Saturday, October 06, 2007

Serious health issues and virtual world residents

The Washington Post reports that virtual worlds are a major source of support for many seriously ill people.

"....just a few examples of an increasing number of sick, disabled and troubled people who say virtual worlds are helping them fight their diseases, live with their disabilities and sometimes even begin to recover. Researchers say they are only starting to appreciate the impact of this phenomenon. "

Momentum is increasing in both education and healthcare to take advantage of the increased facility both socially and visually that an avatar and 3d environment brings.

We estimate that as many as one third of residents over 40 in Second Life have serious illnesses.

Do people with health issues come to an avatar community simply as a fight-or-flight response? It's both. Yes, escapism is the motivation for joining an online community, especially one that the media still describes as a "game". However, acceptance by a community provides them an ability to speak openly of troubles and receive support in return. They feel the simulator-side of a community in that they can be stronger, more clear and have a better external presentation using an avatar under the controlled conditions of a virtual community, then apply what they discover in themselves and in how they relate to others to their real life situations. An avatar based community promotes a level of friendship and intimacy that text does not achieve and that may not be as present in task based environments such as games. For many people an avatar based community is empowering. They can return to the fight.

For some this is the first such acceptance and support they have found in their lives. It can be overwhelming after struggling in the face of a misery, sometimes alone, to encounter tangible care and support, even understanding or ideas for solutions. Hours are spent connected to their community, drawing strength, ideas, and emotional release from ever-present tensions. How many hours? Second Life estimated an August average of 23.5 hours per person over that month. There are few other communications methods that engender such engagement levels without strong incentives such as prizes.

Avatar-based communication is most effective once a level of familiarity with the real person has been acquired. There is nothing more intimate than health issues. Let's find out how many people have significant health issues, how big is this market? Based on our research, it appears to be large and growing.

Friday, September 28, 2007

Pharma's virtual world community challenge

Since my current work is heavily health-care oriented, I will often attempt to justify my writing time by bringing issues into practical examination within the health care space.

The value pharma companies bring, as different from Coke, is vast amounts of health knowledge locked up in their product development processes. Pharma virtual communities will need to compete with Coke by delivering more of this knowledge out to community members accepted into their fold.

Unbranded, condition-specific communities of interest sponsored by a pharma has, at this early stage, the opportunity to be utterly generous with knowledge as well as allowance of free discussion about treatments. Luxury only because once the environment is more evolved, the pressure to convert from unbranded to branded will grow. Right now the PR value of entering this space successfully is much greater than the need for conversion. The transposed (from current web and DM practice) pressure to convert will be present at the beginning, but a brave and legally thoughtful pharma will benefit greatly by gathering and engaging communities related to their brands and listening to their every word, not simply what they want to hear. Later, once the ability to gather community members becomes competitive, attention to conversion will justifiably return.

Creating a presence in a virtual world environment successfully means the legal model will be understood well enough to proceed, which in itself is a big win. the resulting PR is a bigger win yet.

Right now, companies crawl blogs and newsgroups for conversation about condition and brands to better understand opportunities for brand positioning. When communities come to fruition, the notably long engagement times that avatar environments bring is a wealth of easily and continuously accessible strategic fodder. This is gold, not a threat.

Governmental and non-governmental agencies such as the CDC,
NIH, and National Cancer Society have begun to investigate and even embrace this environment. They have worked out adverse event responses and have used virtual worlds as the pinpoint to much broader PR effects. When the CDC drives thousands of vaccinations of children using direct contact in Whyville and a lightly applied community structure, they succeed. When they continue to create buzz about it years later, they succeed admirably. Bertalan Meskó notes that Virtual hospitals, virtual first aid, and communities of survivors are popping up everywhere. Msoft showcases bloodtracking and Second Health launches medical care machinima to demonstrate complex medical scenarios.

