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"Dot-gov by design"

First, instant messaging revolutionized communication by enabling kids to juggle multiple conversations. Soon businesses realized it was a good way to help customers or keep employees in separate offices — or countries — in touch toll-free. Now the federal government has gotten the message.

Eight hours a day, five days a week, the National Cancer Institute operates "LiveHelp," an instant-messaging service in which trained cancer information specialists answer questions and help people find information about cancer.

By the end of November, NCI was handling 150 instant-messaging sessions a week from offices in Detroit and Kansas City, Mo. That number is expected to increase as more people become aware of the service, said Judy Patt, a LiveHelp project officer.

The service, which went live in April, uses cancer information specialists already trained to answer questions from callers to NCI's toll-free telephone line.

So far, most of the questions posed through instant messaging have been similar to those asked over the phone — mostly about cancer treatments and clinical trials, Patt said.

But instant messaging has also generated more questions about rare types of cancers. That may be because people searching for information on rare forms of cancer spend more time on the Internet and are more likely to discover the LiveHelp icon, she said.

The cancer information specialists have discovered that handling instant-messaging queries is a bit different from handling phone calls.

Instant-message information specialists must be adept at expressing themselves in writing, Patt said.

And instant messages are a bit harder to interpret than phone questions because they lack the voice intonation that gives valuable context to phone conversations, she said.

Then there is this disconcerting phenomenon: "We have a lot of disconnects," Patt said. "You might be in the middle of a session, and the person is suddenly not there anymore. You may have sent them to a Web site, and you don't know if they found what they were looking for, or they had to go attend to a screaming child, or what."

Ironically, the service grew out of an effort to use machines rather than people to answer questions about cancer.

Employees in NCI's Communication Technologies Branch wondered whether text-to-speech technology could be used to provide automated responses to requests for information from the public, said Bill Trefzger, a project manager in the Communication Technologies Branch.

Trefzger soon concluded that people are better than software when it comes to answering health questions. Luckily, NCI already had "a whole cadre of well-trained specialists."

Without the information specialists already on staff, it is unlikely that NCI would have had money to staff the program, Patt said.

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