These infrastructures and the apps that they are driving ought to get us rethinking how our societies function. O’Reilly says the Web 2.0 is not the redesign of the web, but stripping down the web to its essential core, similarly so for Government 2.0. Read and comment Tim O’Reilly’s book Government as a platform. My comments hovered around Society 2.0 — not a redesign of society, but getting back to basics for a more engaging and participative society.

From Expo, I found Tim’s conversation with Federal CTO Aneesh Chopra very interesting. It’s not that the views or ideas are so very radical or innovative. It’s the fact that they are executing to a vision. A vision built on the potential of mass collaboration, tranparency and participation. The core of this vision in driven by something called the Open Government Directive. Simple stuff, not rocket science — what impresses me is the execution — and potentially world changing. Ten years from now we will be wondering how we functioned as a society without transparency, collaboration and participation.

See this very rich review of Expo.

And now it appears that “data openness” has hit health care – see this post and here come the healthcare apps. With infrastructures like Healthvault and Google Health in place, one can expect the uptake to be faster and deeper. Solutions to meet privacy concerns still remain to be established globally, but I believe that once the utility of the service increases, so will security and privacy. Looks like the bottom-up consumer-centric apps design I had hoped are on the horizon. Time will tell….

In the meantime, check this site

This dance is pretty obvious for most citizens, however, the voice of the citizen is absent in this discussion on the cost of healthcare and what we should be doing about it. I hope this is not for long and that the debate on cost of healthcare can be channelled inclusively and constructively to produce some creative solutions.

Last autumn in an article in a Norwegian trade journal, I talked about patient-driven self-service site Patientslikeme.com. Yesterday, the Aftenposten carried an article on a patient with ALS (or Lou Gehrig’s disease) around the rising cost of healthcare. The individual interviewed described how ALS had almost destroyed his life but that state-financed healthcare made it possible for him to lead a meaningful life. The story behind Patientslikeme.com also has a link to ALS. Same conditions but different solutions.

I was struck by how in Norway, the state takes care of ALS-patients — at a pretty high cost. In the US, beyond health insurance, there are mechanisms that catalyze innovation. It is useless pitching one system against the other since I’m concerned about finding how state-financed healthcare (in Norway) can drive innovation. I think a first step is in sensitizing people to the notion that resources (healthcare included) are limited and we all need to be active in finding solutions. Something like where the state can serve as a platform and that cultivates creative services.

I believe social media solutions have an important role to play – not as a technology in itself, but as a catalyst to socialize the ideas and complexities of healthcare for ordinary citizens. To raise awareness and then to get them to take a more participative, co-production role in health care services and to be part of the solutions. Utlimately helping drive inefficiencies out of the system and lowering the cost of healthcare.

In that respect it is good to see that the magazine of the Norwegian Medical Association carried an article on the role of social media in healthcare Tidskrift. I consider it a simple but significant start.

If the US-led financial meltdown was attributed to “capitalism gone crazy”, then the PIIGS crisis must be “socialism gone crazy”. On the face of it, the answer in both cases seems to be stricter enforcement of the law for all including politicians! It is only reasonable to expect that players who have agreed on the ground rules stick to them. Or risk being expelled from the game. Yeah? by who? Maybe we should learn to govern overselves better – by participating. See my previous posts (here and here) where I commented the excellent film “Us Now”.

I am not an economics expert, but these events are a cue for citizens to get more involved in how their lives are affected. Is there another option? Admittedly, getting involved is easier said than done – the time crunch, information-overload and complexity is challenging (my reflections here). We must ask for more participation and we need to start participating whereever possible.

The PIIGS crisis is driving austerity measures that threaten the stability of the welfare state. A welfare state reaching newer heights with expenses needed to serve a demanding population that is also living longer. Raising taxes is not going to help! We as citizens need to take more responsibility; we need to participate …. we need learn how to co-produce services. Government agencies regarding citizens as “customers” is misleading and hollow and sets false expectations – there is no 1:1 equivalence between the tax one pays and services received. We are better off if we get rid of the notion of “customer” in public services and focus on including the citizen in the design and delivery of services. Savvy commercial businesses are already advocating customer participation – and are going beyond self-service. Hopefully, the public sector agencies will create their own brand of participation.

But first, politicians and bureaucrats need to truly understand this fundamental shift of citizen participation. They must provide for the trust-infrastructure that encourages participation and drives transparency. Yep, more participatory democracy and less representative democracy.

