Remixing Public Health: Tools for Public Health Innovation


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This is an extensive outline of some tools, trends, concepts, platforms and ideas that we can harness to drive innovation in public health and the Healthy Cities movement.

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Remixing Public Health: Tools for Public Health Innovation

  1. 1. Re-mixing Public Health: A walk (long) through Open Health & the Emerging Social Mediascape Jody Ranck, DrPH Principal Investigator, Public Health Institute July 2009
  2. 2. Why Re-Mixing? <ul><li>Because it sounds trendy? </li></ul><ul><li>Borrow and steal from already existing tools, disciplines </li></ul><ul><li>Recombinant innovation </li></ul><ul><li>Making the invisible visible and changing behaviors and policies—the mash-up is an important metaphor </li></ul><ul><li>Complexity of our problems—demands solutions coming from multiple sectors, geographies, etc. </li></ul>
  3. 3. Why should Public Health Care about social media? <ul><li>New types of communities/knowledge systems emerging </li></ul><ul><li>Socio-techological change: not a question of WHETHER social media will change how we think, behave, etc. but rather, it is a question of HOW? </li></ul><ul><li>Complexity of health issues requires new thinking </li></ul><ul><li>New modes of governance & citizenship </li></ul><ul><li>Ways of delivering healthcare changing </li></ul><ul><li>Luddites will become irrelevant in many areas </li></ul>
  4. 4. Public Health Challenges <ul><li>From command-control systems to distibuted systems and production </li></ul><ul><li>System built on 1910 Flexner Report </li></ul><ul><li>Health Society: expansion of territory of health  health is no longer just about health systems </li></ul><ul><li>Health outcomes linked as much to other sectors as health sector—perfect multi-sectoral issue, but many silos </li></ul><ul><li>Health competes with many other issues </li></ul><ul><li>Behavioralist paradigms-dated, not producing outcomes </li></ul><ul><li>Socio-technological change: health innovations change societies, social change changes innovation systems: New Meanings of Health AND Innovation!!!!! </li></ul>
  5. 5. Government/Civil Society Shift
  6. 6. Section 1: Social Media and Public Health <ul><li>Introduction to Social Media Tools </li></ul><ul><li>Medicine 2.0 </li></ul><ul><li>Health 2.0 </li></ul><ul><li>How do we get to Public Health 2.0 and beyond? Why should we care about social media? </li></ul>
  7. 7. How do we respond: Social Media <ul><li>Blogs, wikis, vlogs </li></ul><ul><li>Podcasts, photo-sharing </li></ul><ul><li>Social Networking Platforms </li></ul><ul><li>YouTube </li></ul><ul><li>RSS </li></ul><ul><li>Social Tagging, eg. Delicious </li></ul><ul><li>Microblogging: Twitter </li></ul><ul><li>Data Visualization/Infographics </li></ul><ul><li>Enterprise 2.0 Platforms </li></ul><ul><li>New and Old media ecosystems together </li></ul>
  8. 8. Social Media: an Ecosystem
  9. 9. Eco-system of ‘old’ and ‘new’
  10. 10. Convergence of old and new <ul><li>Old media reporting on stories from social media, eg. Iran election & CNN </li></ul><ul><li>Campaigns that use social media to drive broader media strategy, eg. Obama campaign </li></ul><ul><li>In developing world use of mobiles and radio in agriculture and health </li></ul><ul><li>Online video growing rapidly, eg. Hulu </li></ul><ul><li>I’m sick of the word “new” </li></ul>
  11. 11. Public Health 2.0 <ul><li>Social Media </li></ul><ul><li>Architecture of Participation </li></ul><ul><li>Open Innovation </li></ul><ul><li>Crowdsourcing </li></ul><ul><li>Citizen Engagement through social media </li></ul><ul><li>Mobiles </li></ul><ul><li>Urban Informatics </li></ul><ul><li>Cloud Computing </li></ul><ul><li>Design Thinking </li></ul>
  12. 12. Medicine 2.0/Health 2.0
  13. 13. Medicine 2.0
  14. 14. If Medicine can do it…
  15. 15. Public Health 2.0? Can we do better than “cope”?
