Over the past two hours at Health 2.0 in Paris, the attendees of this excellent conference (almost 500 folks) have been treated to a large variety of both online patient and physician communities from both Europe and the United States.  From PatientsLikeMe to IWantGreatCare to Imedo, we’ve seen excellent examples of web communities from the US, UK and Germany.  On the physician side, we’ve been treated to resources like santé log in France, Sermo in the US, and Medting in Spain.

One of the questions that was raised by the moderators and by the audience is can these communities translate across geographies?  This question was not raised in the context of language translation but instead from the perspective of broader community engagement.  That same question was also tweeted by @andrewspong in the context of the intersection of these communities between physicians and patients.  That tweet is an excellent one and got me to thinking about how a CLOUD-enabled Internet might change some of the context around how communities are formed and engaged.As CLOUD points out on its welcome page, part of the challenge for any of these patient or physician communities or for that matter, Facebook, or any community site is the fact that the Internet has been segregated by web pages.  The Internet at its core is a large global community.  It is only when you engage the power of HTML for its wonderful presentation capacity that you begin to create silos and separation.  On that note, the Health 2.0 moderator just asked the question of how many online communities doctors will join.  47% of the audience thinks doctors will only join two sites or communities, and one of the panelists commented that doctors want to keep their Facebook and professional lives very separate.  But from a CLOUD perspective, we don’t think one should have to choose.

On my personal blog at The End of Linearity, I point out that “there is no there on the Internet.”  This is a fundamental shift in thinking.  One of the biggest challenges for a Facebook or PatientsLikeMe is the fact that they spend large amounts of time aggregating users at their sites or destinations.  If I’m at Facebook, then I’m not at PatientsLikeMe and vice versa.  At a certain point, users are only going to engage so many communities, so what if that one “patient like me” doesn’t end up at PatientsLikeMe?  What if instead, PatientsLikeMe was a viewer of connections on the Internet and not a destination?  What if Medting didn’t need to aggregate doctors at all but could focus all of their energy on tools, resources and services rather than attracting doctors?  What if patients with a certain disease could bring together in one viewer (notice I didn’t say website) the great content from the first panel at Health 2.0, fellow patients from the second panel and appropriate physicians from anywhere in the world from the third panel?

For this to happen, the Internet must not only move away from its web-centric view of the past fifteen years, but it also must move away from concepts of identity like OpenID that simply makes it easier to log in to these same websites.  We need to move towards a context-centric view of the Internet and bring together people not webpages.  By making it about WHO I Am™, then wherever I am on the Internet, I can be everywhere I need to be.