Co-creation in health
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How The Best Web Tools Fit Into Bloom's Digital Taxonomy - Edudemic

How The Best Web Tools Fit Into Bloom's Digital Taxonomy - Edudemic | Co-creation in health |
There's a new pyramid that details how the best web tools fit into Bloom's Digital Taxonomy. It's a must-see for all teachers and students alike!

Via Dr. Susan Bainbridge
Paula Jamieson's curator insight, July 2, 2013 4:38 PM

I've seen lots of these 'Bloom's Mash Up's' lately - I guess it is just a matter of finding what works for you. I personally think that visually this pyramid style would appeal to Junior teachers, it's less fuss and would be less likely to cause information overload than the full circle style ones.

Ruby Day's curator insight, July 3, 2013 1:11 AM

Technology with learning!

Alison D. Gilbert's curator insight, July 3, 2013 7:02 AM

I like knowing which web tools is the best way to learn a particular skill.

Co-creation in health
E-citizens, e-patients, communities in shaping e-health, health literacy.
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Referral Criteria for Outpatient Palliative Cancer Care: A Systematic Review

Referral Criteria for Outpatient Palliative Cancer Care: A Systematic Review | Co-creation in health |



Outpatient palliative care clinics facilitate early referral and are associated with improved outcomes in cancer patients. However, appropriate candidates for outpatient palliative care referral and optimal timing remain unclear. We conducted a systematic review of the literature to identify criteria that are considered when an outpatient palliative cancer care referral is initiated.


We searched Ovid MEDLINE (1948–2013 citations) and Ovid Embase (1947–2015 citations) for articles related to outpatient palliative cancer care. Two researchers independently reviewed each citation for inclusion and extracted the referral criteria. The interrater agreement was high (κ = 0.96).


Of the 186 publications in our initial search, 21 were included in the final sample. We identified 20 unique referral criteria. Among these, 6 were recurrent themes, which included physical symptoms (n = 13 [62%]), cancer trajectory (n = 13 [62%]), prognosis (n = 7 [33%]), performance status (n = 7 [33%]), psychosocial distress (n = 6 [29%]), and end-of-life care planning (n = 5 [24%]). We found significant variations among the articles regarding the definition of advanced cancer and the assessment tools for symptom/distress screening. The Edmonton Symptom Assessment Scale (n = 7 [33%]) and the distress thermometer (n = 2 [10%]) were used most often. Furthermore, there was a lack of consensus in the cutoffs in symptom assessment tools and timing for outpatient palliative care referral.


This systematic review identified 20 criteria including 6 recurrent themes for outpatient cancer palliative care referral. It highlights the significant heterogeneity regarding the timing and process for referral and the need for further research to develop standardized referral criteria.

Implications for Practice:

Outpatient palliative care clinics improve patient outcomes; however, it remains unclear who is appropriate for referral and what is the optimal timing. A better understanding of the referral criteria would help (a) referring clinicians to identify appropriate patients for palliative care interventions, (b) administrators to assess their programs with set benchmarks for quality improvement, (c) researchers to standardize inclusion criteria, and (d) policymakers to develop clinical care pathways and allocate appropriate resources. This systematic review identified 20 criteria including 6 recurrent themes for outpatient palliative cancer care referral. It represents the first step toward developing standardized referral criteria.


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Consumer Health and Patient Engagement – Are We There Yet?

Consumer Health and Patient Engagement – Are We There Yet? | Co-creation in health |

Along with artificial intelligence, patient engagement feels like the new black in health care right now. Perhaps that’s because we’re just two weeks out from the annual HIMSS Conference which will convene thousands of health IT wonks, users and developers (I am the former), but I’ve received several reports this week speaking to health engagement and technology that are worth some trend-weaving.

As my colleague-friends Gregg Masters of Health Innovation Media (@2healthguru) and John Moore of Chilmark Research (@john_chilmark)  challenged me on Twitter earlier this week: are we scaling sustained, real patient engagement and empowerment yet?

Let’s dive into the reports’ findings to divine an answer for Gregg and John.

Change Healthcare published the company’s 8th Annual Industry Pulse Report, which examines key challenges facing payors and other stakeholders this year. The report analyzes results of a survey of over 2,000 Change Healthcare customers (from academia, government, technology vendors, hospitals, providers, and health plans), conducted in October-November 2017.

Several findings address patient and health engagement in this study, including:

  • The failure of high-deductibles’ “skin-in-the-game” theory to turn  patients into active health consumers
  • The growth of health plans and providers integrating social determinants of health into health strategies and tactics for improving peoples’ health outcomes and engagement
  • The migration of incentives from negative “sticks” to positive “carrots” along with more value-based benefit design in motivating consumer health behavior.

