To continue with the Health Policy Innovation review and discussion, part II will focus on innovation systems and platforms that Kickbusch et al propose. We’ve all heard of the Personal Health Record, the elusive holy grail of “the next big thing” in health care. Now what would the public health analog of this be? The authors here point to the concept of a “Personal Health Information System” that forms the backbone of a public health innovation system that has shared, co-created aspects that distinguish it from the PHR. The goal is to use the PHIR as a “community-centered collaborative innovation system”. The old model of public health was one that focused on educating people to behave in a healthy way and the public health system will offer protection from epidemics, safe access to food and water, and access to medical care. We’re now shifting to a model where patients in the health care system are increasingly considered co-producers, citizens rather than consumers, and we’re seeing the creation of bottom-up health commons (a common theme in this blog).
The traditional model of biosurveillance and epidemiological models are more command and control types of regimes that are now shifting to what the authors call “integrated health governance”. This means a new vision of health services that is less vertically driven and fragmented to a more value-based, citizen-driven model based on health networks. This is where the PPPP model, of public-private-partnerships that are “people-driven” come in. In order to facilitate this model we’ll need to think about how to develop platforms that offer the tools, often co-created with citizens, that could promote desirable changes in behaviors. There are some interesting working examples of this way of thinking and doing innovation and one of the most impressive examples is NESTA in the UK which has been one of the leading centers for rethinking public services through the broad lens of open innovation, co-creation, design.
NESTA and the Young Foundation’s Health Launchpad could provide interesting conceptual approaches to what I have in mind with the “Public Health Innovation Center” concept I’m working on at the moment. This could be the basis of a node for the ePHIS mentioned above. This system, as structured in the Kickbusch volume, would bring together the health policy sector and the need for health information governance, to a market-driven sector that provides technology platforms, to localities where specific health strategies are generated, to professional health provider networks. The citizen health information node is at the center and provides the platform for each piece to feed in for health innovation through health knowledge networks (I’ll add a diagram at a later point that makes this easier to visualize). A model based on this concept has already been deployed in a rural community in Barreiro, Portugal with high diabetes rates. A community of 1050 with 65% prevalence rate of diabetes became the site of the iCitizen, a citizen-centered health information system that contains both PHR and ePHIR with a focus on digital literacy and participatory research was begun in 2008 to test the concept.
I’ll be adding part III of this series through a discussion of “Wiki Government” and soon to be followed by an analysis of transparency policies to create the building block of a more robust picture of Public Health 2.0.