Social media and healthcare

This weekend Aftenposten carried different stories around the cost of healthcare (for eg here and here – Norwegian texts). The technocrats and the bureaucrats will haggle about numbers and details while politicians extol the virtues of their party programs — or more likely downplay the programs of rivals.

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.

Posted in consumer-centered design, crowdsourcing, service innovation, social media | Leave a comment

From consumer-citizen to participant

Just as the global economy is making its recovery from the global financial crisis, we have the Euro-crisis on our hands. And adding to the excitement, the volcanic ash continues making business difficult for many industries on the continent. One can argue that the volcanic activity is unpredictable — not so the financial crises. They are symptoms of society going into group-think and freely swallowing what is dished out by politicians and spin doctors. The Euro-crisis – PIIGS crisis is probably more appropriate — was caused by the nations disregarding established guidelines set by the EU for managing debt and public spending.

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.

Posted in co-production, crowdsourcing, societal digital infrastructure, transparency | Leave a comment

Welfare 2.0?

Living in a welfare state, I am being increasingly convinced that the next level of welfare must embrace corporate social responsibility (CSR) – in a radically different way. Not very unlike the way that the Indian conglomerate Tata has demonstrated CSR over the years (see this recent article if you are not familiar with Tata).

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.

Posted in business models, health care, societal digital infrastructure, sustainability, transparency | Leave a comment

Are public services different from other services?

There must be other people who also react to the notion of services from the public sector. What exactly are services from the public sector? How do these services compare to commercially provided services? Admittedly, the term “services” is overloaded, but to me – these “services” are just the provisioning of citizen rights. Are the public sector services actually a platform for service production? Something that allows commercial service providers to develop deeply engaging and experiential — and mainly trust-based services

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

Posted in education, health care, interoperability, societal digital infrastructure | Leave a comment

Innovations in service delivery

I have been spending a lot of time looking for innovations in service creation and come up with some very interesting cases. But none so impressive that could actually get me back to health care blogging.

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”.

Posted in service design, service innovation, telemedicine | Leave a comment

Open Source is more than free software

The open source movement has been popularised by the geeks, who benefited immensely from the collaborative power of the internet. The notion of open source has been around for centuries albeit in small communities where knowledge sharing was a way of life. The concept of bartering and peer production was given shape in the late 19th century. And in 2003, collaborative projects like Wikipedia emerged and have proven to be quite successful.

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.

Posted in Digital Home, intention-value-network, open source, societal digital infrastructure | Leave a comment

Consumer Centered Service Development – First Tuesday 23rd may 2006

As social media technologies build for interoperability, interesting things can happen. This presentation is 3 1/2 years old, but posted to slideshare 3 weeks ago. And now being linked to my blog.

Am just curious to see how this works in pratice.

Posted in consumer-centered design, consumerisation of IT, service innovation | Leave a comment