One of my favorite series of papers that inform my advisory work comes from PwC on the New Health Economy, this week publishing its report on Customer experience in the New Health Economy – the data cure. A highlight of their survey found that one-half of provider executives sees customer (patient, clinician) experience as a top strategic priority over the next 5 years, and most payer execs are investing in technology to improve member experience. Remember that health insurers rank very low on consumer experience compared with retailers and grocers.

PwC offers five pillars for healthcare stakeholders to build on to improve experience, including:

  • Convenience
  • Quality
  • Support
  • Personalization, and
  • Communication.

Finally, CarePayment studied the skin-in-the-game motivation for engagement, finding that 61% of patients don’t have money saved for healthcare expenses, and two-thirds of people have avoided or delayed medical care in the last year due to expected costs.

An alarming anti-engagement statistic is that 44% of the 1,000 consumers surveyed said they would not get needed medical care, even if it put their health at-risk, knowing they would have out-of-pocket expenses of $500.

The 20/20 CarePayment survey team also noted in their press release that among people who did not seek healthcare, medical debt is a growing and common problem impacting + nearly 1 in 4 Americans under 65.

The CarePayment poll was conducted in November-December 2017.

Health Populi’s Hot Points:  So, Gregg and John, to your question: has patient empowerment and engagement scaled yet in U.S. healthcare?

Well, it depends on how we define the terms, and through what and whose lens. I do see green shoots of engagement among patients in the U.S., both for clinical activation and financial/shopping muscles.

A question in the Change Healthcare survey hints at one of the challenges in assessing and inspiring patient engagement: “What is the best approach for turning passive patients into active healthcare consumers?”

For many years, my discussions with patient activists on social media have informed me about some of the toxic language that prevents trusted conversations between people – patients, consumers, caregivers — and health care providers, plans, and pharma. Words like “adherence,” “compliance,” and in this question the verb, “turning,” are turn-offs for the very people legacy healthcare organizations want to engage.

Contemporary health engagement for patients in the U.S. is also complicated by the fact that patients are responsible for financing at least part of their healthcare — resulting in self-rationing among a large percentage of people who truly need to access care, the CarePayment survey points out. We’ve seen these behaviors based on other data sources, notably over the years via the Kaiser Family Foundation which I perennially cover — even back in 2012 before the advent of the Affordable Care Act.

As providers, payors and pharma allocate capital resources for technology to improve relationships with patients on the hardware side of the ledger, these healthcare organizations should also be mindful of other processes and mindsets facing consumer-patients — both in terms of helping people navigate the healthcare system, and at the same time, avoid the financial toxicity that can prevent them from seeking care in the first place.

Via Plus91
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Hans Jonas, la ricerca della vita buona. "Sulle cause e gli usi della filosofia e altri scritti inediti"

Hans Jonas, la ricerca della vita buona. "Sulle cause e gli usi della filosofia e altri scritti inediti" | Co-creation in health |
Secondo il pensatore tedesco Hans Jonas l’uomo si realizza in un sano pensiero filosofico, evitando gnosticismo e storture scientiste Per non diventare delle «formiche tecnologiche»


«Che l’immagine dell’uomo non vacilli, si offuschi e sbiadisca, che gli uomini non si riducano a formiche tecnologiche o edonisti senza anima o marionette frastornate dal nostro furibondo potere». A cosa attingere per evitare questa deriva? All’uso adeguato della filosofia che instrada verso la vita buona e all’esercizio della virtù? Sono dilemmi che hanno il sapore dell’attualità benché sollevate da Hans Jonas nel 1955. Potrebbe d’altro canto essere diversamente se «le questioni filosofiche - puntualizzava il pensatore sei anni prima - si ripropongono ad ogni nuova epoca tanto daccapo, quanto alla luce della loro intera vicenda storica antecedente?». Le citazioni provengono dalle annotazioni del filosofo appartenenti alla sua stagione canadese, dal 1949 al ’55.