  16. 16. Why does it matter? <ul><li>A new type of web: mobile, participatory </li></ul><ul><li>Demands for transparency, eg. </li></ul><ul><li>Non-profit sector is adopting & innovating rapidly in the social media space </li></ul><ul><li>Convergence of old and new media: it’s not just about teens on MySpace anymore! </li></ul><ul><li>New forms of sociality emerging: biocitizenship and social networks in health </li></ul><ul><li>Ethos of cooperation </li></ul><ul><li>New commons  Health commons  New public health + spirit of innovation </li></ul>
  17. 17. Section 2: What do we do with Social Media? <ul><li>Content </li></ul><ul><li>Community </li></ul><ul><li>Collaboration </li></ul><ul><li>Collective Action </li></ul>
  18. 18. Why social media? <ul><li>Gaurav Mishra’s 4 C’s of Social Media: </li></ul><ul><li>Content: everyone can be a creator </li></ul><ul><li>Collaboration: conversation, co-creation, collective action </li></ul><ul><li>Community: Sustained collaboration </li></ul><ul><li>Collective Intelligence: Joy’s Law-the smartest people work somewhere else </li></ul><ul><li>See : </li></ul>
  19. 19. Content
  20. 20. Content
  21. 21. Content Aggregators
  22. 22. Hyper-local/citizen news
  23. 23. Hyperlocalities
  24. 24. Content: Neighborhood News
  25. 25. Content: New Journalism –business models
  26. 26. Content: blogging the city
  27. 27. What’s up with that “Twitter thing”
  28. 28. Twitter as listening post, filter…
  29. 29. Twitter and distributed surveillance
  30. 30. Twitter & misinformation
  31. 31. Twitter and civic engagement
  32. 32. Twitter Source:
  33. 33. Twitter for Public Health <ul><li>Find interesting minds: @mindofandre, @AndrewPWilson, @bloodandmilk, etc. </li></ul><ul><li>Follow conferences, legislative updates, reports from field </li></ul><ul><li>Pool/aggregate data </li></ul><ul><li>Suite of Twitter tools </li></ul><ul><li>Social News Campaigns: podcast, blog, etc. </li></ul>
  34. 34. Content in summary: Public Health 2.0 <ul><li>Citizenry as co-creators of content </li></ul><ul><li>Need for deeper listening to what matters </li></ul><ul><li>Use of social filters to highlight what is important </li></ul><ul><li>Experts are often poor prognosticators </li></ul><ul><li>Yet, we need to move beyond populist rhetoric of the crowd </li></ul><ul><li>New forms of biological/technological citizenship emerging-people can find like-minded people on social media platforms and build, curate content, eg. Blogs, wikis, Twitter hashtags (eg. #H1N1) </li></ul>
  35. 35. Collaboration <ul><li>Content become center of conversations </li></ul><ul><li>Curation of aggregate content </li></ul><ul><li>At what point does content and conversation convert to meaningful collaboration? </li></ul><ul><li>How can you break problems down into modular, workable pieces that engage community? </li></ul>
  36. 36. Types of collaboration <ul><li>Defining or framing a problem </li></ul><ul><li>Debate about strategies </li></ul><ul><li>Moving across silos/sectors </li></ul><ul><li>Filling in holes in data </li></ul><ul><li>Ongoing conversations around issues </li></ul><ul><li>Rapid response to emerging issues </li></ul>
  37. 37. Collaboration: platform for government & citizens
  38. 38. Toronto Transit Camp Case Study <ul><li>TTC did not define problem to be solved </li></ul><ul><li>Sought ideas for reform from users </li></ul><ul><li>Used blogs, wikis, discussion boards, offline polling, etc. </li></ul><ul><li>Can use additional tools such as citizen study circles, citizen juries </li></ul><ul><li>Illustrates need to identify the “right” networks </li></ul>
  39. 39. Platforms: moving beyond silos
  40. 40. All Hazards Consortium Case Study <ul><li>Involved VA, MD, DC </li></ul><ul><li>Brought together private sector, non-profits, universities, citizens, govt agencies </li></ul><ul><li>Govt Agencies are the “innovation champions” in the network: create collaborative environment </li></ul><ul><li>Govt role is about controlling the process </li></ul><ul><li>Govt creates infrastructure for social knowledge creation </li></ul>
  41. 41. Collaboration: defining a problem
  42. 42. Collaboration: mapping problems
  43. 43. Collaboration: open street map
  44. 44. Open Street Map: telling stories
  45. 45. More Telling Stories with Maps
  46. 46. Open Street Map: coordinating agencies
  47. 47. Collaboration: co-created problem definition
  48. 48. Collaboration: Gov 2.0 using the cloud to break down silos
  49. 49. Virtual Alabama Platform Results <ul><li>$150,000 to build </li></ul><ul><li>10 days to create </li></ul><ul><li>Can now share data in the cloud across government sectors </li></ul><ul><li>The cloud is growing in importance—public health needs to be part of the discussion! But more on that later…. </li></ul>
