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Transformative governance of personal health ecosystems


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Invited speech of Dr. Totti Könnölä, CEO inf Insight Foresight Institute in the scientific conference 'Bioengineering for Healthy Ageing. Adding Life to Years' November 9th 2017, CosmoCaixa Barcelona.

Future personal health ecosystems encompass various areas of application such as chronic disease management, life-style management, independent living and emergency services. Such future systems assist in the provision of continuous, quality controlled and personalised health services to empowered individuals regardless of location and provide a horizontal development area across variety of patients, clinical specialties, technology fields and health services. Hence, the development of such ecosystems requires transformative governance that enable coordination and federation of diverse stakeholders.

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Transformative governance of personal health ecosystems

  1. 1. Transformative Governance of Personal Health Ecosystems Dr. Totti Könnölä, CEO Insight Foresight Institute Bioengineering for Healthy Ageing. Adding Life to Years, B Debate, November 9th 2017 CosmoCaixa Barcelona Transforming Innovation Ecosyste
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  3. 3. Climate change & Volatility of commodities Digitalisation, Industry 4.0, AI, bio-nano-info- cogno convergence Inequility & Exponentials Social media & Sharing economy Conflicts & post-truth politics Volatility, Uncertainty, Complexity & Ambiguity (VUCA) INNOVATION ECOSYSTEM A RESPONSE TO ‘VUCA WORLD’
  5. 5. FUTURE PERSONAL HEALTH ECOSYSTEMS Devices, ambient, wearable and/or in-body Intelligent processing, data analytics and expert knowledge Personalised prevention, diagnosis, treatment and rehabilitation. 6
  7. 7. MARKE T Use/ younger age Patient / older age Public Public PHS services for prevention  Mostly users with risk factors  In widespread diseases (public health)  Requires health literacy on part of patients  Requires change in public health care systems to more preventive care  Long innovation cycles (adoption 5-10 years) Public PHS services for therapeutic use  For the unhealthy, elderly, disabled, mentally declined  Most likely in widespread diseases, (public health)  Demand mediated by public actors, difficult acceptance in the system  Long-term development and adaptation of technology  Large firm involvement more likely because of long innovation cycles and financial burden involved  Long innovation cycles (adoption 5-10 years) Private Life-style PHS products/services  young, dynamic, stylish, cheap, web- based applications;  demand difficult to foresee, may be viral in adoption and in dropout  Very short innovation cycles PHS products/services for home care  Addressing the unhealthy, elderly, disabled, mentally declined  Users hard to reach through advertising  Demand through informal carers, also depends on acceptance by patients 8
  8. 8. HIERARCHY OF PHS SOLUTIONS Hierarchy Definition Technology Sensor Technological system Sensor + Device + Network Health application Solution (Sensor + Device + Implementation) Health care service Service (Solution + Management + Business model – Clinical) Health care service ecosystem Ecosystem (Services + Platform + Interoperability) 9
  9. 9. TRANSFORMATIVE GOVERNANCE Agent Platform Platform ecosystem Economy Platforms Agents • Policentricity • Connectivity • Diversity • Redundancy • Directionality • Federation • Coordination • Value through scale and scope • Activity • Structure • Governance 10
  10. 10. International National Regional Local Creation and Diffusion of Knowledge Enhancing Relations and Networking Development of Capabilities Multiple Layers of Innovation Ecosystems 1. Issues: • Societal challenges • Coordination challenges 5. Outcomes • Relate to objectives across different layers 6. Impacts • Relate to societal and coordination challenges across the layers 3. Inputs and implementation • Use of human, financial, technical etc. recourse across the layers • Modular and scalable foresight design 4. Outputs • Relate to inputs and implementation across the layers (deliverables, e.g. documents) 2. Foresight Objectives 2. Objectives Horizontal Vertical Temporal Intersystemic
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  12. 12. MULTI-LAYERED LANDSCAPE OF PERSONAL HEALTH SYSTEMS Layer Challenges Transnational innovation systems Fragmentation of PHS initiatives Duplicity of efforts Lack of standards and interoperability Room for further coordination National innovation systems National health systems reluctant to new product service systems Barriers to market access Rigidities in reimbursement models Lack of interoperability, fragmentation of health data Dublicity of efforts Promising private sector initiatives Regional innovation systems Promising pilots that often suffer from lack of sufficient scale Difficulties in streamlining PHS efforts with the national health system Innovation eco- systems Promising public sector pilots Promising private sector initiatives Difficulties in engaging all relevant stakeholders including e.g.
  13. 13. 2030 SCENARIOS, NOT PREDICTIONSSCENARIO ALPHA: “THE DREAM SCENARIO” The government has moved to a steering role, overseeing outcomes and stimulating compliance through soft methods. Its direct intervention in and financing of healthcare has been substantially reduced, except for acute problems. SCENARIO BETA: “TRANSITIONAL SCENARIO” Social gaps with respect to health consumerism, access to, and confidence in technologies have persisted (constraining take up and mainstreaming of PHS and other eHealth innovations), the role of government related healthcare institutions and basic financing mechanisms have not changed but rising costs are de facto eroding the full public coverage. SCENARIO GAMMA: “SHARED RESPONSIBILITY FOR A HEALTHY SOCIETY” Although pervasive health consumerist attitudes and behaviours became dominant, the outbreak of acute crisis management have led the 14
  15. 15. 16 visits to health centres/hospitals by people with chronic diseases professionals educated into PHS budget spent on chronic diseases saved by PHS use hospital mortalities of elderly admitted for emergency care patients with long term conditions monitored electronic health records, in a common format across the EU people suffering acute episodes whose EHRs can be accessed by emergency care adults active in a patients’ groups people with PHS for advice in everyday PHS tools scientifically proven as reliably advantageous spending in PHS funded by private consumption/enterprises population with PHS systems that are integrated with EHR systems.
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  17. 17. TRANSFORMATIVE GOVERNANCE CONCLUSIONS Ecosystems - all players in, try foresight To scale-up think platforms and accept disruption Federate and coordinate the ecosystem 18
  18. 18. Insight Foresight Institute (IFI) Avda. Concha Espina, 8-1 Dcha. 28001 Madrid, Spain “With us, achieve game-changing strategies, implement them effectively and reach out to have impact”