Walled Gardens vs. the Open Web: A Central Debate in Tech Finally Coming to Healthcare

The September issue of Wired magazine and an article in last Sunday’s New York Times illustrate a central debate in technology circles. The debate is not new — it’s being going on for two decades — but it has newfound vibrancy. The essence of the debate is about competing tech/business models: walled gardens vs. the open world wide web (web).





The debate is highly controversial and nuanced. There are “experts” on both sides.

My point today is not to take sides (although I’ll admit my canine partiality to the open web), but rather:

  • to point out that the debate is occurring 
  • to explain what the discussions are about
  • to suggest that competition between walled gardens vs. the open web is creating healthy competition and providing consumers with great choices (e.g., Apple iPhone as a walled garden vs. Google Android OS as a more open approach)
  • to point out that health care has not had much to say in this debate…until very recently.

A while back I started writing a series “Healthcare Crosses the Chasm to the Network Economy” . This essay continues that series.

A Refresher — What’s the Difference Between the Internet and the World Wide Web?

Being clear on the difference between the Internet and the web is foundational to understanding the debate going on in the tech community.

Webopedia provides a quick refresher on the differences. You can skip over this if you’re sure you already understand the differences.

Many people use the terms Internet and World Wide Web (aka. the Web) interchangeably, but in fact the two terms are not synonymous. The Internet and the Web are two separate but related things.

What is The Internet? The Internet is a massive network of networks, a networking infrastructure. It connects millions of computers together globally, forming a network in which any computer can communicate with any other computer as long as they are both connected to the Internet. Information that travels over the Internet does so via a variety of languages known as protocols.

What is The Web (World Wide Web)? The World Wide Web, or simply Web, is a way of accessing information over the medium of the Internet. It is an information-sharing model that is built on top of the Internet. The Web uses the HTTP protocol, only one of the languages spoken over the Internet, to transmit data. Web services, which use HTTP to allow applications to communicate in order to exchange business logic, use the the Web to share information. The Web also utilizes browsers, such as Internet Explorer or Firefox, to access Web documents called Web pages that are linked to each other via hyperlinks. Web documents also contain graphics, sounds, text and video.

The Web is just one of the ways that information can be disseminated over the Internet. The Internet, not the Web, is also used for e-mail, which relies on SMTP, Usenet news groups, instant messaging and FTP. So the Web is just a portion of the Internet, albeit a large portion, but the two terms are not synonymous and should not be confused.  

The Arguments for Walled Gardens

Eric Pfanner’s New York Times article capsulizes the rationale suggesting the world is moving toward walled gardens:

The argument goes something like this: After falling in love with the openness of the Web, consumers are recoiling from its chaos and embracing the sense of order offered by walled-off digital realms. These include applications for mobile devices like Apple’s iPad and iPhone and password-protected social networks like Facebook, where much of what people do takes place beyond the reach of search engines and Web browsers.

Chris Anderson, Editor of Wired, elaborates in his article The Web Is Dead. Long Live the Internet:

You wake up and check your email on your bedside iPad — that’s one app. During breakfast you browse Facebook, Twitter, and The New York Times — three more apps. On the way to the office, you listen to a podcast on your smartphone. Another app. At work, you scroll through RSS feeds in a reader and have Skype and IM conversations. More apps. At the end of the day, you come home, make dinner while listening to Pandora, play some games on Xbox Live, and watch a movie on Netflix’s streaming service.

You’ve spent the day on the Internet — but not on the Web. And you are not alone.

This is not a trivial distinction. Over the past few years, one of the most important shifts in the digital world has been the move from the wide-open Web to semiclosed platforms that use the Internet for transport but not the browser for display. It’s driven primarily by the rise of the iPhone model of mobile computing, and it’s a world Google can’t crawl, one where HTML doesn’t rule. And it’s the world that consumers are increasingly choosing, not because they’re rejecting the idea of the Web but because these dedicated platforms often just work better or fit better into their lives (the screen comes to them, they don’t have to go to the screen). The fact that it’s easier for companies to make money on these platforms only cements the trend. Producers and consumers agree: The Web is not the culmination of the digital revolution.