  50. 50. Collaboration Lessons <ul><li>Sourcing knowledge from edges </li></ul><ul><li>Learn from outside of the health field </li></ul><ul><li>Collaborate with other sectors in more robust manner </li></ul><ul><li>Co-creation of knowledge with users </li></ul><ul><li>We’re often our own worst enemies: silos, blinders </li></ul><ul><li>Our value networks are more complex: need more debate, discussion to deal with complex ecosystem of partners </li></ul><ul><li>We deal with PUBLICS not a public </li></ul><ul><li>Collaborative problem-solving is central yet not typically funded by foundations </li></ul>
  51. 51. Collaboration: co-creation of knowledge Jason Corburn shows how citizens can challenge dominant risk assessment paradigms used by EPA and scientists. Citizens as co-producers of expertise or citizen-scientists
  52. 52. Community <ul><li>Difficult to sustain engaged community </li></ul><ul><li>MyBarackObama, DailyKos, etc. </li></ul><ul><li>But we see with diverse patient communities </li></ul><ul><li>TuDiabetes </li></ul><ul><li>Sharing, aggregating, conversing-  </li></ul><ul><li>Translation into Collective Action </li></ul>
  53. 53. Community
  54. 54. Communities
  55. 55. Community of shared interests
  56. 56. Communities
  57. 57. Communities
  58. 58. Communities
  59. 59. Communities
  60. 60. Genetic Alliance <ul><li>Information portal </li></ul><ul><li>Policy Advocacy </li></ul><ul><li>WikiGenetics, WikiAdvocacy </li></ul><ul><li>Resource Repository </li></ul><ul><li>Good Example of emerging bio-sociality & biocitizenship in action </li></ul>
  61. 61. Health 2.0 Communities <ul><li>Communities around micro-macro issues </li></ul><ul><li>User-generated content, filters </li></ul><ul><li>Information  knowledge  new power relationships in clinical encounter </li></ul><ul><li>Platforms for fundraising, policy, advocacy </li></ul><ul><li>Data aggregators that move beyond HIPAA constraints </li></ul><ul><li>We’ve yet to see substantial movement in power structures of health & medicine </li></ul><ul><li>But they’re still potent “issue networks” and signal of new form of bio-sociality that has potential to shift health politics </li></ul>
  62. 62. Where does Public Health fit in? <ul><li>Need to move from top-down approaches </li></ul><ul><li>Less control, democratization of expertise-we are no longer the privileged experts all the time: listen, engage </li></ul><ul><li>Think critically about populist hubris in social mediasphere without resorting back to PH knows best ethos </li></ul><ul><li>Who speaks for communities? Beyond bioethics to somatic ethics and relationships online </li></ul><ul><li>How can we cultivate democratic ethos of public health in social mediasphere? </li></ul><ul><li>Organizational design: how to incentivize collaboration and community building rather than maintenance of silos? </li></ul>
  63. 63. Thinking About ROI of Social Media
  64. 64. ROI <ul><li>Government 2.0 sites: transparency, accountability, efficiency </li></ul><ul><li>Open innovation platforms: valuations of each app or service </li></ul><ul><li>Citizen feedback and trust </li></ul><ul><li>Social capital from highlighting successes and even failures </li></ul>
  65. 65. ROI (Social Media) <ul><li> </li></ul><ul><li>Beth Kanter: Return on Insight: </li></ul><ul><li>More than Math: Listen, Learn, Adapt </li></ul><ul><li>May need internal organizational/cultural changes </li></ul><ul><li>Pick the Right Metrics </li></ul><ul><li>Tangible and Intangible Benefits </li></ul><ul><li>Numbers and Stories </li></ul>
  66. 66. Section 3: Social Media Platforms <ul><li>Collaboration: digging deeper </li></ul><ul><li>Typologies of collaborative platforms </li></ul><ul><li>What problem are you solving for? </li></ul><ul><li>What are some characteristics of collaborative organizations? </li></ul><ul><li>Network Organizations and Public Health </li></ul>
  67. 67. Collaborative Platforms: Some lessons from Satish Nambisan <ul><li>Exploration: Defining a problem where dissensus exists </li></ul><ul><li>Experimentation: Testing out solutions </li></ul><ul><li>Execution: Disseminating solutions </li></ul><ul><li>Each of these is a form of crowdsourcing </li></ul><ul><li>See: Satish Nambisan (2009). Platforms for Collaboration. Stanford Social Innovation Review, Summer, Vol. 7, No. 3. </li></ul>
  68. 68. Exploration Platform
  69. 69. Exploration Platform
  70. 70. Exploration/Innovation Platform
