OK, yes – as a business that advises its clients around digital media, Blue Latitude really should have rolled out a blog before now.

But, still, we’ve got a great excuse: we’ve all been spending our non client-focused hours slumping like zombies in front of the TV. And so, apparently, has everyone else.

Check out this visualisation from the awesome David McCandless, highlighting the time spent by adults in the US watching TV in the average year vs. the amount of time and effort estimated to have gone into the creation of Wikipedia.

It’s this statistic that forms the key plank of Cognitive Surplus, the latest thesis from academic and bald Tom Hanks lookalike Clay Shirky, the title of which refers to the volume of free time currently going to ‘waste’.

Why watch TV, argues Shirky, when – courtesy of the collaboration tools available to us through the social web – this time could be better put to altruistic projects focused on improving our society, the world we share and, ultimately, the quality of all human knowledge and understanding?

Turn off the TV and do something less boring instead

Projects that Shirky discusses include the ‘Pink Chaddi’ movement of distributed political protest in India and the development of African crowdsourced social activism platform Ushahidi.

Then there’s the example of PatientsLikeMe.com, particularly interesting from my perspective within Blue Latitude’s pharma and healthcare practice.

If you’re unaware of PLM, then do yourself a favour and watch its founder Jamie Heywood in action at TedMed last year. In a nutshell, the site’s communities allow patients with chronic diseases to share detailed information on their conditions and their ongoing treatment regimes.

This data, when aggregated, analysed, and shared then helps these patients to optimise their personal condition management – specifically the drugs they take and the manner in which they use or combine them with other treatments.

It’s an example that clearly demonstrates both the potential power of the Cognitive Surplus and, conversely, how this untapped resource of time and intelligence might not – to quote from the title of Shirky’s TED Talk – “change the world”.

Shirky sees the social media movement in much the same way that John Reith, the first Director General of the BBC, regarded television at a comparable stage of that medium’s development: primarily as a service focused more on the collective edification and education of its viewers than their entertainment.

Obviously, we’re all well aware that Reith’s original vision bares no relationship to the bulk of programming that now dominates contemporary cable channels (or indeed the BBC itself). Similarly Shirky’s vision of a collaborative social media promised land appears compromised by the spam-clogged junk space that constitutes much of user-generated content online.

Reith also had it easier. All the audience need to do was to press the On Button, make a cup of tea and lean back. Changing the world through social media enabled collaboration requires that audiences lean forward to self-organise, contribute and engage.

Cognitive Surplus vs. Lies, Stupidity & Laziness

When it comes to healthcare in particular, while there are those audiences – the much vaunted ePatients – who play an active part in driving towards their optimal health outcomes through use of social media tools, these are strictly in an educated, connected and first-world minority.

Data from Manhattan Research shows that while around 50% of users online for health will have encountered user-generated information, less than 10% of them have ever contributed such content. Even within PatientsLikeMe, not all users contribute at the same level, and this is a service where individual benefit is in direct proportion to individual contribution, unlike Shirky’s starting point of Wikipedia.

Meanwhile, back in the real world, ‘lean back’ activities still dominate people’s leisure time. Indeed, despite the rise of the internet – and in fact, partly because of it – TV viewership continues to rise.

The Cognitive Surplus, then, is never going to find itself tapped to resolve some of the key health issues that place the greatest stress and burdens on society.

Take diabetes for example, estimated by the WHO to be incurring a cost on the US healthcare system of $132 billion a year; or obesity, currently affecting approximately 10% of the world’s population.  Both of these conditions also have a particularly strong growth in developing markets.

Talk to healthcare professionals and you’ll hear that there are segments of patients with these conditions who just won’t do what they’re told. They won’t follow their medication regimes or change their lifestyles, and they’ll try to misrepresent these facts if conversation during a check-up takes a difficult turn.

The ‘Connective Surplus’ in our pockets

So what’s the solution? How can aggregated data of the type assembled by the highly motivated few on PatientsLikeMe be collected from even the most de-motivated of patients? How can this be made a ‘lean back’ rather than ‘lean forward’ activity?

