludes, “…experts and their expertise cover no more than the tips of the iceberg of human knowledge”. I believe the best prognosis for the future of online health services is indeed a healthy dose of both amateur and professional content: the establishment of a pro-am hybrid, which values the contributions of all and maintains a relevance and reliability of contributions through communal evaluation.

Bruns, A. 2008. Blogs, Wikipedia, Second Life, And Beyond: From Production To Produsage. New York: Peter Lang.

The once static web has evolved into the “read-write Web” offering new opportunities for online interaction, collaboration, and learning particularly through the use of wikis (West and West 2009, 1). Wikis provide a common environment where produsers can actively participate in the co-creation of information and knowledge, and the collation of collective intelligence. This co-creation of knowledge evolves in the shared space as produsers write, discuss, evaluate, edit, and reflect with the ultimate goal of completing a common project and developing sources of information. A dynamic community is established and fostered through ad hoc structures and a multitude of interlinkages between various pieces of information (Bruns 2005, 102). Consequently, all produsers are equally able to make valuable contributions in a more fluid approach towards the community’s collective intelligence via a wiki.

In contrast to wikis, blogs like mine are generally posted by a single author and while I invite readers to post comments (please do) there is no specific design for multiple authors, group collaboration or edits to my posts. This blog is linear in design and comments left have to be approved; whereas, wikis are dynamic and allow participants to edit, change, or delete any content they desire with limited moderation.

An application of a wiki within the field of health is the UBC Health Library wiki. This wiki was developed with the intention of increasing the efficiency of health librarians as information retrieval experts in the digital age. With a wealth of knowledge to tap into, the use of a wiki was seen as the best way to share this expertise and expand the collective intelligence of those who access and contribute to the wiki on a global scale. As contributors have to register with the project leaders of the wiki before adding or altering content, the UBC Health Library wiki is evident of the element of structure that exists within wikis, while maintaining more fluid hierarchies through the ad hoc nature of produsage processes. An example of a wiki that encourages open participation, without any barriers to the sharing, accessing or editing of content is the Raw Living Wiki designed as a resource for anyone interested in the raw, vegan, organic live-food diet and lifestyle. The essence of wikis based on elements of produsage within the “read-write Web” are often considered controversial as anyone, anywhere, can edit the content of the wikis.

Traditionally, people have accessed and placed trust only in the contributions of accredited experts. Wiki projects can bring field experts, community leaders, practitioners and patients into the collaborative space. The contributions of experts can be supported, and often outperformed, by enthusiastic ‘amateurs’. Clearly, a Nutritionist could outline the benefits of a vegan diet, but the collective intelligence of the community is undoubtedly enhanced by incorporating the perspective of a vegan living the raw lifestyle day to day.

As wikis function as an information source and a platform for knowledge co-creation through open content, it is important that people are able “to distinguish the credible, authoritative voices of fully formed issue communities from the vague, uncertain voices haunting the as yet less developed areas” (Bruns 2005, 133). This is a particularly important issue when obtaining valuable and reliable health information within the professional – amateur hybrid that wikis, and indeed produsage itself, support.

Bruns, A. 2008. Blogs, Wikipedia, Second Life, And Beyond: From Production To Produsage. New York: Peter Lang.

West, J. and M. West. 2009. Using Wikis for Online Collaboration. USA: Jossey-Bass.

Gatewatching operates on the premise that individuals are capable of making judgments about useful, interesting and worthwhile content, without relying on the “somewhat patronising tone of industrial journalism” (Bruns 2005, 74). In saying this though many sites will still maintain an element of hierarchical approaches for management purposes. One such example is Streetcorner which encourages local readers to submit their own health related news, views or commentary, while still employing staff to contribute further news items; manage consumer enquiries; and moderate content.

