Health 2.0: Conversation is healing

Twenty-first century medical technology is still frequently managed with nineteenth-century structures, organizations, models, and management practices.

Professor Michael E. Porter, Harvard Business School World Innovation Forum. June 8, 2010

The Web 2.0 revolution is also reaching the field of healthcare. New technologies make possible a new paradigm in which, at last, health can be truly focused on citizens, and not so much on technical and healthcare processes.

It is not about technology, but about people, because at the end of the day it is people who have to change to adapt to new challenges; but it is clear that today technology provides us with an excellent opportunity to update and make our state of well-being more efficient, and to improve care in a scenario of crisis and restrictive budgets. In other words, the Era of Collaboration makes possible a new concept of comprehensive, agile, ubiquitous and simpler health, focused on citizens and driven by the participation and shared work of patients, professionals and managers.

What is Health 2.0? Based on what has been said, we could define Health 2.0 as a new comprehensive form of citizen-centred healthcare, in which the agents involved (patients, professionals, managers, providers) actively participate by using new technologies throughout the entire healthcare cycle to improve the quality and productivity of healthcare. Health 2.0 is therefore a great step forward, a change of focus that allows us to focus on people. New technologies are finally making citizens owners of the information they generate. And what is more positive, they are helping us to see and appreciate for ourselves the added value that this information can bring us.

The collaboration platform is ready. Web 2.0 is a huge crowdsourcing platform where we can all collaborate and create voluntarily and freely in trust-based networks. Social software allows us to create communities of interest and offer personalized services with a rich user experience. The “2.0” extension refers to a new, improved version of the tools, which are at the same time more sophisticated and simple to use. This simplicity makes it possible for Web 2.0 to reach virtually all users, and therefore have a great impact on organizations and society in general.

Health 2.0: new models of social value creation

Web 2.0 is making possible the emergence of new models of social value creation in the field of healthcare:

Information and prevention. Today more than ever, citizens can find useful, personalized and up-to-date information. This access to information can become the most powerful tool to promote a healthy life, based above all on the prevention of diseases.

Agility. Each citizen should be able to consult their medical records online securely, from anywhere and at any time, with the possibility of enriching and updating it with relevant information. Using this system, the medical professional can also access the records in an agile way, and has the opportunity to carry out better monitoring, since they have updated information.

Ubiquity. The new tools make it possible to implement an effective telecare service. This translates into an improvement for patients, who do not need to leave their homes to travel to the care center, and in significant cost savings for the health system, which can decongest the care centers.

Shared experience. Patients have the ability to communicate and share their experiences with other patients in specialized social networks. The emergence of these new groups has filled an important gap, since many patients with specific needs could feel isolated and disaggregated.

The power of collective intelligence. 2.0 tools allow healthcare professionals to build a true collective intelligence, made up of the knowledge and experiences of the entire community. This source of accredited and up-to-date knowledge allows best practices to be shared, and has an impact on the advancement of science and healthcare practice. In the end, the patient obtains better diagnoses and more accurate treatments.

Efficiency and productivity. For health managers, the availability of these tools opens up new ways to increase productivity in times of restrictive budgets. The opportunities are unbeatable: today it is possible to streamline administrative procedures, eliminate bureaucracy, cut costs by creating internal markets for providers, decongest care services through telecare, and a long etcetera. All these options make it possible to address this new crisis scenario with significant cost savings and an increase in the social value and quality of the service provided to citizens.

Citizen-centred care

Saying that healthcare should be citizen-centred is not a simple cliché devoid of content. Healthcare has already begun a significant shift from the place of diagnosis from hospitals to primary care centres. And it is precisely new technologies that can help us take the next step, which is to bring prevention and care directly to patients’ homes through telecare. 2.0 technologies also have a lot to say about specialised care, insofar as they make it possible to design care services for specific patient segments (diabetics, dependent elderly, frail children, etc.). The continuous and up-to-date flow of information, and the availability of 2.0 tools make this specialisation of services possible. And specialisation allows the creation of multidisciplinary teams in which medical professionals can concentrate their action on their specific field of activity, the one in which they are able to provide greater value to the patient. In this way, attention is focused on the specific needs of the citizen, placing the emphasis on prevention, as opposed to the traditional concentration of resources in crisis situations. It is, without a doubt, a small great revolution. As we have mentioned, the objective is to get closer to the citizen, and to build a health system based on the informed participation of all agents – patients, professionals, managers – who contribute valuable knowledge to the healthcare chain to promote prevention, early diagnosis and specialized treatment.

Let the conversation begin

In a way, to converse is to cure. It is clear that talking does not weld bones, nor do tumors be removed. But in the conversation that opens up between the different agents are many of the keys to guaranteeing higher quality health care, and much closer to the patient. Web 2.0, with its social networks, its specialized blogs, its wikis, its podcasts, its videos and its messaging services, teaches us that what is important is not the information itself, but the millions of conversations that take place every day:

– Patient communities. As we have mentioned, patients have built their own social networks. In them they can share their experiences, talk about their disease, the treatments and resources available, and the ways to deal with the situation. Patients are no longer alone. They feel accompanied and understood. And medical professionals can also use all this information to apply a more humane and more accurate approach.