Pharmaceutical companies cannot adopt TOS models that Coke contemplates because healthcare is not entertainment, and is limited by the $10 value of incentives. Unlocking some of the vast knowledgebase of the pharma company is a key to creating enough value for conversion from unbranded to branded communities. People facing cancer are notably persistent in digging for detailed, research-oriented information, understandably.

Personalities and causes work on the unbranded side of the fight against many conditions, and are given greater value when framed by an avatar-based community. “Meeting” a public figure in the context of an avatar-community is more powerful than the diffuse -TV appearance-woman’s magazine article-way this sort of PR is handled now.

Branded experiences are limited to non-claim based positioning content. It’s static, one-way and highly regulated. Missing ingredients today are KOL’s (Key opinion leaders), clinical trials information, pure research-based content, online education, treatment demonstration, and a way to harness patient’s ability to disseminate information into their condition community about tangible benefits that a brand brings.

Create the branded community and fill it with active staff delivering useful information at varied levels of complexity. The problem of complexity in health care information is best dealt with by bringing patients into direct contact with experts or empowered community members who can use questioning to guage how detailed and protracted the delivery of information should be in a given session to a given avatar. Addtionally, developing methods that carry avatars into the real world are critical. Examples of connecting virtual and real with prepaid cards such CVS Pharmacies and Habbo and Target with Kaneva show value transfer in action.

Add an unbranded, condition-specific community to enlist consumers to provide active and consistent events, seminars, gatherings, and personality sightings and together you have a workable mechanism for avatar-based marketing. Use the result in the wider social network as reach to new consumers.

The HCP (health care professional) side is even more in need of the presence of KOL’s, online education, and in-depth research information. HCP’s also need to hear differing opinions about treatment options and methods. Accomplishing this under the firm gaze of a KOL to navigate the antagonistic regulatory environment that conversations with real people face is critical and impossibly inefficient any other way than in an avatar-based environment. A flexible framework for the virtual world that allows these different interactions is a critical decision point.

Not to say that companies have done any of this well, yet. Lack of engaged staff and constant inflow of useful information, lack of consistent, round the clock activity, and lack of distribution mechanisms that allow a connection to the community to remain while the avatar is away in their other communities.
has resulted in “ghost town” corporate presences and cries of faddism. Not true for the simpler, more controlled worlds, however, as evidenced by the Whyville effort by the CDC.

So, which pharma is far-sighted enough to negotiate with regulatory agencies and their own risk-averse culture to create a value-driven, condition-specific community?

Wednesday, September 26, 2007

Avatar liability and community

IMVU has added age verification, so the spread of identity determinism in avatar-based communities continues. Smart legal minds have pointed out the goodness of this but have noted that this is not a solution to the problems, merely a toe in the water.

The original opportunity of anonymity is fading. Now, one's avatar in a VW is forced into a sometimes uncomfortable association with one's full RL identity. For predators, good, no loss there. For the rest of us, it's murkier.

Avatar is defined as “incarnation of a higher being onto planet earth.” Not willing to be bested, we lesser beings now use our avatars to incarnate versions of ourselves possessing godlike powers into magical domains. But we don’t just walk around; we use our avatars to approach the semantic web through a back door.

Instead of waiting for a personal software agent to fill our coffers with information, as the semantic web envisions, we have already put ourselves compulsively to work on Face book, blackberry, Wikipedia, Flikr,, Google and Twitter doing our hunter-gethering as we always have done. Why? Because it’s not simply information we want. We need to continue to advance our relationships, behavior, law, community, and self.

Gartner's prediction of the coming predominance of the avatar based communications platform fulfills on the long prediction we will process and disseminate all this newly available information across vast distances from a single, integrated, recognizable and verifiable incarnation.

Traction gained by semi-reality now demands that our poor avatar show a human face while this is going on. Messy things, humans.

Nested regulation in the real world waterfalls from human rights, through national and regional law, and finally the law of your community in whatever form that takes; from building to family.