Each site may employ a different approach to both Gatewatching and communal evaluation. For example, the New York Times health section Well has specific journalist and reader defined roles, with readers limited in their contributions with the ability to only submit comments. Well has maintained a fairly conventional approach to journalism while evolving to an on-line format, and seeks to sift through medical research and expert opinions to collate a practical, collective intelligence, whilst maintaining a degree of perceived authority and reliability. As Flew (2008, 145) affirms, “A division between the producers and users of news remains even if there is scope to comment on stories”. Well is very much a “mainstream” on-line news site; whereas, Streetcorne constitutes a step towards a much more “emergent, bottom up” form of news site (Flew 2008, 145).

The benefits of each of these methods of journalism can be argued. The New York Time’s approach to Well seeks to preserve their reputation as a reliable and quality news source by limiting ‘amateur’ contributions. In comparison, Streetcorner aims to tap into the collective intelligence of produsers, rather than mere consumers, and allow a greater capacity for local knowledge. All forms of citizen journalism comprise alternative and vital additions to the production and consumption of traditional, commercial journalism.

The development of further sites that encourage the contributions of everybody and anyone would undoubtedly be beneficial for the health industry. This generation of discussion and debate centered on a multitude of health issues, from all around the world, would result in a collective intelligence comprised of a diverse range of perspectives. Through the new eyes of the conventionally considered ‘amateurs’, health professionals (and possibly a range of professionals?) may discover the means to solving some of society’s most prevalent and harrowing issues through the processes of produsage and the implementation of citizen journalism.  

Bruns, A. 2008. Blogs, Wikipedia, Second Life, And Beyond: From Production To Produsage. New York: Peter Lang.

Flew, T. 2008. New Media: An Introduction. South Melbourne: Oxford University Press.

Consumers, or as Bruns (2005) terms them “produsers” because they are able to effectively contribute to the community’s knowledge or understanding of particular issue by expressing their viewpoint on particular topics of interest and generating a sense of collective intelligence. As Bruns (2005, 21) details, “Produsers engage not in a traditional form of content production but are instead involved in produsage – the collaborative and continuous building of and extending of existing content in pursuit of further improvement”. Thus, this process results in an unfinished artefact as users continually debate, evaluate and extend on the information provided.

One such example of an online community fostering the processes of produsage is the social action network Evolver , which provides a platform for individuals, communities, and organizations to discover and share new tools, initiatives, and ideas around a common interest or value, such as health, on a global scale.

Social networks and software such as that which forms the basis of Evolver exemplify the way in which these networks remove the barriers formed by aspects such as geography, background, financial status, and ultimately provide a mechanism for “widespread, equitable collaboration across large communities of users” (Bruns 2005, 3). The Food Evolution Group within Evolver is a specific example of a community, united by a shared interest and enthusiasm for health that aims to generate a collective intelligence around the focus of organic food and nutrition, especially within the global economic recession. This group fosters and employs the processes of produsage by encouraging evolvers to share “tips, links, articles, recipes, stories etc.” The group also maintains a focus on turning physical products into artefacts by featuring product reviews and sampling opportunities, and by valuing the opinions of other ‘produsers’ rather than the alternative, traditional methods of solely relying on marketing and advertisers, which are often considered critically.

Furthermore, this collective content creation also highlights the ability of produsage processes to provide an avenue for problem solving through a probabilistic approach. Consequently, Evolver members can work together as a community driven by common interests and concerns to create solutions to the designated issues. Each participating member will contribute either an expression of opinion in a comment or post; inspiring news; enlightening information; or simply share resources or swap services, within a topic they feel they can make a valuable contribution. These participations are taken beyond the level of simply interactivity and are translated into an element of intercreativity through non-hierarchical, many-to-many media (Bruns 2005, 16). By evaluating opinions or information and indeed extending on these shared resources of knowledge and interest through discussions, members of the Evolver community are no longer merely interacting with these information, opinions and news sources, instead they are harnessing the tools to create content themselves, and ultimately utilising to great effect the benefits of produsage.

For further information you may like to consult Axel Bruns’ book or visit his blog.

Bruns, A. 2008. Blogs, Wikipedia, Second Life, And Beyond: From Production To Produsage. New York: Peter Lang.