Blogs and/or Peer Review, how will they co-exist?

Of late there has been discussion in the role of blogs in communication, both for relaying information, and stimulating action. Much of the discussion in my environment about this is generated by the fact that I am blogging most of what I am doing, and intentionally so (such is the life of a change agent/leader type).

On the micro level, it has been interesting and great to explain to the organizations and people that I meet that I am blogging what I see/do (with the exception of any personally identifiable information of patients). The reactions are varied, as one might expect and there isn’t really a lot of time to explain everything there is to about Web 2.0 because people are busy just doing what they do.

On a macro level, I have a prepared talk that I have given about blogs and their role in change management / communication. I think they have a huge one now and into the future, especially in a learning organization.

At the same time, I think about the value of peer review in describing what I’m doing. What is it?

When I look at the communication revolution that is happening with Web 2.0, I’m unsure that MEDLINE citations are the most important standard for creating portable knowledge in health care, especially in the areas I am working with, Informatics and process management and improvement (LEAN and Toyota Management System).

As it was pointed out to me last week by our advisors, the Medical Home movement came from a PDF on a Web site, and I would call that piece pretty transformative. A lot of the data I have used in patient centered health information technology has been very robustly compiled by the Pew Internet & American Life Project, also very transformative.

It is said that Google Juice is one of the most potent measures of the viability of ideas, because it incorporates a host of different signals to authors that their work is worthy of application across environments.

It is also telling that my sabbatical work has been funded with the understanding that it will be blogged from day 1, in the interest of rapid feedback and continual learning of the community I am interacting with.

It’s worth asking if a blog of an experience would violate the Ingelfinger Rule. In 1994, the New England Journal of Medicine said, “We plan to maintain both the Ingelfinger Rule and the embargo and to follow up on any apparent violations vigorously.”

I admit that one of the goals of this experience is to expand the role of blogging in communicating about quality improvement. I believe in it, and achieved what I consider significant success in the 2 years I’ve been doing it in an official capacity. It’s been pretty incredible, actually. Expanding the audience from a medical group to the world is going to provide great learning as I go. Plus I really enjoy it (can you tell?).

Comments and perspectives welcomed.

Ted Eytan, MD