  71. 71. Exploration Platforms <ul><li>Used to help frame issues </li></ul><ul><li>Create communities around different aspects of a problem—modular approach </li></ul><ul><li>Science of asking the right question </li></ul><ul><li>Used to build consensus around vision, strategy, approaches </li></ul><ul><li>Participants need to know what they’re being asked to accomplish </li></ul>
  72. 72. Experimentation Platform
  73. 73. Experimentation Platforms
  74. 74. Experimentation Platforms <ul><li>Too many organizations go from idea to implementation without testing idea </li></ul><ul><li>Neutral environments for testing things out—rapid prototypying </li></ul><ul><li>Virtual innovation labs: Y Combinator </li></ul><ul><li>Need agreement on success metrics </li></ul><ul><li>Uncover implementation challenges </li></ul>
  75. 75. Platforms for Implementation
  76. 76. Implementation Platforms <ul><li>Used for rolling out findings </li></ul><ul><li>Create and distribute templates to assist replication </li></ul><ul><li>Coordinate efforts of those in network </li></ul><ul><li>Connected to offline sessions for sharing information, experiences </li></ul>
  77. 77. Innovation Platform: turning ideas into action, social businesses
  78. 78. Sambisan’s Ingredients for Platforms <ul><li>Need a Network Perspective: embrace non-traditional partners </li></ul><ul><li>Modular or Plug-and-Play Expertise: agile </li></ul><ul><li>Portfolio of Success Metrics </li></ul><ul><li>Ability to dismantle barriers between government, business, non-profits </li></ul>
  79. 79. Networked Public Health <ul><li>Different types of networks: loosely coupled, centralized, distributed, etc. </li></ul><ul><li>Partnerships and Networks are not the same thing </li></ul><ul><li>Rather than broad social movements-see more micro-movement </li></ul><ul><li>Coordination and Control of Networks—governance </li></ul><ul><li>Designing Networks: building relationships, managing in less hierarchical domains, interdependencies, roles and accountability </li></ul><ul><li>What would the PHR for public health look like: collaborative platform that enables citizens to build, share, use data </li></ul>
  80. 80. Section 4: Apps for Democracy Example <ul><li>New way of driving innovation through engagement with citizenry </li></ul><ul><li>Democratizing data </li></ul><ul><li>Improving the quality of data </li></ul><ul><li>Building platforms for win-wins for gov/citizens </li></ul><ul><li>What can we learn from this for public health? </li></ul>
  81. 81. Platforms: Apps for Democracy
  82. 82. AppsforDemocracy examples..
  83. 83. Apps for Democracy
  84. 84. Apps for Democracy
  85. 85. Apps for Democracy
  86. 86. Apps for Democracy
  87. 87. Apps for Democracy
  88. 88. Apps for Democracy Lessons <ul><li>How can we do more with less? </li></ul><ul><li>Some initial apps may appear trivial, incentivize for quality </li></ul><ul><li>Helps move out of silos, command/control structures that hinder civic engagement </li></ul><ul><li>Many agencies will resist change and not release data—incentives? What are costs for non-engagement? </li></ul><ul><li>Opening up data creates conditions for innovation, better data </li></ul><ul><li>Respond to citizens, not customers </li></ul>
  89. 89. Apps for Health? <ul><li>Crowdsourcing new tools for citizen engagement in public health </li></ul><ul><li>Multiple rounds on different themes </li></ul><ul><li>A way to drive innovation in tough economic climate </li></ul><ul><li>Apps for Healthy Cities 2.0? </li></ul><ul><li>Highlight neglected public health issues </li></ul><ul><li>Incentivize multi-sectoral collaboration </li></ul>
  90. 90. Challenges for AppsForHealth <ul><li>Privacy issues with health data </li></ul><ul><li>Development of open standards </li></ul><ul><li>Apps for individuals vs. community health outcomes: difficult translation </li></ul><ul><li>Lack of good behavioral change models: crowdsource alternative paradigms? </li></ul><ul><li>Complexity of chronic diseases vs. simplicity of apps </li></ul>
  91. 91. Section 5: The City and Public Health as Platform <ul><li>City as Platform </li></ul><ul><li>Open Innovation Platform </li></ul><ul><li>Tools to think with </li></ul>
  92. 92. City as Platform
  93. 93. The City as Open Innovation Platform
  94. 94. Villes 2.0 <ul><li>Can the city be re-imagined as a platform that can be modified by its users? </li></ul><ul><li>What resources can be shared and mobilized for re-thinking the city? </li></ul><ul><li>The suite of web 2.0 tools available can be used to re-fashion urban services, make user-friendly </li></ul><ul><li>New Ethos embodied in Apps for Democracy </li></ul>