A lungo conservate all’Hans Jonas Nachlass dell’università di Konstanz sono state ripescate e raccolte in anteprima mondiale da Fabio Fossa in questo libro (Sulle cause e gli usi della filosofia e altri scritti inediti, Ets, pp.120, euro 10). Hans Jonas non è tra gli autori più conosciuti al grande pubblico eppure il suo curriculum scintilla. Dopo gli studi con Rudolf Bultmann e Martin Heidegger nella Germania degli anni Trenta, prende la via dell’esilio, lontano dall’Europa. La sua vita però non si riduce a studio e contemplazione. Anzi l’agire ne costituisce una cifra di rilievo. Lo prova, nel corso della Seconda guerra mondiale, la scelta di arruolarsi nella Jewish Brigade, inquadrata nell’esercito britannico e operativa sul suolo italiano. I rapporti con la penisola scandiscono la vita di Jonas. Sarà proprio al rientro dall’Italia, nel 1993, dopo avere ricevuto il Premio Nonino dedicato ai maestri del nostro tempo, che il filosofo tedesco naturalizzato americano si spegnerà a New York all’età di novant’anni.


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Health Equity - Guide for Public Health Practitioners and Partners

Health Equity - Guide for Public Health Practitioners and Partners | Co-creation in health |

The Delaware Division of Public Health (DPH), the University of Delaware’s School of Public Policy & Administration, and other partners created the Health Equity Guide for Public Health Practitioners and Partners to help Delawareans better understand tools and strategies that promote health equity and support upstream population health approaches. The 179-page document is designed to assist all sectors which can include but are not limited to government, education, workplaces, private sector, nonprofit agencies, faith based institutions, and health care settings address underlying causes of health inequities in communities and promote optimal health for all in Delaware.


Our overall health is strongly influenced by where we live, learn, work, play and pray. It is also heavily influenced by your income level, education, and health care services. Our culture, language, political and religious beliefs, social norms and attitudes, and the rates of poverty, crime, and violence also affect our health. Delaware can achieve greater health equity as its environmental, social, and economic conditions improve.

The Division of Public Health (DPH) is working with many community leaders, non-profit organizations, other state agencies, and stakeholders to address health equity issues within our state and improve overall health for Delawareans. By engaging in healthy behaviors and improving environmental and social conditions, there is less risk of disease, disability, and injury. In order for this to occur, we all need to ensure that the healthy choice is not just the easy choice, but that it is also a possible choice within communities. The guide show cases existing evidence-based practices, tools and resources that can assist Delawareans to reach their full health potential and improve their overall quality of life.

DPH contracted with the University Of Delaware (UD) to develop the guide with the purpose of increasing awareness of DPH staff and other partners across the state and bring us closer together to address health equity issues in Delaware. This guide explores the major themes, frameworks, and approaches regarding health equity, all while keeping the context of Delaware in mind. The Health Equity Guide for Public Health Practitioners and Partners shares evidence-based and promising strategies, and provides numerous references and web links for additional information.

We proudly present the final product and can provide technical assistance and support.

Using the Guide

Everyone, no matter what sector you work within, can utilize the guide to prioritize health equity in their overall work.

Health inequities are historically entrenched and pervasive, but they are not insurmountable. We can be most effective by transforming our collective thinking from a perspective focused on treatment of the individual, to one that focuses on prevention, health, and wellness of the broader population. The guide provides a call to action for all of us to make fundamental shifts in our approaches.

The Guide was developed to be adaptable to all types of audiences – from academicians to grass roots community groups – and includes digestible strategies which highlight Delaware specific and national examples. The Guide is best utilized as an electronic file due to the inclusion of hyperlinks.


Guillermo Grosso's curator insight, December 28, 2017 8:46 AM

Health Equity - Guide for Public Health Practitioners and Partners

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Word ban at CDC includes 'vulnerable,' 'fetus,' 'transgender'

Word ban at CDC includes 'vulnerable,' 'fetus,' 'transgender' | Co-creation in health |

Officials at the Centers for Disease Control and Prevention, the very agency tasked with saving and protecting the lives of the most vulnerable, are now under order by the Trump administration to stop using words including "vulnerable" in 2018 budget documents, according to The Washington Post.

In a 90-minute briefing on Thursday, policy analysts at the nation's leading public health institute were presented with the menu of seven banned words, an analyst told the paper. On the list: "diversity," "fetus," "transgender," "vulnerable," "entitlement," "science-based" and "evidence-based."
Alternative word choices reportedly were presented in some cases. For instance, in lieu of "evidence-based" or "science-based," an analyst might say, "CDC bases its recommendations on science in consideration with community standards and wishes," the source said. But those working on the Zika virus's effect on developing fetuses may be at a loss for appropriate -- or acceptable -- words.
The reaction in the room was "incredulous," the longtime CDC analyst told the Post. "It was very much, 'Are you serious? Are you kidding?'"


