A difficult problem to solve
Typical of the kind of knowledge problem that occurs in the environment of the Internet is exampled in this problem sent to me by Tillman Pearce the medical director of an oncology business unit for a large pharmaceutical company in France. He wrote:
I work in the pharmaceutical industry developing new cancer therapies. As such I am aware of current treatment options around the world and am aware that most patients around the world are never presented with all the options (this is as true in the US as elsewhere). I have therefore considered the possibility of developing a web-based service for informing patients (or doctors) of therapeutic options for specific patient/disease states.
Looking in the Internet, one finds a profusion of sites purporting to provide such services. All these services (ALL) provide standardized documentation on basic categories of disease. For example, look up colon cancer -- within a day or two of effort you can find about 30 sites providing info on colon cancer. They all state basically the same thing and 99% are based on what is currently approved in the United States.
The problem is, nobody has "generic" colon cancer. Rather, you are a male or female of a certain age; your performance status and liver, heart, kidney function are either excellent, good, poor, or other; your cancer has been partially or completely removed; the histology is either of good or bad prognosis; you have or have not received certain prior therapies (chemo and/or radiation).
Depending on these (and other) variables, specific therapies are considered highly recommended, possibly recommended or not recommended. Furthermore, you might be interested in knowing what treatments are offered not only in your country, but in other parts of the world (a drug I work with has been available in France since 1996 and for various reasons is not yet available in the US; I am aware of about 150 studies around the world with this agent -- the "gold standard" site, that of the US National Cancer Institute, lists about 15 studies).
A valuable service would necessarily CUSTOMIZE the recommendations to particular situations and provide comprehensive information. A major anomaly today is that most services are providing standardized products rather than harnessing the power of OOPS to provide customized products in real time and at mass production costs. Furthermore, I would attribute this striking anomaly to the fact that those who have had the idea of health econsultation services have not had a deep understanding of their customers' needs (tailored information to the specifics of the patient/disease state) but rather provided superficial services hoping to quickly capture eyeballs (revenues) to maybe later invest in something with more value added.
Similarly, consultancies have not really understood what is involved in providing meaningful advice to patients and hence have not understood how their technologies might satisfy the needs. [An aside, my problem is that people expect information to be free, so I haven't figured out how to create a viable business model, even if I think I understand the patient needs and technological solutions].