  95. 95. Government-Citizen Cooperation
  96. 96. Co-created Govt services
  97. 97. Responding and Engaging in a world of Tweets Gavin Newsom claims using free service like Twitter saved 100k over using SMS for 311 service
  98. 98. Disaster planning Use of social media platforms to cross silos and help build more resilient infrastructures—avoiding future Hurricane Katrinas
  99. 99. Civic Partnerships
  100. 100. Civic Engagement
  101. 101. The tools are here… <ul><li>Mapping </li></ul><ul><li>Open data </li></ul><ul><li>Transparency </li></ul><ul><li>Data visualization </li></ul><ul><li>Platform integration for services </li></ul><ul><li>How to tie it all together and make sense? </li></ul><ul><li>We need to rethink organizations, networks, communities </li></ul><ul><li>In many ways this is what AppsForDemocracy points toward… </li></ul>
  102. 102. Opportunity Mapping: how to make it user friendly? GIS is enabling greater use of maps and geo-coded data to make patterns more visible
  103. 103. Urban Eco-Maps
  104. 104. Green Maps
  105. 105. Crime Mapping
  106. 106. Crime Mapping
  107. 107. Crime Mapping
  108. 108. Open data
  109. 109. Open Data
  110. 110. Democratizing Data
  111. 111. DBpedia
  112. 112. Databases
  113. 113. Linked Data Linked data and semantic web are next stage of where the internet is heading
  114. 114. Open City Data (San Francisco)
  115. 115. Wikis and linking communities
  116. 116. Transparency
  117. 117. Transparency: legal
  118. 118. Crowdsourcing Health Politics & Transparency
  119. 119. Transparency: Food Safety
  120. 120. Transparency
  121. 121. Transparency
  122. 122. Transparency: Corporate
  123. 123. ‘ Radical’ Transparency
  124. 124. Transparency policies
  125. 125. Transparency Policies: <ul><li>Need to provide info that is easy to use </li></ul><ul><li>Target transparency systems towards interested parties </li></ul><ul><li>Be nimble in responding to changed priorities of users </li></ul><ul><li>Create benefits for disclosers of information </li></ul><ul><li>Design with metrics for accuracy and compatibility </li></ul><ul><li>Design for comprehension: eg. Visualization/infographic tools </li></ul><ul><li>Incorporate analysis and feedback </li></ul><ul><li>Sanctions for non-reporting </li></ul>
  126. 126. Data Visualization tools
  127. 127. Data Visualization tools
  128. 128. Services for Creating Visual tools
  129. 129. Data Visualization
  130. 130. Infographics
  131. 131. Widgetization of Web
  132. 132. Mapping Services
  133. 133. GeoCommons
  134. 134. Geoweb <ul><li>More data are geocoded, web-based and mobile </li></ul><ul><li>Growth in use of Google maps, etc. </li></ul><ul><li>GIS becoming more ubiquitous, user-friendly </li></ul><ul><li>Peer-to-peer geo-based services on iPhone </li></ul><ul><li>More bottom-up, co-created maps </li></ul><ul><li>Power of place and information in policies </li></ul><ul><li>Participatory mapping and planning </li></ul>
  135. 135. Planning differently…
  136. 136. Participatory Budgeting Social media tools and Wiki Government + Mapping and Visualization Tools can re-make the participatory budgeting movement
  137. 137. Planning: Wiki Government
  138. 138. Geosimulation
  139. 139. DIY: tools for building urban tools
  140. 140. Section 6: More tools and signals <ul><li>Making the Invisible Visible </li></ul><ul><li>Mobiles and Urban computing </li></ul><ul><li>Persuasive Technologies and Games </li></ul>
  141. 141. Tools for making the invisible visible <ul><li>Low cost diagnostics </li></ul><ul><li>Sensors </li></ul><ul><li>Visual Tools </li></ul><ul><li>Augmented Reality </li></ul><ul><li>Mash-ups </li></ul><ul><li>Mobiles </li></ul><ul><li>=Tools for Collective Action on Health Issues </li></ul>
  142. 142. Making the invisible visible…
  143. 143. Spatial Information Design Lab
  144. 144. Making it Political VISIBLE
  145. 145. Aesthetics of Political Visibility
  146. 146. Augmented Reality
  147. 147. Urban Computing <ul><li>Urban infrastructures </li></ul><ul><li>Maps, traffic info </li></ul><ul><li>Sense of place </li></ul><ul><li>Mobile devices, sensors </li></ul><ul><li>Social computing/networking: familiar strangers </li></ul><ul><li>City info, open data </li></ul><ul><li>Augmented Reality—now on mobiles </li></ul>
  148. 148. Urban Computing <ul><li>City Sense: San Franciso-Hot Spots </li></ul><ul><li>Understand behaviors of “users” of the city </li></ul><ul><li>Citizen Science, eg. Working with SF Street Sweepers on air quality </li></ul><ul><li>Ergo—mobile air quality </li></ul>
  149. 149. Urban computing: sensors
  150. 150. Urban Computing (cont.)