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 "Un sessantotto cattolico?" - Con BRUNETTO SALVARANI, Tonio Dell'Olio, Luigi Sandri, Sergio Tanzarella

 "Un sessantotto cattolico?" - Con BRUNETTO SALVARANI, Tonio Dell'Olio, Luigi Sandri, Sergio Tanzarella | Co-creation in health |

“Sessantotto”: un anno cruciale, su cui ancora ci si interroga, e verosimilmente ci si interrogherà ancor più in coincidenza dell’anniversario dei suoi cinquant’anni. Se il termine è usato per designare fenomeni di varia natura, sul piano politico, sociale e culturale, appare evidente che nella sua genesi e nel suo svolgimento il ruolo di pezzi del mondo cattolico fu tutt’altro che secondario: dal cosiddetto dissenso alla nascita delle comunità di base, dal fiorire di riviste, fogli e bollettini all’aperta contestazione del magistero, con azioni non di rado sfociate in gesti clamorosi. Di questo, e della sua attualità o meno mezzo secolo più tardi, in un contesto ecclesiale completamente mutato, rifletteremo con Tonio Dell’Olio, presidente della Pro Civitate Christiana di Assisi, Luigi Sandri, giornalista e scrittore, e Sergio Tanzarella, docente di Storia della Chiesa presso la Facoltà teologica dell’Italia Meridionale. E ci sarà spazio anche per ripensare alla lezione del vescovo della pace, don Tonino Bello, a venticinque anni dalla sua prematura scomparsa.


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The Square and the Tower: Networks and Power, from the Freemasons to Facebook - Niall Ferguson

The Square and the Tower: Networks and Power, from the Freemasons to Facebook - Niall Ferguson | Co-creation in health |
The 21st century has been hailed as the Age of Networks. However, in The Square and the Tower, Niall Ferguson argues that networks have always been with us, from the structure of the brain to the food chain, from the family tree to freemasonry. Throughout history, hierarchies housed in high towers have claimed to rule, but often real power has resided in the networks in the town square below. For it is networks that tend to innovate. And it is through networks that revolutionary ideas can contagiously spread. Just because conspiracy theorists like to fantasize about such networks doesn't mean they are not real. 

From the cults of ancient Rome to the dynasties of the Renaissance, from the founding fathers to Facebook, The Square and the Tower tells the story of the rise, fall and rise of networks, and shows how network theory--concepts such as clustering, degrees of separation, weak ties, contagions and phase transitions--can transform our understanding of both the past and the present.
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Powering Collective Human Intelligence

Pierre Lévy, a Fellow of the Royal Society of Canada, Professor at the University of Ottawa and Inventor of Information Economy Meta Language (IEML) participated in Risk Roundup to discuss “Powering Collective Human Intelligence”.
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An evidence-based framework on community-centred approaches for health: England, UK

An evidence-based framework on community-centred approaches for health: England, UK | Co-creation in health |


Community participation is a central concept for health promotion, covering a breadth of approaches, purposes and activities. This paper reports on a national knowledge translation project in England, UK, which resulted in a conceptual framework and typology of community-based approaches, published as national guidance. A key objective was to develop a conceptual framework linked to sources of evidence that could be used to support increased uptake of participatory methods across the health system. It was recognized that legitimacy of community participation was being undermined by a scattered evidence base, absence of a common terminology and low visibility of community practice. A scoping review, combined with stakeholder consultation, was undertaken and 168 review and conceptual publications were identified and a map produced. A ‘family of community-centred approaches for health and wellbeing’ was then produced as way of organizing the evidence and visually representing the range of intervention types. There are four main groups, with sub-categories: (i) strengthening communities, (ii) volunteer and peer roles, (iii) collaborations and partnerships and (iv) access to community resources. Each group is differentiated using key concepts and theoretical justifications around increasing equity, control and social connectedness. An open access bibliography is available to accompany the framework. The paper discusses the application of the family of community-centred approaches as a flexible planning tool for health promotion practice and its potential to be used as a framework for organizing and synthesizing evidence from a range of participatory methods.