– Communities of professionals. Health professionals also have the opportunity to share their experiences and knowledge, their practices, their approaches, their doubts, their points of view, etc. with the rest of the community. In the end, these networks translate into better citizen care.

– Health networks. Health networks put patients in contact with professionals, and provide useful information to users. They usually include assessment services, testimonials, advice, recommendations, etc.

– Sources of health information. Never before have we had so much information at our disposal. Citizens can find out how to lead a healthier life, and they can answer their questions about a virus or an allergy on the spot. For their part, professionals have excellent sources of consultation, and can be aware of the latest medical advances.

– Direct communication. It is obvious, but it should be emphasized: 2.0 communication tools (videoconferencing, chat, blogs, forums, etc.) make telecare possible, and allow the patient and the professional to maintain a fluid relationship. This system avoids travel and makes continuous monitoring possible, as it allows patients to be monitored from anywhere and at any time. In the end, the conversation – that is, the updated flow of information between the different agents involved – translates into continuous care, perfect for the early detection of diseases, and also results in a much more effective management of resources, since duplicates of procedures, prescriptions, diagnoses and therapies are avoided.

That is why we can say that, in a way, to converse is to cure. Because collaboration between patients, professionals and managers provides us with valuable information. And these courageous and frank conversations help us to strengthen prevention, and to achieve earlier detection of diseases, more accurate shared diagnoses, a recovery accompanied by people who have gone through the same ordeal before, fewer relapses and an earlier and more complete recovery.

The challenges of healthcare: a matter of people

The field of health is no stranger to the changes we are experiencing. It is clear that the health system must face new economic, organisational, demographic and social challenges. Among these key factors, we must take into account the growing demand for care caused by an ageing population, the effect of immigration, the new diseases derived from the current lifestyle, and even the demands for administrative decentralisation. But there is undoubtedly a leading factor: the economic crisis has led to a significant cut in budgets, and has called into question the sustainability of the current health financing model. In the current crisis scenario, it is essential to improve productivity in the health system to avoid the collision of patients’ needs with economic reality. Universal coverage and access to services remain essential challenges, but they are not enough in a context of health deficit. A central issue to ensure the sustainability of the health system is the value of the health care provided to citizens for every euro invested in the system. Health managers must necessarily strive to maintain and improve the levels of care achieved as part of the welfare state; that is, they must strive to create value for patients, and at the same time they must see how to reform the public health model to reduce costs and attract more revenue. New technologies 2.0 and, specifically, Web 2.0, represent an immense opportunity for innovation to change the very nature of the health system. It is very important to point out that this redefinition of the health system is not a technical problem. It is not a question of processes or technology. It is a question of people. In the end, it is not enough for us to change technology and the structure of institutions. It is we ourselves who must change. Citizens have to take ownership of their health, health managers have to get on the lifeboat of the

Leadership 2.0 To explore the future, medical professionals have to change the way they relate to each other to access the new open conversations, and health centers have to adapt to the new needs of home care.

Where to start

Get out of your “Comfort Zone”. Become an innovative leader and dedicate a part of your time to exploring the new reality and finding the trends that in the near future will affect your life, your profession and your organization. Here are some keys to action:

1. Build your agenda for Health 2.0. It is impossible to move in the right direction if we do not first define what our objectives are. In fact, if you do not have a personal agenda, it is highly likely that you are part of someone else’s agenda. Therefore, to begin with, we must develop a new agenda with the challenges of Health 2.0.
2. Make small changes, scale later. We can’t change everything at once because the weight of the previous legacy is too great, and the system could collapse. That’s why it’s important to introduce small innovations into the organization’s culture. Once we see that the changes work, and that they allow us to respond to new challenges, we can scale them to the rest of the organization. It’s ultimately about changing a little so that everything changes.
3. It mobilizes collective attention to future challenges. Change is a matter of people, and innovation only works when it is a task shared by all. That is why all agents must be involved in this change. We must create the freedom and the right space for citizens, professionals and managers to contribute their ideas and innovative contributions. It is about creating the right conditions for a new model of health 2.0 to emerge.
4. Learn the new language of collaboration with the same zeal with which you learned English in your day to ensure a future in any multinational. Actively participate in the most relevant blogs and social networks for your profession or sector and, when you consider that the time has come, publish your own and create your own brand (Personal Branding) to make yourself known and establish your network of contacts.
5. Encourage new conversations. We must encourage courageous conversations between the different agents of the health system. 2.0 tools allow us to create new communication channels and new meeting spaces. These conversations will bring healthcare closer to citizens, and will become the seed of future changes and innovations.