  151. 151. Urban Sensing: mobile computing
  152. 152. CENS:(Cont)
  153. 153. CENS: (cont)
  154. 154. CENS: Feedback Loops
  155. 155. Persuasive Tech Example: Prius dashboard: changing behavior
  156. 156. Persuasive Technologies—mobile web
  157. 157. Persuasive Technologies: BJ Fogg <ul><li>Captology: computers as persuasive tech </li></ul><ul><li>About intentions of designers of products persuading user: goal focused </li></ul><ul><li>Less concerned with altering framing of perception that user has already developed </li></ul>
  158. 158. Persuasive Technologies <ul><li>Reduction: reduce complex behavior to simple tasks </li></ul><ul><li>Tunneling: leading user through pre-determined set of actions </li></ul><ul><li>Suggestion: suggest behavior at most opportune moment </li></ul><ul><li>Self-Monitoring: monitor behaviors to achieve pre-determined goal </li></ul><ul><li>Surveillance: one party monitors behavior of another </li></ul><ul><li>Conditioning: using operant conditioning to change behaviors, eg. Telecycle—when pedaled to a target speed and image is clarified on screen </li></ul>
  159. 159. Persuasive Games
  160. 160. Persuasive Games: Ian Bogost <ul><li>More focused on using rhetoric to engage user in a discourse about behavior itself, more reflexive </li></ul><ul><li>Does not accept as a given that user understands or accepts the larger reason for a behavior </li></ul><ul><li>Persuasive Tech is largely framed around psychology, Persuasive Games around rhetoric </li></ul>
  161. 161. Persuasive Games <ul><li>Stimulate critical thinking: not the same as “serious games” that do not question established norms </li></ul><ul><li>“ Killer Flu”: helps to understand how pandemic flus mutate and the geographical contingencies of the epidemiology </li></ul><ul><li>“ Fat World”: politics of Nutrition </li></ul><ul><li>“ Food Import Folly”: interrogates role of FDA, in collaboration with NY Times </li></ul><ul><li>“ Bacteria Salad”: on agri-business, food safety </li></ul><ul><li>“ Stone City: Cold Stone Creamery”: on portion size and profits </li></ul>
  162. 162. Public Dashboards as Persuasive Technologies
  163. 163. Urban-Mobile Computing
  164. 164. Hypercities
  165. 165. Hypercities <ul><li>Layers of historical information about cities </li></ul><ul><li>Puts the archives of cultural histories and diverse communities on the web </li></ul><ul><li>Encourages exploration of the history and layers of the city </li></ul><ul><li>Goal is to change the way we interact with information on the city and with each other </li></ul>
  166. 166. Mobile Health
  167. 167. Mobile Health: Frontline Medic/Open MRS Source: Josh Nesbitt,
  168. 168. Mobile Health Applications <ul><li>Education and Awareness </li></ul><ul><li>Data collection (for public health or clinical domains) </li></ul><ul><li>Remote monitoring </li></ul><ul><li>Communication and Training for Healthcare Workers </li></ul><ul><li>Disease Surveillance and Epidemic Outbreak Tracking (Malaria, HIV/AIDS, TB, Avian Flu, chronic diseases- esp. diabetes) </li></ul><ul><li>Diagnostics and Treatment Support </li></ul><ul><li>mLearning, mobile health 2.0 (citizen facing) </li></ul><ul><li>Emergency Response </li></ul><ul><li>Decision Support Systems </li></ul><ul><li>Remote Patient Monitoring </li></ul><ul><li>Health Extension Services </li></ul>
  169. 169. Smart Mobs for Health
  170. 170. RED: Open Health <ul><li>Design: don’t improve existing services but design for desired outcomes </li></ul><ul><li>Design begins with point of view of individual, not the system </li></ul><ul><li>Co-creation </li></ul><ul><li>Smart Mobs in Health=ActivMobs </li></ul><ul><li>Redesign the patient-professional relationship </li></ul><ul><li>Use this ethos for designing next gen mHealth ? </li></ul>
  171. 171. Convergence of social media and mobiles, eg. InSTEDD
  172. 172. InSTEDD
  173. 173. Mobile Health Research: CITRIS
  174. 174. Mobile Crowdsourcing
  175. 175. Mobile crowdsourcing: micro-volunteering
  176. 176. Section 7: Innovation Systems and Public Health <ul><li>Open Innovation </li></ul><ul><li>User-led Innovation </li></ul><ul><li>Peer-to-Peer </li></ul><ul><li>New Commons </li></ul><ul><li>Prevention Economies </li></ul><ul><li>Design Thinking </li></ul><ul><li>Forecasting </li></ul>
  177. 177. How we think about innovation is changing…
  178. 178. NESTA (UK) Innovation: Cooperation and the Commons
  179. 179. New Innovation Approaches: User-led Innovation
  180. 180. Peer-to-Peer
  181. 181. P2P Health
  182. 182. Commons: Science/Health Commons
  183. 183. Prevention Economies: Nordic Region as Global Health Lab
  184. 184. Nordic Region Health Lab <ul><li>Prevention as top policy priority </li></ul><ul><li>Open access to data </li></ul><ul><li>Engagement with Civil Society organizations </li></ul><ul><li>Collaborative Ethos </li></ul><ul><li>Innovative science, strong industry participation </li></ul><ul><li>Equal access to health </li></ul><ul><li>Citizens and User-driven innovation </li></ul>
