Collaborative online communities have developed a variety of products and services often relying on voluntary labor well known examples include a computer operating system, a web browser, an online encyclopedia, and even the design of t-shirts. Yochai Benkler wrote in The Penguin and the Leviathan, "once you open the possibility that people are not only using the web as a platform … but to pool their efforts, knowledge, and resources … the possibilities for what they can create are astounding." Taking a cue from Benkler, our aim was to create a learning resource that radically improves the treatment and management of a chronic disease in children by making it possible for a geographically dispersed community of clinicians, scientists, patients, and parents to pool their knowledge and learn from each other. We will share what we have learned about the high tech of the building a web space, as well as, our approach to design relying on personas and scenarios, organizing learning resources through taxonomy and folksonomy, and engaging the community through co-design. While this social learning intervention is directed toward a medical need, the principles of this approach are applicable in any organization that wishes to capitalize on the web as a platform to enable the creation of user-generated content and to create a community that learns by sharing what they know.

1. LEARNING RESOURCES AND T-SHIRTS?
CREATING A WEB-BASED LEARNING EXCHANGE
David Davis, MFA,
Education Technology Consultant
Learning & Development
Cincinnati Children’s Hospital Medical Center
Daniel McLinden, EdD
Senior Director, Learning & Development,
Cincinnati Children’s Hospital Medical Center
Associate Professor, Department of Pediatrics
University of Cincinnati College of Medicine
TechKnowledge 2015
Session FR203
Friday, January 16 @ 9:30 AM - 10:45 AM
Roman IV

2. The Improve Care Now Exchange

3. “Once you open the possibility that people
are not only using the web as a platform to
produce their own individual content, but
also to pool their efforts, knowledge, and
resources … the possibilities for what they
can create are astounding.”*
* Benkler, Y. (2011). The Penguin and the
Leviathan: The triumph of cooperation
over self-interest. New York: Crown
Business.

4. `
When are learning resources like a t-shirt?

5. We are not the only ones to think this way, for example…

6. Benkler, Y. (2006). The wealth of networks: How social production transforms markets
and freedom. New Haven, CT. Yale University Press.
Benkler, Y. (2011). The penguin and the leviathan: How cooperation triumphs over self-
interest. New York. Crown Publishing.
Howe, J. (2008) Crowdsourcing: Why the Power of the Crowd is Driving the Future of
Business, Crown, New York.
Page, S. E. (2007) The Difference: How the Power of Diversity Creates Better Groups,
Firms, Schools, and Societies, Princeton University Press, Princeton, NJ.
Surowiecki, J. (2004) The Wisdom of Crowds: Why the Many are Smarter than the Few
and How Collective Wisdom Shapes Business, Economies, Societies, and
Nations, Doubleday, New York.
Tapscott, D., & Williams, A. D. (2006). Wikinomics: How mass collaboration changes
everything. London: Penguin Books.
Von Hippel, E. (2005). Democratizing innovation. Cambridge, MA. MIT Press.
Wenger, E., White, N., & Smith, J. D. (2009). Digital habitats: Stewarding technology for
communities. Portland, OR: CPsquare.
Evidence exists, for example…

7. • Source: http://c3nproject.org
• Hommel, KA; Denson, LA; Crandall, WV; & Mackner, LM (2008). Behavioral Functioning and
Treatment Adherence in Pediatric Inflammatory Bowel Disease; Review and recommendations for
practice. Gastroenterology & Hepatology, 4(11), 785-791.
• Mangione-Smith R, DeCristofaro AH, Setodji CM, Keesey J, Klein DJ, Adams JL, Schuster MA, McGlynn
EA. (2007). The quality of ambulatory care delivered to children in the United States. The New
England Journal Of Medicine, 357(15), 1515-1523.
• McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, & Kerr EA (2003). The quality of
health care delivered to adults in the United States. The New England Journal of Medicine, 348(26),
2635-2645.
Patients are getting 50% of the
recommended treatment and
only adhere to the treatment
50% of the time - the chance
for good outcomes is 25%.*

8. The Innovation Lab
www.C3Nproject.org
@C3NProject

9. The context
Transform the health, care and costs for all children and adolescents
with Crohn’s disease and ulcerative colitis by building a sustainable
collaborative chronic care network, enabling patients, families,
clinicians and researchers to work together in a learning health care
system to accelerate innovation, discovery and the application of new
knowledge.
www.improvecarenow.org
@ImproveCareNow

10. Create a learning system that makes it possible
for a geographically dispersed community of
clinicians, scientists, patients, and parents to
pool their knowledge, learn from each other
and improve outcomes.
The Challenge…

11. The Idea
Aim: Create a learning resource that will radically
change for the better what people know about how to
implement an effective and reliable care delivery
system to treat and manage chronic disease beginning
with pediatric inflammatory bowel disease.
In other words: “We need a way to share
knowledge, tools, and know-how across
a dispersed community.”

