How to Improve Online Dialogue @ http://change.gov

On the occasion of the launch of an online discussion about Health Care on the website of President-elect Barack Obama, http://change.gov, Intellitics reported early assessments of the experiment, among them:

• Over on techPresident, Micah Sifry calls it “the beginning of a rebooting of the American political system,”
• Eric Eldon of VentureBeat thinks of it as “a great early step in making government more open.”
• Tim of Intellectis gives "kudos to the people behind Change.gov for experimenting with large-scale e-participation so early in the process". He believes "the opportunities for online dialogue and deliberation to help boost civic engagement and to improve public decision making at all levels of government are tremendous."

He also points out a few open questions, here quoted in their entirety:

• "No clear process model: Judging from the information available on the website, it is not entirely clear how exactly the comments will be processed, what impact realistically they may or may not have on any policy decisions, or what kind of follow-up and follow-through either the transition team or the new administration are willing to commit to. This can become a problem since it risks disappointing participants (e.g. when assumed impact doesn’t match actual impact and participants are left frustrated over the time and energy they spent in vain).
• Lack of focus in the comments: Instead of simply answering the question (”What worries you…?”), many participants choose to share rich combinations of personal stories, experiences, concerns, assumptions, questions, ideas, solutions, values, priorities, resources, data etc. While this shows just how much energy the participants bring to the table, it also tends to leave the discussion somewhat directionless. There is no process in place to further organize this input, nor does the forum software support participants in being more disciplined or structured.
• Lack of organizer participation: I was able to spot one instance of comment deletion by the forum administrators, presumably according to their comment policy (screenshot). I may be wrong, but other than that the transition team does not seem to actively engage in the discussions (e.g. ask or answer questions, express agreement or disagreement, or otherwise facilitate the process or provide general community management etc.). I only looked at a few sample pages, though, so I may be wrong.
• Overwhelming amounts of unstructured data: The discussion on Change.gov was off to a fast start, reaching 2,000 comments in the first 24 hours. As with many online discussion forums that reach a certain activity level, the amounts of content produced by the participants can be quite staggering. For example, total word count on this forum may well be approaching 500,000 words already (for details how I got this number, see my rough calculations). That means it becomes extremely time-consuming to keep up with even a small fraction of overall input (poor navigation adds to the problem). Moreover, the fact that this data is largely unstructured makes further processing very difficult if not impossible."

All of these questions are procedural challenges I address with my model of Organized Dialogue (OD). They illustrate the kind of challenges facilitators of Organized Dialogue have to face:

• the transparent coupling of the OD with other processes
• the (time-consuming) content structuring of (mass) input by participants
• staying with key questions related to the defined purpose of the OD
• a clear and acceptable role of the facilitator

Some of these problems could have been addressed by reframing the question. Asking "What worries you most about the healthcare system in our country?" means inviting broad impressions that are hard to handle, and structure. That is a question to get people to vent their frustrations, and experiences, the purpose of which is to be able to say: "I can hear your pain." But that is not a setup for a continuous dialogue.

Instead, the transition team first could have asked more specifically: "What do you think: which worrisome part of the healthcare system in our country should the President-elect address in his inauguration speech?" (Or the first 100 days in office, for that matter). The coupling of the OD with the inauguration speech would have made the purpose clear, and instead of asking for worries, this question focuses on components that need fixing badly.

In a second step, answers could have been clustered into different webs of meaning, presumably something along the lines of typical issues

• replace the existing system completely
• improve accessability
• expand coverage
• make billings more transparent
• eliminate racial and ethnic disparities
• improve emergency readiness
• take a holistic approach to health
• improve information
• reform liability regulations
• set quality standards
• improve patient safety
• expand rural health care
• qualify and reward the workforce better

After presenting these clusters, a third step could have been to let people evaluate these issues according to importance, the most basic method of which would have been to let people vote on their importance. In a fourth step, experts could have commented on the results, how the issues are interconnected, and what they think should be central concerns. Additionally, all of these issues could have been deepened by asking people for experiences of what needs to be stopped, and which good practice needs more implementation.

All of these steps should have been outlined ahead of the dialogue in a few sentences, along with a short description of the role of facilitators / administrators. People could have also been asked to suggest experts they trust on these issues, so they could have been brought into the disscussion - but that would have taken the dialogue to a whole new policy level, and I don't think that's what the transition team is worrying about right now.

What question would you have asked? What steps of the OD do you think could have been taken?