  185. 185. Lessons <ul><li>Health as a goal in itself </li></ul><ul><li>Steps toward a prevention economy rather than sickness economy </li></ul><ul><li>Health as economic driver rather than drain on resources </li></ul><ul><li>Multi-sectoral </li></ul><ul><li>Demands open health model </li></ul>
  186. 186. New Innovation Architectures <ul><li>Clayton Christensen’s “Network Facilitation Model” </li></ul><ul><li>Need to move beyond single slice, blockbuster product or service </li></ul><ul><li>Cooperative models with Health Commons </li></ul><ul><li>Public Health as the Platform for “plug and play” </li></ul><ul><li>Enabler of innovation </li></ul>
  187. 187. Design Thinking: IDEO’s Human Centered Design <ul><li>What do people desire? </li></ul><ul><li>What is technologically and organizationally feasible? </li></ul><ul><li>What can be financially feasible? </li></ul>
  188. 188. Desireability Feasibility Viability
  189. 189. Design Thinking <ul><li>Observations </li></ul><ul><li>Stories </li></ul><ul><li>Themes </li></ul><ul><li>Opportunities </li></ul><ul><li>Solutions </li></ul><ul><li>Prototypes </li></ul><ul><li>Implementation Plan </li></ul>
  190. 190. Service Design
  191. 191. Scenarios and Forecasting for Public Health <ul><li>Making visible the drivers of change and trends </li></ul><ul><li>Identification of emerging opportunities and threats </li></ul><ul><li>Building more resilient systems in a system that is not centered around command/control systems </li></ul>
  192. 192. Innovation, Risk & Failure <ul><li>Woody Allen: If you’re not failing every now and again, it’s a sign you’re not doing anything very innovative </li></ul>
  193. 193. Wikipedia of Failures as Innovation Platform <ul><li>Failure as forgotten data point </li></ul><ul><li>But understanding why things fail can help drive innovation </li></ul><ul><li>Rapid (Slow) prototyping in Public Health </li></ul><ul><li>Take risks, learn, rethink and innovate </li></ul>
  194. 194. Section 8: Future Issues <ul><li>Cloud Computing and Identities </li></ul><ul><li>Technological Citizenship </li></ul><ul><li>Resilience </li></ul><ul><li>Public Health Platforms in the Cloud </li></ul>
  195. 195. Pointing toward the Future: The Cloud… <ul><li>“ At the end of August [2008], as Hurricane Gustav threatened the coast of Texas, the Obama campaign called the Red Cross to say it would be routing donations to it via the Red Cross home page. “Get your servers ready—our guys can be pretty nuts”, Team Obama said. “Sure, sure, whatever”, the Red Cross responded. “We’ve been through 9/11, Katrina, we can handle it.” The surge of Obama dollars crashed the Red Cross website in less than 15 minutes. —Newsweek </li></ul>See J.D. Lascia (2009). Identity in an Age of Cloud Computing, Aspen Institute, Boulder CO.
  196. 196. Cloud Computing <ul><li>Virtual Platform, eg. SalesForce, web mail, Delicious, YouTube </li></ul><ul><li>Transition from self-generated power to the grid (transition we’re going through now) </li></ul><ul><li>Software as a Service (SaaS), eg. Amazon Web Services </li></ul><ul><li>Enables greater customization </li></ul><ul><li>Can lower the carbon footprint of IT for orgs </li></ul>
  197. 197. Cloud Computing <ul><li>Now, you use cloud computing at home, but your CTO doesn’t allow you to use it at work </li></ul><ul><li>But we may have “inter-clouds” between orgs to facilitate cooperation, eg. Virtual Alabama </li></ul><ul><li>Therefore, public and private identities emerging </li></ul><ul><li>Boundaries as socio-cultural constructs </li></ul><ul><li>How can public health take advantage of cloud? What are the risks? </li></ul><ul><li>We need to start a discussion </li></ul>
  198. 198. Cloud Computing & Identities <ul><li>Management of multiple identities, eg. Biz identity, health identity, friend profiles </li></ul><ul><li>Open identities that reveal just enough data </li></ul><ul><li>So this cloud is a mash-up of lots of social objects with different rules </li></ul><ul><li>And markets are becoming cooperative ecosystems, not zero-sum competitive markets </li></ul>
  199. 199. Cloud Eco-systems <ul><li>Drive for open identities and equalities comes up against old biz models  conflict </li></ul><ul><li>Privacy and security mean different things to different people  HIPAA = blunt instrument, regulatory regimes are not the final word… </li></ul><ul><li>Reputation systems/management not decentralized  digital footprints </li></ul><ul><li>Reputation as value </li></ul>
