As chronic diseases are increasingly straining healthcare systems, social factors are gaining importance. Since the birth of social medicine (19th century), we saw many failed attempts to beat the dominance of the biomedical model. Social prescriptions have come, raising hopes that non-biomedical solutions will improve outcomes and optimise resource use. Social Prescriptions connect citizens to support to address social determinants of health and encourage self-care for physical and mental health. Social prescriptions can make us healthier cheaper and with fewer side effects than most drugs. Social prescriptions can become a disruptive force as they can be personalised, improve lifestyle-related diseases, and support non-biomedical issues affected by social determinants of health.
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Using technology-enabled social prescriptions to disrupt healthcare
1. Using technology-enabled social
prescriptions to disrupt healthcare
Dr Sven Jungmann, Co-Founder of the FoundersLane Health Circle
Initiator of the Fightback movement
Member of the World Economic Forum
2. A massive thanks to my fabulous co-authors:
Pritesh Mistry
Royal College of General Practitioners
Tim Conibear
Waves for Change
Muir Gray
University of Oxford
Anant Jani
University of Oxford
You can read the full article here
4. As chronic diseases are increasingly straining healthcare
systems, social factors are gaining importance
1. Watson J, Salisbury C, Jani A, et al. Better value primary care is needed now more than ever. BMJ 2017; 359: j4944
2. Jani A and Gray M. Making social prescriptions mainstream. JRSM 2019 (in press).
Increasing factors require
unsustainable levels of funding1
Aging populations
Increasing chronic disease
and multimorbidity
New therapeutics and
diagnostics
Many chronic diseases are preventable or
can be alleviated through lifestyle
interventions.
…of health outcomes are determined by social factors.
These are rarely addressed in systems based on the
biomedical model.2
70%
5. Thanks to digital, we can look
beyond the biomedical box
Since the birth of social
medicine (19th century), we
saw many failed attempts
to beat the dominance of
the biomedical model.
Every idea has a
„right time“
Social prescriptions have
come, raising hopes that
non-biomedical solutions
will improve outcomes and
optimise resource use.
Europe warmed up
to social Px
Social Px connect citizen to
support to address social
determinants of health and
encourage self-care for
physical and mental health.
Activating new
ressources
6. This happens when an innovator
creates a solution to a problem
that cheaper than and less
profitable than the incumbent‘s
offering. The new solution is also
better on a dimension of
importance to the customer.
Over time, the novel solution
becomes increasingly better and
starts to seize growing
proportions of the market.,
„Disruption from
Below“
Social prescribing is poised to become an essential ingredient for a
“disruption from below” of the next wave of health innovations
Growing pressures
The pharmaceutical industry
faces the ‘better than the
beatles’ problem: while for
songs, novelty carries an
intrinsic value, drugs have to
be better than the current gold
standard.3 While development
costs are high and on the rise,
capturing adequate returns is
increasingly difficult.
Novel opportunities
Social prescriptions can make
us healthier cheaper and with
fewer side effects than most
drugs. Social prescriptions
can become a disruptive force
as they can be personalised,
improve lifestyle-related
diseases, and support non-
biomedical issues affected by
social determinants of health.
3. Scannell JW, Blanckley A, Boldon H and Warrington B. Diagnosing the decline in pharmaceutical R&D efficiency.
Nat Rev Drug Discov 2012; 11: 191–200.
7. 1 2 3
There are barriers that we must overcome first to unleash
the potential of social prescriptions.
Data availability Independence Omnipresent service
...make it simpler and less expensive to
obtain data on individual patients and
providers
...increase flexibility outside of the
location-dependent care delivery
...provide around the clock availability
and nudges as well as frequent
feedback as needed.
Digital is expected to fuel scalable social prescriptions because they...
8. To achieve their disruptive potential, digital
technologies need to be informed by
technological and lifestyle trends that influence
our daily behaviour, particularly those that would
allow social prescriptions to blend into what
feels normal to patients’ regular lives.
Original quote from the publication:
Key quote
9. Tech enabled social prescriptions can bring living services to life
in healthcare
A helpful trend
‘Living Services’ are fueled by connected
devices and are defined by Fjord as:
sophisticated, contextually-aware digital
services designed to anticipate and
respond to a user‘s needs. They react in
real-time to changes in the environment
and patterns of behavior, in ways that will
transform how we live, work, and play.
Living services require a combination of
ubiquitous sensors (wearables, nearables,
ingestibles...), connected devices, user
interfaces, the cloud, and network
connectivity combined with data (incl.
subjective outcome measures) and analytics.
10. If we link these data to personal health profiles
(case-mix and outcome measures), we can
provide doctors with tailored prescribing
recommendations and give patients access to
predictive models that provide feedback on the
future health benefits incurred from adhering to
social prescriptions.6
This isn‘t just about technology. Only thanks to
new insights from behaviour change science are
we able to shape healthier behaviour. This could
give rise to ‘Learning Health Care Systems’ 4
which use the continuous collection of dynamic
data to shed light microtemporal processes.5
Tech-enabled social prescribing enables a real shift from intuitive
and empirical to precise medicine
4. Learning Healthcare Project. The Potential of Learning Healthcare Systems. See www.learninghealthcareproject.org/LHS_Report_2015.pdf
5. Dunton GF. Sustaining health-protective behaviors such as physical activity and healthy eating. JAMA 2018; 320: 639–640.
6. Christensen C, Grossman J and Hwang J. The Innovator’s Prescription: A Disruptive Solution for Healthcare. McGraw-Hill Education: New York, 2009.
11. Affordable Impact
With improving tech,
social prescriptions
will have increasing
impact, particularly
for lifestyle-driven
chronic diseases.
There are hundreds of
technologies that can
make care delivery more
affordable and convenient.
Other data could be
obtained from spending
data and home appliances
to complete the picture of
one’s lifestyle. These
technologies can give
users personalised
behavioural
recommendations.
Because of tech’s low marginal
costs, they can become
accessible at scale and provide
more precise and adaptable
interventions compared with
medicines, where
pharmacogenomics-based
precision medicine is still
expensive and takes time to
adapt.
12. Sustainable and effective social prescribing requires us to co-develop and learn to use
technology that removes barriers, manages large data, reduces workload for the
system, and helps patients be in control of their health.
Scaling tech-enabled social prescriptions
1 2 3
Information needs to be
captured and shared effectively
across organisations . This
requires better standards and
APIs for data sharing that
facilitate ethical interoperability,
ensuring user safety.
The active use of personal
sensors will create a high density
of information flowing into
systems. This requires effective
data storage and tools to analyse
combined datasets, making
them meaningful for everyone.
Stakeholders need accurate
data on what is available in
communities, if users are
engaging with the intervention,
and whether it has helped. This
requires tools to be transparent
regarding safety and
effectiveness of digital tools.
Removing barriers Managing data Supporting stakeholders
13. „When consumers engage with a brand today, such as an
airline or a bank, they compare their experience not only
with other airlines or banks but also with any service
company, such as ride-sharing providers. Take the
seamless and largely invisible payment systems these
providers offer. Now consumers want payment
experiences like this in every industry, consciously or
subconsciously.“ — Fjord
Healthcare must follow the innovations that other industries are already embracing.
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Most digital transformation tools
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Often corporates lack the speed
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