This radically different way of societal welfare is not just for the developing world. In fact, social media is also empowering grassroot movements, increasing social engagement and making an impact in the developed world. I believe that the best reason to embrace embrace CSR is to alleviate the costs associated with providing quality care while simulatenously strengthening the network in the local community. The “state” – federated or centralized – can only provide care up to a certain point after which it becomes prohibitively expensive. And communities cannot outsource all aspects of care-giving without losing a bit of the feeling of community. (Aside: Robots for care-giving seem to be set to play a dominant role in care-giving in Japan but Sweden approaches the same issue differently. There is room for a combination – depending on demographics and societal practices – though my personal preference is for the Swedish model. I believe it can scale better in the developing world.)

I believe that for CSR to scale up and out, it requires a trusted societal digital infrastructure. An infrastructure that encourages the creation of businesses to provide for eg. care-based services or education services while also enforcing transparency. Transparency generates trust, and trust can be used to provide deeply experiential services for consumers and citizens – while also being of value for service providers. See this article for an analysis on the economic value of trust.

NHIN Direct is one such platform effort for the health sector. I am posting this here and not on my health and wellness blog because NHIN Direct appears to take the form of the Societal Digital Infrastructure that I have talked about for a long time. This platform can be duplicated for the education sector and other government-driven industries.

Tim O’Reilly provides excellent commentary on NHIN in the context of a wider topic of Government as a platform. In fact, he refers to Dr Halamka’s excellent post that goes into more detail. I believe that as platforms emerge, entire sectors have the potential to innovate. The role of such public sector services are also catalytic.

Service innovation could become mainstream activity for commercial and public sector enterprises – project portfolio management is the (somewhat dull) practice most likely to absorb service innovation practices. But, how should enterprises open their practices to include external partners? The answer is far from obvious. Lot of work to be done there. And how can this spread to the masses where the seeds of innovation originate and germinate?

Consumer/citizen-centered design will eventually get there … I’m even more convinced than before.

Note: This post was started on the 28.2 but completed on 15.3

Listening to the Aravind talk at TED India I was left speechless. Just earlier in the day I had attended a working meeting to structure a research project around service innovation. Earlier in the week, I had attended a similar meeting around service innovation in health care. Watching the video, I was struck by how innovation was happening in practice.

What was more startling was that they were addressing the same problem – just applying the similar technologies with a different mind set (and may be a different value system). Our health care, in the western world, need not be so expensive and so unreachable. Admittedly, we do not have large volumes, but we have the technologies like telemedicine but have not deployed them correctly. The real shocker was taking the McDonald-model to health care. More so, my own realization that there is a sense of job-protection at play when we restrain ourselves in thinking of doctors “flipping burgers” (or consultants for that matter).

The move by Aravind Eye care give themselves competition, by sharing knowledge to competitors and thereby raising the bar, is truly inspiring. And at the same time, daunting for many. Have we created a society where we must hang on to job-status at any cost? Not deliberatly at any rate. Service innovation can come from beyond intelligence and capability.

Or to quote Dr. G. Venkataswamy, the founder of Aravind “Intelligence and capability are not enough. There must be the joy of doing something beautiful”.

Yochai Benkler points out in his TED talk, that “social production” is the long term disprutive force that will challenge the players in the commercial market place. Benkler’s book “The Wealth of Networks” is made available as a source for open discussion using Yale’s annotation platform.

So as the Internet continues its growth, the notion of an open source is moving to other domains. Like the Open Architecture Network that provides solutions to a wider audience. Peer production is here to stay… and a key question is to figure how commercial players and the public sector would respond to this disruption.

Am just curious to see how this works in pratice.

My own contribution on Day 2 was during the workshop on “Designing public services” was enlightening. My role was not as an expert in service design, but as a consumer-citizen; a c-c trying to make a case for participatory design. I am even more convinced that consumer-centered design is critical in the design of services and even more so in the design of public services. This blog was taglined “citizen-driven design. Shaping the agenda for Society 2.0″ some years ago and my search for methods and practices for citizen involvement continues. It’s not a question of “getting there” — but more on evolving democratic processes to capture the “requirements” from citizens.

My presentation – that focused on scenarios for health care and wellness – was actually making a point around “capture of requirements”. I used scenarios as a means to convey “requirements — while making the point that we need to be more intention-oriented in understanding services. I view intentions as an abstraction above needs and requirements and suspect intention-orientation will open for citizen participation while also providing a means to “manage” the design process using conventional practices like “requirements management”. Besides citizen participation, intention-orientation will also help unify practices from the different disciplines involved in service design.
So it is with some expectations I will be attending Dugnadssamfunnet 2.0 (Norwegian) arranged by the Ministry of Government Administration and Reform.