Designing to change it all
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| License | CC Attribution 2.0 Belgium: You are free to use, adapt and copy, distribute and transmit the work or content in adapted or unchanged form for any legal purpose as long as the work is attributed to the author in the manner specified by the author or licensor. | |
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Transcript: English(auto-generated)
00:20
I think for the last presenter talk that we have today, we have Winfried Revenus talking
00:27
to us about how he is designing it to change it all. Take it on from there. Yeah, thank you. Please give me feedback if you can hear me good. I have one stuffed ear and I can't hear myself good.
00:44
If you can't hear me, go. We have a problem. In healthcare, people are treated like broken cars. And our healthcare is organized like silos. Communication between the silos is very bad.
01:00
Funding is separated between the silos. But also when you're in one silo and there's very little electronic communication and electronic cooperation between them. So it is really totally separate places. And when you enter into one silo, it's like a bit of a darts game
01:21
that determines what kind of help you get. Enter the medical one and you get the medical treatment. Enter the social care one and you get the social treatment. And when you look at modern e-health systems, well, there we have Freud, which is an old, nice, once a week session.
01:41
And those e-health systems copy that. They make just one-to-one copy of what works or not works offline. Big miracle, online it works just as good or just as bad. And then there are lots of new inventions pushed. Very nice technology push, but they don't stick to the long run.
02:04
They really get useless. So maybe we should rethink the problem. And when you look at health, then there are many aspects to it. You know, it can be really the physical health, mental health,
02:20
but also all kind of other things like how you are able to function in the day-to-day base, social interactions, and all different aspects of health. And when we go back to those silos, we really should connect them and eventually get rid of the silos and make sure health care becomes a network.
02:43
And when you look at the electronic health care, this is really a very nice app. It doesn't happen to be so that some people in the audience, every now and then, hear voices that aren't there.
03:00
No hands. It's quite common. Statistically, there should be someone here, hearing those. And this is an app that has a small language game. And when you play that game, it occupies the language parts of your brain. And it occupies it to the level that you can concentrate on other voices,
03:22
real voices, like mine here in the presentation again. And that's really monetizing on the effect that you can use apps like this whenever you want, wherever you want, so that you can do interventions in an app that are not a copy of what Sigmund Freud did once.
03:41
So these apps not only should monetize on those possibilities, but also really connect people, really should connect people to other people, but also to resources, activities that really can help them, can really help them improve their life. But almost most important for the projects I'm presenting about now
04:04
is left side is the classical health care. It's very predefined parts. And then you are in the hospital or in the medical care or out of there. And it's very... But we want people to search their own.
04:23
People know what they need. Or you can help people to find out what they need. And what helps for them. But then you need those predefined parts. You really need to get people in control. So, well, we're more or less saying we want to change all of health care.
04:41
Nothing more, nothing less. And that may be a problem. This is a condensed stakeholder analysis of everybody involved in health care in the Netherlands. Up to insurers, ministries, communities, hospitals, whatever.
05:07
And that's quite large fields. Hard to change. And to go on to the digital world, here we try to map all initiatives in the Netherlands that are busy with changing how digital health works.
05:24
And I try initiatives to improve something, to do standardization there, to connect organizations. So, we even came to the conclusion that when people were in the circuits, they start to meet each other, the same people,
05:42
on meetings from all kinds of different organizations. So, there's something strange going on there. So, we don't only have to design where we want to go, grow the picture, what we want to do, but we also have to design how to get there.
06:01
So, we thought, what is the best way to change all of it, how to get people along? And the best way is to show it can be done differently. So, we started in five local areas, experiments with challenging people to change how they work, how they do their health care in that local area.
06:24
And we connected those areas. We challenged them to get together, to exchange the experience, to tell about it, and to show what's going on. And we also equipped them.
06:41
We gave them lessons. We learned them how they can cooperate, how they can change. And what's very nice about what you're seeing here, it's a video about the workshop, and really people from all kinds, from the community, from insurers, patients, doctors, all together, talking together,
07:01
how can we change this world? And then when we go to the digital world, and this is a picture we use quite a lot to describe what we're doing there, you have different fields of your personal health management, like your smartwatch, your Fitbit, but also the dietary things you do.
07:24
Maybe you're diabetic and have some extra measurements there. Then you have the professional health care, really what happens in hospitals. And then you have very much the social part of it. And each of them, well, they're quite well developed.
07:40
But at the places where they cross and where they have to cooperate, there is very little crossing across the domains. Doctors don't want to know what my Fitbit told me. They're very scared to have any interaction with my social surroundings
08:00
for privacy reasons and things like that. So the really interesting thing is, can we monetize what's in between where the cross sections are? And there's one other thing we do with the digital world, what we want to do there. We only want to tackle real problems.
08:22
We really want to look for what's happening in those five areas, what do they need, what are the challenges they have. And this is a sad but also clear story about it. The man we wrote, created this user story about,
08:44
existed in reality. But in reality, he committed suicide because he couldn't find a good help, because there were silos and he couldn't move from one place to the other. And so we really started thinking what steps could have been taken, what could we have done to change,
09:02
to really make a difference for him and to move along. So, and that's really about connecting and breaking the silos. Does it refuse to go to the next slide?
09:22
And another thing, you know still, the own initiative, the own choice, the own way of looking for your, finding your own way of moving through the system. How to do that? How give people control over their own process?