Avatars are risky because the guiding chunk of the regulatory waterfall between community and world-at-large is missing. We don't know what laws we are subject to, and entities don't know how to successfully identify and punish violators of their laws. A good commentary on legal sparring in Second life shows how the problems are not limited to the regulatory level, but are personal as well.

Obvious scenario: our age-verified avatar smokes a virtual cigarette while interacting with the other members of the Marlboro tribe. New York State prosecutes identifiable people who smoke in public semi-real spaces, forcing the provider of the virtual world to stop realistic representations of public smoking forcing a change to the Terms of Service. Liability falls to the individual if they refuse this regulation on the grounds that the smoking is not real. The avatar is cast out.

Saudi Arabia has some bones to pick with the avatars of Second Life.

Legal precedent allows a virtual community to regulate itself as long as that regulation does not conflict with the regulations it inherits.

Avatars will be insured like cars.

Liabilty is currency in a virtual world. Any Avatar Metadata Protocol can only be viable through an avatar’s application for acceptance into a community resourceful enough to limit risk for its “citizens” in a way that is affordable.

A community Terms of Service becomes its business model; the TOS will be as behaviorally free as the amount of risk its host community is able to share. A closed system that limits and monitors speech, UGC, and behavioral representations will vastly lower its liability and therefore the cost to that community for allowing entry by an avatar. Value will have to replace behavioral freedom in order for an avatar to bother engaging in the community.

Above that, communities must inherit the laws in force at the physical location of the world host, be it a private server or a commercial entity.

Members of commercial communities must indemnify the host entity in return for access to its value.

Members of privately served communities using software like Metaplace (clever name) will limit risk by serving from low liability locales in addition to obtaining a TOS from the avatar.

Avatar metadata will be extensible passports that attach boundary agreements for travel to a different community.

Value wars between competing commercial communities will break out as they attempt to include an avatar into their community exclusively.

Sounds like fun, huh?

Tuesday, September 25, 2007


Virtual Worlds is my beat at the office. I am asked to react to client thoughts about entering the VW space. In doing this I keep gathering useful info I thought I would share.

Real/unreal legal challenges
Second Life remains the bellwether for confusing social and legal issues created by virtual worlds.

Linden Labs, maker of Second Life, has aggressively banned casinos out of concern for legality in many countries. Money laundering and tax avoidance fueled this focus.

Next, a
Dutch prosecutor opened an investigation of “ageplay” in February on the grounds that representations of child sex are illegal in the Netherlands. The prosecution was dropped because the representations within a VW were deemed “too much a computer animation” and not realistic enough, but not before a flurry of action and reaction resulted.

Within SL, people of both sexes use different avatar representations such as animals, faeries, tinies, monsters, vampires, and also children. Child avatar owners fully role play childlike attributes including baby talk. (This is not unknown in the analog world as well, of course). While numbers are unknown, the numbers of age players that are nonsexual appear to outweigh sexual representations. Sexual representations require two consensual adults behind the avatars (behaviors cannot be forced and minors are not allowed in SL).

Popular responses to the initial threat of prosecution fell into two areas: people wanting any representation of children in SL stopped because it was felt to be a “training ground” for paedophilia. Another view centered on free speech and the feeling that, like violence, bestiality, and many other behavioral representations, consensual ageplay in a fantasy environment is “bedroom speech” no clear indicator of real world behavior any more than shooting people in Halo is.

Interestingly, most debates make the assumption that men were the culprits to be prosecuted or prevented while the consensual partners, (many possibly women in control of the child-like avatars) were not cited in the debate, even though Dutch law points to the possessor of the child avatar as the primary law breaker. The legal quandary that virtual representations create has led Linden Labs to seek ways to cascade legal liability away from the software maker and down to individuals in the world.

