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Crowdsourcing, in theory and practice

By Jeanne Pinder

Tow Fellow, “A How-To Guide to Crowdsourcing”

Here’s one big lesson I learned in building a startup that uses crowdsourcing as a tool of journalism: As in all things journalism, it’s important to listen.

I founded my startup, ClearHealthCosts, in 2011, after volunteering for a buyout from The New York Times, where I worked for almost 25 years as a reporter, editor and human resources executive.  We use crowdsourcing and other reporting tools to bring transparency to the health care marketplace by telling people what stuff costs.

I have spent the last few months as a Tow Fellow working on the “How-to Guide to Crowdsourcing” with co-authors Jan Schaffer and Mimi Onuoha. My experience with ClearHeathCosts undoubtedly informed our research, and as we launch our Guide this week, I wanted to share some of the personal lessons I’ve learned.

Health care is the last big remaining opaque marketplace. It’s very hard to find out what things cost. It’s a perfect place to use the hive mind: to collect highly actionable, relevant information, which is normally hidden from view.

I had some experience with this, having had a bill including a charge of $1,419 for a generic drug I found I could buy online for $2.49. By listening to others, I learned that my experiences were not unique. I founded the company with a grant from the Tow-Knight Center for Entrepreneurial Journalism at the CUNY Graduate School of Journalism.

We started out using shoe-leather journalism—talking by phone with providers, for example – and  database sourcing and curation, to find and share information. We’ve always been interested in crowdsourcing, and grew it as part of our reporting strategy, as crowdsourcing grew more common in news, noted by us and others.

In 2012, Emily Bell, Clay Shirky and C.W. Anderson mentioned this trend in their Tow Center report on “Post-Industrial Journalism.” “What’s going away is a world where the news was made only by professionals, and consumed only by amateurs who couldn’t do much to produce news on their own, or distribute it, or act on it en bloc,” they wrote “…The kinds of changes that are coming will dwarf those we’ve already seen, as citizen involvement stops being a set of special cases and becomes a core to our conception of how the news ecosystem can and should function.”

How we work: we collect pricing, then invite members of our community to share their prices. In addition to our own community, we also provide tools and guidance for the communities of our media partners: KQED public radio in San Francisco, KPCC public radio in Los Angeles, WHYY public radio in Philadelphia, and MedPage Today, a wing of the health giant Everyday Health. (More soon!)

By using our embeddable PriceCheck widget, we and our partners join hands with community members to make a community-created guide to health care pricing, and to do great journalism – and to have a conversation about the topic.

In building this practice, we had to overcome some objections.

Objection: How would you know if people were telling you the truth?

What we learned: The data reveal the wide range of prices. The data sets are, in a way, self-validating: you can see outliers. But those outliers may not be wrong, they’re just outliers. By listening, we understood even better: there is confusion about pricing, of course. That’s part of the story. So we created drop-down menus to help people specify the procedure they had, making sure we’re comparing apples to apples. And there are not a lot of people out there trying to lie to us about the prices of their mammograms.

Objection: People won’t want to share this intimate medical information with you.

What we learned: Hundreds and hundreds have shared prices. People are really upset about health-care pricing, and they tell us they’re glad we’re doing this. Sample comments: “Great idea!!  I’ve loved you folks for years, and now even more J” and “I love what your organization is trying to do and I would like to contribute information. ” Also, people engage in different ways: sharing data, searching data, Tweeting about us, sharing our Facebook posts or writing about us.

Objection: It’s really hard to crowdsource.

What we learned: Again, by listening, we have learned a lot about who to ask, how to ask, what to ask, when to ask. And we’ve learned that once you’ve got your basic framework set, then it’s pretty easy (though not always perfect) and definitely rewarding.

We’ve also learned that it’s important to make it simple for people to contribute – and also to thank them, to show them what we’re doing with their contributions, and to make the process a true collaboration, a conversation.

Our impact

Our partners are enthusiastic. PriceCheck “has allowed us to work together with our audience to tell stories about health costs,” said Rebecca Plevin, health reporter at KPCC. “Through this crowdsourcing effort, they’ve become our sources on data and they’ve brought that data alive through their personal experiences.

“I think the crowdsourcing model has also captured the imagination of our listeners,” she added. “When I’m out in the community, people often tell me that they love the way we’re working with our audience to report on health costs.”

We’ve had other impact too: Here’s a sampling. Lisa Pickoff-White, senior producer at KQED, and Lisa Aliferis, the KQED health editor and lead reporter, just won a Society for Professional Journalists award for journalism innovation for PriceCheck. Pickoff-White spoke about our work at the National Institute of Computer-Assisted Reporting conference and also at the Association of Health Care Journalists conference. I was invited to speak to the California State Senate Health Committee in Sacramento about price transparency. We were asked to write about our data for the Harvard Business Review/New England Journal of Medicine collaboration, and also for JAMA Internal Medicine, the prestigious journal. We have also been invited to supply information to Covered California, the California state insurance exchange, and to the Center for Medicare and Medicaid Services of the federal government.

News-gathering tools change

One lesson for me in learning how to do crowdsourcing is that it’s part of the evolution of journalistic practice: In the old days, reporters went out with a pad, pencil and camera. Later, we used phones, while the old-timers told us that was lazy. Now we do some of our reporting on the Web, and deliver our reporting on that same Web.

Remember, too, that recently, reporters resisted putting their phone and email addresses on stories. Now, reporters frequently put their phone and email on stories: It’s a way of saying “come talk.”

Another thing I learned: There are significant differences in how mature news organizations and digital natives think about their conversations with their communities. The digital natives’ work may not fit this report’s definition of crowdsourcing – a specific ask, a specific task – but it is an important part of what they do.

Look at ProPublica: Engagement in their “Patient Safety” Facebook community has helped power remarkable coverage, as has their outreach over the Agent Orange investigation.

At Medium, Buzzfeed, Gawker and other sites – some more platform than publisher, some more creator than others – conversation with the community is more fluid and frequent.  (To be sure, at some digital-native sites, there’s much less conversation.)

For some mainstream organizations, confronting shrinking revenues and waves of layoffs, there’s a hesitance to devote resources to crowdsourcing.

For ClearHealthCosts, and for our partners, the practice is extremely valuable, and promises even greater rewards.  People are using each other’s finds and insights. Our readers now know things: how it may often make sense to put away your insurance card and pay cash, and whether they should actually pay $6,000 for an MRI.

We see crowdsourcing as one more example of the journalist’s listening talents, and also as the natural evolution of shoe-leather reporting—for us, today, for health costs, but also for many other news organizations and many other topics.

Elana Gordon, health reporter at WHYY, said calling out to the community to share has been “incredibly rewarding.” She added: “It has allowed us to connect with listeners in a more meaningful way and spurred valuable reporting. That has in turn fueled an even deeper conversation in our community about health care. We learned that crowdsourcing is a challenge, that it requires partnerships and relentless efforts. But if kept up, the payoff is…priceless. “