  200. 200. Cloud Computing and Innovation <ul><li>Greater customization </li></ul><ul><li>Reduced barriers to entry </li></ul><ul><li>Combinatorial innovation </li></ul><ul><li>Benefits of scope may outweigh scale </li></ul><ul><li>Greater organizational complexity and info transparency—more distributed, collaborative approaches </li></ul><ul><li>Rapid proliferation of best practices and change </li></ul><ul><li>Innovation models themselves will change </li></ul><ul><li>Move from marketing push to customer (citizen) pull </li></ul><ul><li>But have to deal with risks as well </li></ul>
  201. 201. Risks of the Cloud <ul><li>Security of data </li></ul><ul><li>Reliability and backup systems </li></ul><ul><li>Data interoperability </li></ul><ul><li>Compliance and liability </li></ul><ul><li>PHRs and privacy in the cloud </li></ul><ul><li>Crime mapping </li></ul><ul><li>Broader privacy politics in context(s) </li></ul>
  202. 202. Technological Citizenship and Public Health <ul><li>Responsibility to know how to use these techs, understand rights </li></ul><ul><li>Techno-social inclusion: need to build the tools and awareness to engage </li></ul><ul><li>What are the new axes of inequalities? </li></ul><ul><li>Re-configuring public health as platform </li></ul><ul><li>Emergence of OPEN HEALTH paradigms </li></ul><ul><li>Whose transparency counts for whom? </li></ul>
  203. 203. Public Health 2.0 <ul><li>Public Health for the Network Society: re-think organizational forms </li></ul><ul><li>Public Health as Platform: enabler of user-led innovation </li></ul><ul><li>Public Health as Multi-sector outcome: Health impact of all policies and actually creating multi-sectoral interventions that work </li></ul><ul><li>Public Health & Social Inclusion in Network Society </li></ul><ul><li>Public Health as resilient system(s) </li></ul>
  204. 204. Social Status Education Physical Environment Parenting Quality of Life Physical Health Incomes Work Mental Health Determinants of Health: How do we design for this? Source: Welling Project, Scotland
  205. 206. Resilience and Public Health <ul><li>Resilience from the non-system called the health system </li></ul><ul><li>Substantive reform unlikely to come from federal govt </li></ul><ul><li>Multiple layers of sustainability: ecological, financial </li></ul><ul><li>Sense, learn, create, re-organize (Andrea Saveri) </li></ul><ul><li>Design platforms for managing complexity </li></ul><ul><li>Increase ability of organizations to absorb threats (pandemics, State of California dysfunctional system, etc.) </li></ul><ul><li>The tools for doing this are already available </li></ul>
  206. 207. How can we respond to this vision of health? From PHRs to ePHIS <ul><li>ePHIS= personal health information systems as open platform for community-driven innovation </li></ul><ul><li>Data + networking/communication </li></ul><ul><li>Connected to tools and platforms presented throughout this presentation </li></ul><ul><li>Eg. Portugal created i-Citizen project for rural diabetic community </li></ul>
  207. 208. Public Health Innovation <ul><li>Not just new products & services </li></ul><ul><li>Prevention is rarely more than 2.9% of overall health budget: need policy innovation </li></ul><ul><li>Will have to be open innovation: open health </li></ul><ul><li>Network governance, new partnerships, taking social determinants seriously </li></ul><ul><li>Become experts at building and maintaining open systems, ie. open health, cooperation, managing new health commons, city as platform </li></ul>See KickBusch, ed. (2008), Policy Innovation for Health
  208. 209. Challenges <ul><li>Dynamics of network organizations? </li></ul><ul><li>New governance models </li></ul><ul><li>How to manage the commons formed through interdependencies? </li></ul><ul><li>Moving from innovation being about tech to innovation concerned with knowledge that creates value </li></ul><ul><li>PPP-P: the extra P = People </li></ul>
  209. 210. The tools are here… <ul><li>Social networks and new governance </li></ul><ul><li>Participatory approaches </li></ul><ul><li>Co-created, peer-to-peer, sharing economies </li></ul><ul><li>Maps, data, platforms </li></ul><ul><li>Mobiles as platform but need more than just mobile talk—policies, strategies </li></ul><ul><li>Need new approaches to behavior, communications, health politics </li></ul><ul><li>We lack coherent strategies and platforms in public health </li></ul><ul><li>Mindset shift towards innovation, open approaches, prevention, decentering expertise </li></ul>
  210. 211. Resources <ul><li>Us Now documentary: </li></ul><ul><li>Wiki Government, by Beth Simone Noveck </li></ul><ul><li> </li></ul><ul><li>Full Disclosure, by Archon Fung et al. </li></ul><ul><li>Investing in Democracy by Carmen Sirianni </li></ul><ul><li>Platforms for Collaboration by Satish Nambisan, Stanford Social Innovation Review, Summer 2009 </li></ul><ul><li>Smart Mobs by Howard Rheingold </li></ul><ul><li> </li></ul><ul><li>Policy Innovation for Health ed. By Ilona Kickbusch </li></ul><ul><li>IDEO Human Centered Design Handbook </li></ul><ul><li>Here Comes Everybody by Clay Shirky </li></ul>