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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
2
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’
PERSONAL HEALTH SYSTEMS
FORESIGHT
5
www.phsforesight.eu
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
APPLICATION AREAS
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
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
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
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
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.
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
INDICATORS FOR PHS
SUCCESS SCENARIO
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.
17
TRANSFORMATIVE
GOVERNANCE CONCLUSIONS
Ecosystems - all players in, try foresight
To scale-up think platforms and accept
disruption
Federate and coordinate the ecosystem
18
www.if-institute.org
info@if-institute.org
phsforesight.eu
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”

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Transformative governance of personal health ecosystems

  • 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
  • 2. 2
  • 3.
  • 4. 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’
  • 6. 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
  • 8. 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
  • 9. 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
  • 10. 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
  • 11. 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
  • 12. 12
  • 13. 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.
  • 14. 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
  • 16. 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.
  • 17. 17
  • 18. TRANSFORMATIVE GOVERNANCE CONCLUSIONS Ecosystems - all players in, try foresight To scale-up think platforms and accept disruption Federate and coordinate the ecosystem 18
  • 19. www.if-institute.org info@if-institute.org phsforesight.eu 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”

Editor's Notes

  1. Reduction in the number of visits to health centres/hospitals required by people suffering early stage chronic diseases through use of PHS Share of health and social care professionals educated into competence concerning applications of PHS in practice Percentage of budget spent on chronic diseases saved by PHS use Reduction in hospital mortalities of frail/elderly admitted for emergency care Share of Patients with long term conditions monitored by physical and ambient sensors Share of citizens with detailed electronic health records that can be accessed by health care professions in a common format across the EU. (100%) Share of people suffering acute episodes whose EHRs can be accessed by emergency care providers without new explicit consent required Share of adults active in a patients’ group supporting active independent living and ways of reducing problems associated with conditions. Share of people with PHS that interact with surroundings and personal information to provide advice in everyday situations on food and other choices Share of people with control over own health data, determining who uses and how. Share of people using tools for individualised, personalised health advice where the advice is evidence-based. Number of such tools that are scientifically proven as reliably advantageous Importance of new evidence and modelling for testing and validating such PHS tools for the uptake of these tools. Share of spending in PHS funded by private consumption/enterprises in complementary fashion. Share of population with PHR systems that are integrated with EHR systems.