The document discusses shifting paradigms in healthcare from an individual, acute, provider-centered model to a community, chronic, patient-centered model. It proposes a new "Life Line" model that takes a person-centered, longitudinal approach focused on health goals, risk management, and prevention over the lifespan through multidisciplinary teams. This represents a paradigm shift requiring new reference frames, visions, audiences, and actors to provide more humanistic and sustainable care.

1. Ligne de vie
and
Personal Health Project
Philippe AMELINE
Odyssée
philippe@ameline.net

2. Web 2.0 and beyond
Web 1.0
e-User
the You model
Web 2.0
e-Citizen
the
I model
My site, my forum, my tribe, my blog...
The big thing is
egology (coined by Joël de Rosnay)

3. Anthropology
I’ve a body that’s apparently
really mine, and it’s what
makes me me.
I number it among my possessions and I
claim to exercise full sovereignty over it.
So I think I’m unique and independent.
It’s not thought of as a thing, not in
New Guinea, any more than in
Amazonia, East Africa or Europe.
On the contrary, it has the
particular form of its connection
with otherness that constitutes
the person.
Q
But that’s an illusion, because there is no
human society in which one thinks that
the body is any good on its own.
All bodies are engendered, and not only
by their fathers and mothers. It’s not
made by the one that has it, but by
others.
My body really mine? It’s
it that determines that I
don’t belong to myself,
that I don’t exist alone
and that my destiny is to
live in a social context.

4. Egology

5. Industrialized care
Care place centered reference frame
Technical excellency - Treating bodies
“Efficient treatment vs Taking good care of”

6. Toward a new model
How to keep scientific evidence, in a
more humanistic and sustainable vision?

7. Continuity
Person centered reference frame
Health Team ↔ Health Project
Life long behavior → Risk management

8. Ligne de vie

9. New paradigms of care
Cohen, J (21st Century Challenges for Medical Education; 9th International Medical Workforce Conference;
Melbourne, Australia; November 2005)
The individual
Acute disease dominates
Episodic care
Cure of disease
Reactive
Physician provider
Paternalism
Provider centred
Parochial health threats
→ The community
→ More chronic illness /disability
→ Continuous care
→ Preservation of health
→ Prospective
→ Teams of providers
→ Partnership with patients
→ Patient / family centred
→ Global health threats

10. Risk management cycle
drugs
lab results
health problems
personal history
family history
biometrics genes
Clinical data social issues
Risk factors
Explicit risk issue
Risk level evaluation
Health goals
drug interaction
quaternary prevention treatment contraindication
primary, secondary, tertiary prevention

11. Conclusion
New reference frame
New vision
= Paradigm shift
New audience
New actors
Opportunity for open source
How do we we grow
the community of people who
are solving interesting problems?

12. Thanks
Blog: http://philippe.ameline.free.fr
Mail: philippe@ameline.net
Forge: http://episodus.sourceforge.net
Twitter: p_ameline