12. What would that place be like?
• There needs to be a place to
exchange tools, processes,
stories and learn from each
other.
• There needs to be a place to
collaborate and co-create new
knowledge.
Beliefs

13. ImproveCareNow Exchange
www.icnexchange.org
Follow: @icnexchange

14. Design
Cooper, A. (2004). The inmates are running the asylum: Why High-Tech Products
Drive Us Crazy and Ho to Restore the Sanity. Indianapolis, IN: SAMS.
Pruitt, John & Adlin, Tamara. The Persona Lifecycle : Keeping People in Mind
Throughout Product Design. Morgan Kaufmann, 2006.

15. Rapid prototyping with a quality Improvement
approach
Planning Design an
intervention to improve one or
more key drivers of technology,
community engagement,
content management and
interaction.
Doing Iterative tests to
determine if we should scale.
Studying and acting on what
we learn.

16. Technology Design
* Gloor, P. (2005) Swarm Creativity: Competitive Advantage Through Collaborative Innovation Networks. Oxford:
Oxford University Press. (p. 121).
**Wenger, E. (2004). Knowledge management as a doughnut: Shaping your knowledge strategy through
communities of practice. Ivey Business Journal, 68(3), 1-8.
personal
community
high
high
small
Interactivity
Sharing
Connectivity
low
** Practice: “The body
of knowledge, methods,
tools, stories,
documents, which
members share and
develop together (p. 3).”

17. Technology Design
Success factors*
1. Establish swarm creativity and give up
central control
2. Nurture the critical roles of creator,
communicator, and collaborator
3. Establish distributed trust
4. Establish a common code of ethics
5. Establish a small-world structure of
high connectivity, interactivity, and
knowledge sharing
6. Set up a collaborative Web workspace
7. Know when to change the
organizational structure
Support Structure**
• A few explicit roles
• Resources for nurturing the community
• Technological infrastructure that enables
members to communicate regularly and
to accumulate documents.
17
*Gloor, P. (2005) Swarm Creativity: Competitive Advantage Through Collaborative Innovation Networks. Oxford: Oxford
University Press (pp. 182-183).
**Wenger, E. (2004). Knowledge management as a doughnut: Shaping your knowledge strategy through communities of
practice. Ivey Business Journal, 68(3), 1-8.

18. Text search
Care Center Tags
Quick browsing
Content Management
Taxonomy and folksonomy
Make it easy to search for what I need.
Make it easy to browse so I can see what is available.

19. Site
Design
Use
Impact
on
Practice
Impact
on
Patients
Is the ICN Exchange
used and is it useful?
Is the ICN Exchange
usable?
Are processes
changing?
Are changes making a
difference?
Evaluating quality and impact

20. Lessons from Our Approach
• 90-day goals kept us moving.
• Predictions were key—what impact would
our changes have?
• A relentless focus on data to understand
who is using, what is being used, and how it
is valued.
• Learning from failure: Not everything has
“taken off.” We step back, we reflect, and
we adapt.

21. Resources
• Quality Improvement
– Langley, G.J., Nolan, K.M., Nolan, T.W., Norman, C.L. & Provost, L.P. (1996). The Improvement Guide: A Practical Approach to
Enhancing Organizational Performance. San Francisco, CA: Jossey-Bass.
– Moen, R.D., Nolan, T.W., & Provost, L.P. (1999). Quality Improvement through Planned Experimentation. New York, NY: McGraw-
Hill.
• Interaction Design
– Cooper, A. (2004). The inmates are running the asylum: Why High-Tech Products Drive Us Crazy and How to Restore the Sanity.
Indianapolis, IN: SAMS.
– Pruitt, John & Adlin, Tamara. The Persona Lifecycle : Keeping People in Mind Throughout Product Design. Morgan Kaufmann,
2006.
• Crowdsourcing, open innovation, etc.
– Benkler, Y. (2006). The wealth of networks: How social production transforms markets and freedom. New Haven, CT. Yale
University Press.
– Benkler, Y. (2011). The penguin and the leviathan: How cooperation triumphs over self-interest. New York. Crown Publishing.
– Von Hippel, E. (2005). Democratizing innovation. Cambridge, MA. MIT Press.
• Community Engagement
– Ganz, M. (2011). Public narrative, collective action, and power. In Accountability through Public Opinion: From inertia to public
action. (273-290). Odugbemi, S & Taeku, L (Eds.) Washington, D.C.: The World Bank.
– Gloor, P. (2005) Swarm Creativity: Competitive Advantage Through Collaborative Innovation Networks. Oxford: Oxford
University Press. (p. 121).
– Wenger, E. (2004). Knowledge management as a doughnut: Shaping your knowledge strategy through communities of practice.
Ivey Business Journal, 68(3), 1-8.
– Wenger, E., White, N., & Smith, J. D. (2009). Digital habitats: Stewarding technology for communities. Portland, OR: CPsquare.
FOLLOW: @icnexchange @C3NProject @ImproveCareNow

22. Daniel McLinden, Ed.D.
513 636 8933
daniel.mclinden@cchmc.org
@danmclinden
LEARNING RESOURCES
AND T-SHIRTS?
CREATING A WEB-BASED LEARNING
EXCHANGE
And with thanks and acknowledging the ICN Exchange team.
David Davis, MFA
513 803 0209
David.davis@cchmc.org
Cincinnati Children's Hospital Medical Center
3333 Burnet Avenue
Cincinnati, OH 45229-3039