Digital Healthcare, Participatory Healthcare

World Health Summit 2009, Charite Berlin: The Wisdom of Patients: The Beginning of Participatory Healthcare and Medicare? Alexander Schachinger PhD. Cand. Humboldt University, Berlin World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 1

“The most value for healthcare connected to the internet is not machines or data, it is people.” Keynote Prof. Clay Shirky at Health 2.0 Conference, Boston 2008 World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 2

World Health Summit, Charite Berlin 1. The New Quality: The Digital Informed and Connected e-Patient 2. Does the e-Patient lead to Participatory Healthcare and Medicare? 3. Health 2.0: New Paradigms and Values World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 3

1. The New Quality: The Digital Informed and Connected e-Patient World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 4

Definition „E-Patient“ E-patients are health consumers who use the internet to gather information about a medical condition of particular interest to them. E-patients are increasingly active in their care and are demonstrating the power of the Participatory Medicine or Health 2.0 / Medicine 2.0 model of care within Social Media. Source: www.wikipedia.org 2009 World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 5

The E-Patient quantitatively % Onliner Healthcare Seeker/ E-Patients t USA: >90%, Internet is source no.1 for health information Germany: >60% , Internet overtakes print about 2010 Quelle: Lee Rainie, PEW Internet & American Life Project, University of Washington DC World Health Summit, Charite Berlin, Lausen;Potapov;Prokosch, Erlangen 2008 Oct. 14.-18. 2009 © Alexander Schachinger, Page 6

Patient-Driven Healthcare: Conclusions by Tim Ferguson  We have underestimated patients online abilities.  We have overestimated imperfect online health information.  e-Patients have become valuable healthcare resources – providers should recognize and use that.  The most effective way to solve problems of today´s healthcare systems it to make it more collaborative. Quelle: White Paper „e-Patients. How they ca heal us health healthcare“ World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 7

Impressions of the Paradigm Shift “The impact of web 2.0 on the balance of power and knowledge between patient and professionals is enormously significant”1 „Our first generation of e-patients is slowly but surely transforming our healthcare system.“2 „e-patients: how they can help us heal healthcare“3 1. UK NHS 2008.www.debatepapers.org.uk/pdf/Futures-Debate.5.pdf 2. Lee Rainie, Susannah Fox in Ted Ferguson 3. Untertitel des e-book von Tom Ferguson “The E-Patient” World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 8

2. Does the e-Patient lead to Participatory Healthcare and Medicare? World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 9

Wisdom of Patients eec Trendforum Gesundheit Mai 2009, Page 10

Wisdom of Patients World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 11

„here comes everybody“ The Nature of the Firm: Social Impact on Reduction of Transaction Costs Transaction Costs „The Firm“ „Bigger Firms“ „Everybody“ Amount of Transactions Communication, Sharing, Group Building, Production, Broadcasting, New Values out of Corporate BoundariesCharite Berlin, World Health Summit, Oct. 14.-18. 2009 © Alexander Schachinger, Page 16

Two Healthcare Networks Healthcare System (GER) Social Media in Healthcare (global) World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 17

...colliding like tankers versus speed boats World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 18

Two Healthcare Networks Healthcare System Social Media Control of knowledge and access by Information is free, peer production authority and institutions, “Wisdom of Crowds”, Centralized intermediation Decentralized disintermediation “reform” is linear, very slow, Non-linear Innovation “on the fly”, Interest-focused and dictated “open innovation” “risk averse”, filter then share “risk taking”, share then filter Proprietary product knowledge, Open source, product transparency firm-based, patented “commons-based peer production” Closed network, strong ties, “B2B” Open network, “Strength of weak ties”, C2C Deregulated and increasing demand, Regulated supply, no price economy Economy of awareness and relevance Mindest: system made, Mindset: liberal and heterogenous, “healthcare online is dangerous” “healthcare online works” World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 19

3. Health 2.0: New Paradigms and Values World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 20

Stages of Medicine 2.0 / Health 2.0 Informational Communication/ Instrumental interaction Participatory Healthcare PHR, PCHR Internet as Diagnose/ Therapy/ Compliance, „information therapy“ Seamless Healthcare, Check-up, E-Learning, Clinical Trials, Coordinated Care, Personalized Prevention Internet as exchange, peers, forums, networks patient2expert2patient Web 2.0 Internet as a Library, Dr. Google Web 1.0 World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 21

Definition „Medicine 2.0 / Health 2.0“ “Medicine 2.0” applications, services, and tools are defined as web-based services for health care consumers, patients, health professionals, and biomedical researchers, that use Social Media technologies to enable and facilitate specifically 1) social networking 2) participation, 3) Apomediation 4) openness, and 5) collaboration“ Gunter Eysenbach, Toronto, 2008 World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 22

Personal (Controlled) Healthcare Records One of the Main Innovation Trajectories of Health 2.0 World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 23

Information Therapy „...is a healthcare term, describing the timely prescription and availability of evidence-based health information to meet individuals' specific needs and support sound decision making.“ World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 24

Global Condition-focused Social Networks World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 25

Participatory Healthcare and Medicare  patient centric  patient as a source  health effective  cost effective World Health Summit, Charite Berlin, Oct. 14.-18. 2009 © Alexander Schachinger, Page 32

Digital Healthcare, Participatory Healthcare

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