09:40
How to avoid that it's, again, another medical process rolling over you. And for that we made something, we called it the privacy game. And it's a very simple game with some questions and, but it challenges people to think about what's,
10:02
how they make choices, what's important for them. And it enabled us to talk with them about how they do it and what's important and what factors are important for them. And that really gave very much information and we have lots more of research to do here,
10:24
but it gave us lots of information in a very agile, short, iterations way, how we could change healthcare. And we put it to practice. We designed an exchange protocol.
10:41
And technically it's totally trivial. Any technicians, you know, you have a web token between two partners, you know, if you know about that stuff, you laugh. And it's very simple, very trivial, but it enables one application,
11:02
for example in the social domain, to open an application or part of an application that's in the medical domain. And we got those people responsible for those applications together and we got them cooperating and saying,
11:21
well, this is interesting to go to directly. So a small trivial protocol really meant a huge change on the ground. And there's one other thing. Who has to implement a protocol like that?
11:42
Developers. So how to get them along? How to make sure they really wanted to implement the protocol? So we start designing a developer journey. What are the steps a developer really needs to take? What are the steps to get it from,
12:02
well, this might be a nice idea to, I've got it running into my application. So we really designed the developer journey to get them along. And one of the nice things is one of our best ambassadors right now is a developer. And he's really telling everybody this is great.
12:21
Go work with these guys because it's very easy. They met the goal of implementing it in half a day. And it is really great to see. And there's also a legal side to it. And one of the interesting things that happened
12:42
was that one of our sister projects had a comparable part of the standard. And what they did, that was putting it into an agpl license. I don't know if anybody knows how licenses and gpl licenses work.
13:05
And agpl license means any code you use it in automatically also becomes open source. But many of the platforms used are not open source. So right now in the Netherlands, quite a lot of big company platforms
13:22
that officially should be open sourced because that sister project put out their code on agpl. So we started a discussion about it. What kind of license do we need? But that's not also a legal discussion. It's also a discussion, how do you want to cooperate? How do you want to work together with these developers?
13:44
And we really like to have this discussion in the open to talk about it, to show, hey guys, this is what we're doing. Well, that is more or less where we are now. And of course, there are lots of more things we're going to do.
14:04
We're about to start an experiment where people get their own budget for health apps and health applications. And they can freely choose and think, well, this helps me, I want to try this, or maybe this is interesting and then they can spend a little budget on it.
14:21
And that creates a market for the builders of the applications because many people think they should be free. And on the other side, it really helps people to make the choices and to find their own way. That's an experiment. Another thing we're building right now, that's how to get people faster to the right place.
14:43
And that's quite often a very social process. People talking, explaining, asking about their problems. So we're now experimenting with digital communities where people can really move, help each other to find the right next help,
15:02
where they can advise each other on what support and what care, or maybe support them right there. And then there's something else we are planning to do. There are several existing standards
15:21
already on communication, on authentication, authorization, semantic standards, and I'm running too fast. I didn't expect it when I... It's fine. So we are working on combining these standards, existing standards.
15:42
We don't want to reinvent the wheel. But to combine them into a social network that enables the combination of professional worlds, the personal worlds and the social worlds, that we can really switch from one to each other. And of course in a privacy-friendly way and very clear to the users,
16:03
now you're sharing this with these people, so lots of choice. And we still are in the process of designing how to do that, using next versions of the privacy game. But that's really what we're building on now. So when I go back to the big picture,
16:25
we want to change healthcare and all of it. And we want to do it by first creating an ecosystem that helps people to get healthy and to create an environment where they get healthy or can live in a more healthy way, in a more meaningful way.
16:44
And that asks new ways of cooperation, new ways how people work together. And I can... Well, I have some minutes left. One very great example of it is in one of the local areas. They discovered there were lots of people
17:04
giving all kinds of help in that area. And they got as many as they possibly could get together, one day a week in the local community center. And if you come there that day, you can get a very cheap bit of bread.
17:23
You can get a cup of coffee very cheap. And there are two rules there. The first rule is when you enter there, one of those professionals will have a chat with you. And it can be about anything. And the second rule is,
17:40
if that professional notices during that chat that you're in need for some kind of help, then you don't leave the building without having the right kind of help there. And that means that this professional needs to get somebody else involved. You need to talk here.
18:00
Maybe a corporation, maybe work together. And that's really a process change. The ICT redesign is only meant to support process changes like that, to help professionals like that to find each other. And the last part, and that's the experiment with those health apps also,
18:21
the finances also kept to the silos, also stopped the corporation, so really are looking for ways to organize the financing, also to break those. So, that's my talk. And I would say, any questions, please let me know.
18:56
Yeah. It was quite funny because just before she left,
19:01
the previous Minister of Health said, well, let's take a risk and put some money into a totally crazy project. So that's very nice lobbying work. But it's also very important, many of the organizations involved say, this is so important, we put our own money into it too.
19:21
The funding from the Ministry will stop quite soon. But most of these local experiments just will continue, because the organizations involved like it too much. Any more questions?
19:41
Do you have any project involving communication of the current health? Well, a matter of fact, in the Netherlands, that's one of those projects on the big sheet,
20:02
and we call it the sister project, and we are very closely involved and connected with it, but it's not at the core of our project. It's already done, it's already quite a lot of money in a system like that invested by the Dutch Ministry of Health, so we're not going to duplicate it, but we try to connect and to try to do a step further than what they did.
20:26
But yes, there is a project like that. Are you saying that it works? Yeah, it works more or less.
20:44
Any more questions? All clear, I believe. The little movie, that's what we want to do. We want to be that fool that's dancing first.
21:06
Thank you.