Linden revised the terms of service (TOS) for Second Life as an initial response. These modifications help lower the temptation to clutter Linden with small claims lawsuits. Additionally “land” owners are required to register land containing “offensive or sexual content” so that Linden can disallow any avatars not officially cleared as being of legal age from entering that land. This has placed land owners in the position of liability and required visitors to that land to verify their identity with Linden using a database marketing company as the verification vendor. Thus liability has devolved effectively from software maker to the “host” of visitors in the world.

A fuller expression of the shedding of liability is the introduction of “Serve your own world”. Areae has announced testing of
Metaplace, a packaged virtual world that can be served by anyone. Each instance of a Metaplace can be connected to another, creating one mega-world out of many separately served parts. This model of separately interconnected, self-served worlds is being pursued by Linden Labs and several other companies as well. The underlying liability for serving a virtual world lies with the company or individual serving it.

The resulting implication is that we will all have to have our own TOS between us and anyone we interact with in a virtual world in order to deflect liability for representations of behaviors that are deemed by someone (anyone, really) to be very realistic, therefore “real”, and therefore threatening.

Cave painting destroyed the separation of reality and unreality using a limited access, legally controlled virtual experience. Today we have virtual worlds; a broad access, legally controlled virtual experience. Perhaps the only difference in 20,000 years of virtual experience is that lawyers have replaced shaman.

Portable populations
Gartner declared that 80% of our communication time will use avatar based worlds within the next 4 years. I suspect that will be true in 2 years for teens.

A Dozen new worlds have been announced in recent months, some client-based, others web browser-based.
IMVU and Gaia are growing at a rate similar to SL was in the fall, while SL itself has leveled off at 9.5 Million accounts. SL remains the only world where a corporation can inexpensively create a presence and communicate directly with “communities of interest”. SL is also the only world allowing user generated content across the world. New worlds are either closed, (adverworlds) best from an advertising context, or are private label worlds (under development).

Sony’s Home for PS3 has been delayed till spring while other corporate efforts such as Qwaq appear ready to go. Qwaq is a self-hosted 3d environment designed for the Webex crowd. The logic goes: Instead of a presentation environment why not get everyone into a virtual room and hash it out using avatars?

Google appears to be
testing a new world with students at the University of Arizona based upon a number of carefully prepared components including Google Maps, Google Earth, and Google Sketchup, a 3d modeling application given away free. The actual virtual world application may be based upon Everyscape but may include learnings of Google’s new social networking platform Socialstream.

Socialstream aggregates content across many different networks to present social information in a way that ties it to the person who posted the information, and not the site from which it came. Imagine you can have your Facebook, Flickr and IMVU in a single location. There are many such efforts underway.

This same goal of a common protocol allowing an avatar to be portable between IMVU, World of Warcraft, and SL (for example) is being investigated by IBM, among others. If this succeeds, it will be similar to the W3C protocols allowing a common view of web pages regardless of platform. The effort here, if successful, is causing many to proclaim the web “dead”, since all the information transfer now accomplished within the web can be done using the avatar as the “homepage” for each person.

VW and healthcare

The Second Health London Local Community Hospital and Polyclinic are now open. Created by the National Physical Laboratory and Imperial College London, the SL sim includes a virtual hospital and animations helping describe complex medical concepts. This is another good example of unbranded health-oriented communities that teach about and influence consumer attitudes. This approach is a good first step into using the educational power of virtual worlds. Some of our clients are looking into this.

A commanding understanding of how best to build connections to health communities remains missing.
This paper about health neo-tribes is an interesting description of the possibilities.

Certainly we know that pharmaceutical companies have to deal with what anyone says in a virtual world, word for word, along with the unpredictability that engenders. The nongovernmental bodies deal with it by sending consumers to health authorities for information about any conditions mentioned in conversation, but pharma companies do not yet have that luxury.

Controlled adverworld presences are a solid opportunity for advertising even within the pharma space, but the problems for any health care company wishing to take full advantage of direct consumer relationships will force a legal and governmental sea-change to succeed. It will happen but it won’t be pretty.