Everyone who has followed this site knows that I have always been a staunch supporter of free speech. The culmination of the efforts to promote openness in healthcare was compilation of HealthTrain Manifesto almost 2 years ago.

A lot happened since then. We had many chances to see how such principles play out in the real world, what works and what does not. Unfortunately, sometimes free speech can go too far. The need for common-sense limitations was probably best put by Supreme Court Justice Oliver Wendell Holmes known for saying "The right to swing my fist ends where the other man's nose begins".

What were the specific events that prompted some re-thinking?

Today's New York Times has an interesting article, entitled: "Delaying News in the Era of the Internet ". They look into how the news of Tim Russert's death has spread on the Internet ahead of official release.

What I found intriguing are the comparisons of NBC with the King Canute the Great, who according to legend "tried to hold back the tide" almost a thousand years ago. Nowadays technology is the tide. Or is it always?

So let us look into what makes a tide and what does not

I rarely do product reviews, but when J. Craig Williams of May It Please the Court blog fame, sent me his book I was intrigued. The title "How to Get Sued"appealed to my humorous side and begged for further investigation. How is this related to healthcare? In Craig's own words:

Since laughter is the best medicine, the whole book is health-related - but seriously, there are a few health-related stories in it that you will find of interest.

In my view the book is important since it sheds the light on the culture of litigation so integral to American society. Pretty much anything in life can lead to a lawsuit. Most people who work in healthcare could fully appreciate these issues.

So what are the most interesting points in the book?

The rise and impact of physician rating service has been a hot topic lately. In traditional media, blogosphere at large and this blog specifically.

Last year I wrote about an organization calling itself "Medical Justice". Their stated mission of "protecting physicians against frivolous lawsuits" is admirable. Unfortunately the ideas and methods are bound to sow distrust and undermine doctor patient relationship.

Anyways they are still making news, but there is a new twist:

Reputation and branding are critical to every company that wants to sustain and grow business. However, how do you tell a successful brand from a tarnished one?

Traditionally PR professionals have run surveys, tracked press mentions and deployed similar measurement techniques. The problem with these approaches is difficulty in brand-by-brand comparison and bias introduced by question design.

Enter Brand Tags "collective brand perception experiment"

Last week Google has finally proved its seriousness about healthcare by opening Google Health release to general public. I am not going to rehash the flurry of (mostly un-informed) coverage and instead offer a few observations.

After a thorough look, I have to say Google exceeded my expectations. In my view the service is far from taking the world of healthcare by storm. But unlike most everyone else, Google certainly has resources to carry on and they will probably keep on their "long hard slog" to dominate healthcare. They surely demonstrated their motivation to be a force for years to come.

So what kind of force are they really going to be?

Earlier I have written on why PHR vendors are missing the boat on privacy and why disruptive innovation in regulated industries is so hard.

A few weeks later we have a powerful demonstration of both points, as Wired for Health Care Quality Act is undergoing the latest round of revisions in U.S. Senate. The summary and recent history of the bill (reported in iHealthBeat) shows than when in doubt politicians will listen to privacy watchdogs.

To rephrase and explain the substance and politics of key points:

Two months ago I wrote about joining a new Community Advisory Board of El Camino Hospital. Today I am happy to announce a first project produced by this body: a community forum on healthcare reform.

Califoria's legislative primary is coming up on June 3 and our Assembly District 22 is having a competitive primary (for presumed Democratic safe seat). The hospital is co-sponsoring "Ask-a-Candidate" forum. If you in the area consider attending in person or submiting your questions in comments.

What kind of questions will be debated?

A perennial challenge in technology markets is correctly guessing the timing of mass adoption. Big successes require being neither too late, when everything is locked up, nor too early, when the market is not ready to adopt innovation.

The more hard data I see on the state of online health innovation the more doubt I have about the chances of significant transformation happening in the near-term. Plenty of factors contribute to this conclusion. I wrote about the challenges with privacy and tepid user adoption. But there are bigger legal challenges.

What do companies like 23andme have in common with Napster?