The Arguments for the Open Web

Evan Hansen wrote How the Web Wins in rebuttal to Anderson:

Today’s apps do some things better than the web, which is why they are so popular. They offer developers greater design control and access to some hardware features that browsers can’t touch. Users get big performance enhancements and better responsiveness.

But there are big tradeoffs involved, too, and the web is far too powerful to be replaced by an alternative that gives away so much of what developers and readers have come to love and expect.

Notably, the web makes it very easy to share, link, embed, cut and paste, bookmark, search – in short, everything that makes content useful in the web-enhanced world.

Reading, it turns out, is not a passive, solitary enterprise; it is deeply tied to social activities. Thanks to the web, readers are no longer just consumers – they are participants and creators in their own right, and they are empowered.

This puts the web front and center in the future of media, not off to the side.

…the advantages of the web are only growing.

The most obvious advantage is that the web is based on standards, giving developers the benefit of a write once, run anywhere environment.

Eric Pfanner quantifies the growth of the open web in his New York Times article

Every day, about a million new devices — computers, mobile phones, televisions and other things — are hooked up to the Internet, according to Rod Beckstrom, chief executive of the Internet Corporation for Assigned Names and Numbers, which oversees the Internet address system. The total number of Internet users worldwide, about two billion, is growing by 100 million to 200 million a year.

Most of this growth is occurring in developing countries, where the Web is dominant and applications stores and the like have made fewer inroads. The number of Web pages has grown from 26 million in 1998 to more than a trillion today, according to Google.

Who’s the Winner?

…again, that’s not the point. To recap, the debate is central, vibrant, and is providing consumers with great choices. There are many successful walled garden business/tech models, as well as many successful  open web business/tech models.

Healthcare Information and Communication Technologies Have Been On the Sidelines

Healthcare hasn’t had much to day in this central debate about walled gardens vs. the open web.

Today very little patient data is in electronic formats. That which is exists mostly in proprietary, non-standardized formats. Until very recently, health IT business/tech models have been closed.

Patients haven’t had expectations that their health information should be available “NOW” and electronically.

We also don’t know much about what to measure and what data to gather. 

Finally, patient data has been hoarded for many reasons — to support “privacy” (which is a good thing, but often a shield), to keep it out of the hands of competitors, and to avoided dreaded HIPAA violations.

…and as I’ll begin to explain in the next post of this series…all of this is changing. RAPIDLY.

A couple hints if you can’t wait:

14 thoughts on “Walled Gardens vs. the Open Web: A Central Debate in Tech Finally Coming to Healthcare

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  11. I don’t think the Web will die anymore than radio did. However, change is inevitable. We are transitioning out of the “Wild Wild West,” gold rush period of the Internet. Walled gardens, secure intranets/social networks, and other systems not yet developed will begin to attract more users and suppliers for the same reasons as in other fields: people want security from viruses and malware, governments/companies will want security for their systems, etc.

    However, the problem with the Internet (or beauty, as it were) is its international component. TV and radio are slightly that way, but the Internet truly is a non-national medium. As has been seen with countries like Iran and China, trying to utilize the good of the on-line world while “protecting” from the bad is difficult to do when others are out there helping to beat at your wall. In the same vein, Chinese video sites and other pirate torrent bays consistently prevent the idea of paid content subscriptions from gaining traction (at least with current price models), since users are as apt to access the video illegally as legally.

    I think what we’ll see in the future is a slowed but continued growth of the Web as a gateway to the closed networks (buisness, personal, financial, medical, etc.) where we conduct more of our business. As was pointed out in a rebuttal to the Wired article, many of these closed wall apps utilize the web to access content. We will still need the information superhyway, but we will spend more time at the rest stops.

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