Well, one potential answer is probably in your pocket right now.

Much as people can do more with their free time than watch sitcoms, their phones can do more than play music and video or post updates to Facebook and Twitter. There is in fact – for want of a better term – a “Connective Surplus”.

By this I mean the largely untapped power of the ever-increasing ubiquity of smartphones and connected mobile devices across diverse populations – including within those less developed geographies and demographics where, fixed line PC internet access, is limited or prohibitively expensive.

This ability of connected communication devices to participate in wider ecosystems of communication is driving a key part of the Federal Communication Commission’s broadband plan in the US, ensuring that necessary bandwidth is available to handle a predicted torrent of “machine to machine” communication.

A key stream within this torrent will be information related to patient condition monitoring and – most importantly of all – this will be information that does not require the user/patient to make any effort towards is collection and analysis. As with the TV, all it requires is switching on.

Innovative and pioneering companies are already making great strides in this space, poised to deliver value when smartphone ownership properly ‘tips’ in 2012 and beyond, and if Deloitte’s bullish view of the mobile health record market is to be believed, around half of US consumers want this kind of monitoring delivered now.

Consider, for example:

• Airstrip Technologies, delivering remote monitoring for cardio and critical care;
• The FDA’s approval of WellDoc’s Diabetes Manager platform earlier this month, (absolutely stunning on paper, let’s see how it works when it launches next year);
• Proteus Biomedical’s work alongside Novartis and Medtronic to develop the ‘raisin’, reporting back wirelessly on vital signs via a battery placed within the pill and powered by the user’s stomach acid;
• Leading UK pharmacy chain Boots – looking to bring telemonitoring clinicsto the high street;
• TRxCare, currently in pre-launch mode, but whose SIM enabled ‘pill boxes’ can demonstrably improve adherence and effectiveness.

Then add to these and other similar examples the growing ecosystem of applications for monitoring physical activity and allowing this to be shared, visualised and analysed.

From Facebook Places to ‘Facebook Paces’

Indeed, it’s not a difficult conceptual step to move from the new Facebook Places service (which automatically posts users’ physical locations) to “Facebook Paces”, incorporating data on physical activity into the expanding set of personal information now logged and shared by the world’s favourite website.

This activity could even be rewarded with the type of ‘badge’ awards popularised by the location-aware service Foursquare.

Obviously, realisation of this type of vision will require strong drivers – strong enough to conquer inevitable concerns around a ‘Big Brother’ state, personal data privacy and the power that may find itself in the hands of the health insurers.

Some of these drivers will inevitably be legislative (driven by the simple economics of the situation), but for pharma and lifesciences and other healthcare organisations a high level plan of action over the next year should look to include:

• Moving on from the circular debates around social media that have dominated the last 18 months or so. Pharma participating in social media isn’t the big game changer some would have you believe.
• Considering the power of machine to machine communication rather than just conversation between patients to have a positive impact on the most important conversation of all – that between a patient and their healthcare professional;
• Researching the motivations around customers pressing the On Button for this type of monitoring, and likewise around the rewards required – whether these have a hard financial focus or play more in the space of ‘gameification’ (where, for example, is the Didget for adult diabetics?);
• Looking – above all – for opportunities to tie any ‘services’ of monitoring and reporting to products themselves, allowing for aggregation of hard data to objectively demonstrate drug effectiveness to all parties, (including payers).

Making use of increased connectivity to monitor and report on outcomes is one of the key directions in which medicine is moving, and for pharma this offers opportunities for ‘adding value to the pill’, product differentiation and preferential status with payers.

And for all my issues with Shirky’s viewpoint there’s one observation in Cognitive Surplus that can’t be faulted: the gap between mediocre and great might be huge, but it’s not as great as the gap between doing something and doing nothing at all.

The smartphone has the potential to be the new stethoscope. Start prompting its use in this way, by working with the currently connected first – before the revolution properly starts.