The entry When The Long Tail Wags The Dog on Dan Bricklin's Website takes a whole different view of "The Long Tail". Are there implications for health information technologies?
I assume everyone who has not been in a Trappist monastery for the last three years has heard of the Long Tail, a term that as far as I know originated with Chris Anderson's October 2004 article in Wired. Bricklin's When The Long Tail Wags The Dog essay explains what is going on in the Long Tail for a certain class of products and services, and though he doesn't mention it, healthcare fits his profile.
Word processors and spreadsheets are far more successful than programs that do a subset of their functions much better than the more general-purpose applications. they are so much more successful, says Bricklin, because people know they can do whatever task was the compelling reason to buy into the application, but they also know they can apply it to a much broader range of tasks. The need for any one of these other applications of the tool may be remote, but knowing the tool is capable of much more than the immediate need is a compelling reason to buy the more general product.
Bricklin cites a podcast interview he did with Donna Dubinsky, ex-CEO of Palm and Handspring, who told about market research Palm did regarding what were the uses to which people put their Palms. They discovered that many people acquired a Palm and loaded one particular application, almost always one that was not supplied "out of the box" by Palm - in our domain, ePocrates comes to mind, but Dubinsky cited an astronomy application as an example, a star finder. this is a classic "long tail" finding. But on digging deeper into the buyers' motivations, they found that more often than not the sale was made not by the application alone, but by the fact that users knew they could also make use of the things Palm's out-of-the-box applications could do for them. The killer app was important, but only when it was delivered in the context of a generally applicable platform.
The implication for healthcare IT, whether for clinical care or research: new technologies need to find a unique niche and provide compelling affordances to the end user, but they cannot stand alone. Delivery in the context of a more generally useful platform will make adoption more palatable and less fearful.
This suggests that my Nokia 770 will only be successful in the healthcare realm when a) a killer app for it becomes manifest, and b) when its rich out-of-the-box feature set becomes as usable as the built-in apps on the Palm and similar PDAs.
By the way, I'm still trying to set up a development environment for it, but work and school pressures are slowing things down. More news at 11... or maybe by the 11th. ;-)
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