Mark Zuckerberg used the term to describe how his collaborators and employees refined Facebook with thousands of small improvements and turned it from a dorm-room project into a $100-billion corporate giant.
A small group of Montreal hackers and medical professionals will launch an experiment next weekend to test the Hacker Way against one of the most intractable, hidebound systems going: Canadian health care.
These hackers won't be the rogues remembered from the 1980s for busting into secret databases, installing viruses or stealing nuclear codes in movies. Instead, about 180 web designers, software writers and other IT experts will meet about 50 doctors, nurses and researchers to try to produce simple health-care applications that could lead to bigger innovations.
Potential cutting-edge reforms could include constructing triage apps, text-messaging programs for HIV patients, or finding a tech solution for treating seniors at home instead of at a hospital.
"The problem is that people in health know what problems they face, but they don't have access to people who can create these solutions. The people with the solutions can't even get into the health-care system. Here, we're putting them in the same room," said Hacking Health organizer Jeeshan Chowdhury, an Edmonton medical student who is in Montreal on a year-long Sauvé Scholar fellowship after studying in Oxford as a Rhodes Scholar.
One surgery resident wants to build a do-it-yourself triage app that would help guide patients to their best health-care options (and, presumably, steer less-serious cases away from crowded emergency rooms.) A research co-ordinator hopes to build a text-message program that could give HIV patients text message reminders to take medication and make appointments.
"Instead of the big billion-dollar solutions that are usually associated with health-care technology, we'll brainstorm smaller problems and deliver solutions in a couple days," said Matthew Huebert, a 29-year-old software programmer in Montreal.
"We won't solve every problem. But I expect we'll have two or three concrete solutions that will make it all worth it."
Trevor Chan, a general practitioner who spends much of his time treating the elderly in Calgary's Foothills Hospital, will look to create an IT solution that might allow some of those patients to receive care at home instead of in hospital, particularly during the lonely overnight hours. A solution might create efficient homecare visits using a combination of health records, GPS and mapping software.
"You see so many instances where people could be at home if they just had a little bit more help, if they felt a little more secure," Dr. Chan said.
Everyone from the provincial premiers to front-line health-care providers agree information technology could provide huge gains in efficiency and cut down costs. However, bridging the gap between the young upstarts who create smartphone apps and the highly structured, rule-bound world of health care is not easy.
"If you go through government channels, everything is a maze. Nothing moves," Dr. Chan said. "I think this is a great experiment."
As he searched for a sponsor for his event, Mr. Chowdhury, 28, hit hurdles with government agencies and health-care companies loath to be associated with the word "hacker." For them, the word is still associated with nefarious computer renegades stealing bank records or hijacking nuclear missiles.
Finally he found Nightingale, which sells electronic medical records systems and "managed to see past the name and didn't find the idea too out of the box," Mr. Chowdhury said.
