The marvellous phrase comes from the Demos publication “the talking cure why conversation is the future of healthcare”  by Jack Stilgoe and Faizal Farook http://bit.ly/e0GUAD They use it to describe the changing relationship between internet enable patients and doctors. I have stolen it as shorthand for a new online environment that I think we need to create that harnesses social networks to manage virtual and physical care and link formal and informal care networks. This is certainly not a Facebook application and I probably need to find another name.

My ideas on what I mean are still developing, but what I’m trying to describe is something that combines some of the features we see in social networking tools like Facebook and Linkedin with facilities that might be provided by a patient portal providing access to knowledge and services and tools to allow patients to create their own records and access and contribute to the records about them held by others.

This environment also need to integrate physical and virtual care managing the handovers between the two, with facilities for secure consultations between patients, their informal care networks and the Health Care Professionals providing formal care. The environment also needs to support a privacy and governance model that allows patients to share and protect their information as they wish for both primary (their direct care) and secondary purposes (uses not essential for their direct care such as medical research).

This environment needs to be open and controlled by nobody while allowing patients to control how their information and healthcare are managed. It needs to provide a technical platform that can facilitate the exchange of information and access to services and support the creation and deployment of a myriad of applications and devices to support health, wellbeing and care.

We see many developments that might form part of this environment the www.connectingforhealth.nhs.uk/systemsandservices/spine , www.google.com/health , www.healthvault.com , www.emisaccess.co.uk , www.patientslikeme.com , www.patient.co.uk But still have some way to go. Do others share this vision? How can we take it forward.