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Investment for health and well-being: a review of the social return on investment from public health policies to support implementing the Sustainable Development Goals by building on Health 2020 - WHO

Investment for health and well-being: a review of the social return on investment from public health policies to support implementing the Sustainable Development Goals by building on Health 2020 - WHO | Co-creation in health |


Governments across the WHO European Region need to take urgent action to address the growing public health, inequality, economic and environmental challenges in order to achieve sustainable development (meeting current needs without compromising the ability of future generations to meet their own needs) and to ensure health and well-being for present and future generations. Based on a scoping review, this report concludes that current investment policies and practices (doing business as usual) are unsustainable, with high costs to individuals, families, communities, societies, the economy and the planet. Investment in public health policies that are based on values and evidence provides effective and efficient, inclusive and innovative solutions that can drive social, economic and environmental sustainability. Investing for health and well-being is a driver and an enabler of sustainable development, and vice versa, and it empowers people to achieve the highest attainable standard of health for all. here to edit the content

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Promozione del patient engagement in ambito clinico-assistenziale per le malattie croniche: raccomandazioni dalla prima conferenza di consenso italiana - Recenti Progressi in Medicina 

Promozione del patient engagement in ambito clinico-assistenziale per le malattie croniche: raccomandazioni dalla prima conferenza di consenso italiana - Recenti Progressi in Medicina  | Co-creation in health |

Riassunto. Il concetto di patient engagement ha assunto crescente attenzione in sanità. Gli ultimi decenni, infatti, hanno visto un viraggio profondo dei modelli di cura verso una sempre maggiore valorizzazione del ruolo della persona, vista come soggetto attivo ed “esperto” all’interno del processo clinico-assistenziale. D’altro canto, i sistemi sanitari si trovano a interloquire con persone che esprimono il desiderio di avere un ruolo più attivo in tutte le fasi del percorso sanitario e di conoscere in maniera approfondita tutte le possibili opzioni di trattamento, i relativi vantaggi e i rischi. Tuttavia, sebbene i ricercatori e i clinici siano d’accordo circa della promozione del patient engagement, a oggi manca un consenso circa le strategie e gli strumenti più idonei per il raggiungimento di questo obiettivo. Le prospettive dei pazienti e degli operatori sanitari sui fattori che possono sostenere o, per contro, ostacolare il patient engagement non sono state ancora sufficientemente studiate e, attualmente, non esistono chiare raccomandazioni sugli interventi più efficaci. Sulla base di queste premesse, l’Università Cattolica di Milano e la Regione Lombardia, sotto la supervisione metodologica dell’Istituto Superiore di Sanità, hanno promosso una conferenza di consenso dal titolo: “Raccomandazioni per la promozione del patient engagement in ambito clinico-assistenziale per le malattie croniche”, che ha costituito un ambiente di scambio e di discussione tra esperti appartenenti a diversi contesti clinici e istituzionali e rappresentanti di associazioni di pazienti, al fine di identificare buone pratiche e strumenti efficaci per promuovere il patient engagement in ambito clinico-assistenziale per le malattie croniche.

Parole chiave. Consensus conference, patient engagement, raccomandazioni.

Recommandation for patient engagement promotion in care and cure for chronic conditions.

Summary. The concept of patient engagement is receiving a growing attention in the healthcare field. The last decades have seen a deep revision of care models in the aim of a greater acknowledge of the patient role, seen as an expert actor, in the healthcare process. On the other side, healthcare systems are facing a growing request for participation expressed by citizens and patients. People claim for being more involved in all the crucial turning point of their healthcare journey and of being better aware of their right and duties. They require a deeper knowledge about all the different therapeutic options with the related risks and advantages. However, although all the different stakeholders agree in considering patient engagement a pragmatic further then ethical priority, a shared consensus related to the strategies and instrument to promote has still to come. Patients and healthcare professional perspective about the factors that may hinder or sustain patient engagement still need to be further studied and at shared recommendations – about the programs better effective and efficient in promoting patient engagement – are still missed. Based on these premises, Università Cattolica of Milano and DG Welfare of Regione Lombardia, under the methodological supervision of the Istituto Superiore di Sanità, promoted a consesus conference entitled “Recommendation for promoting patient engagement in healthcare for chronic conditions”. This consensus conferences constituted the occasion of sharing and discussion among experts belonging to different clinical and institutional contexts as well as with representative of patients associations in order to identify good practices and effective tools to promote patient engagement in the care and cure process for chronic conditions.

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Workplace lessons: Millennials have a lot to teach us

Workplace lessons: Millennials have a lot to teach us | Co-creation in health |

Millennials are known for being caring, innovative and socially conscious. Since millennials are expected to comprise 75 percent of the workforce in just over seven years, older folks could benefit from learning from their perspectives, especially when it comes to workplace wellness.

Via Mike Rucker
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What Level of Health Spending Is “Affordable”?

Among the much-repeated words woven into the US debate on national health policy are “affordability” and “sustainability.” Indeed, this debate is not confined to the United States. Remarkably, no one knows what these words actually mean at the practical level. Is there any economist or other expert, for example, who could be sure what percentage of the gross domestic product (GDP) the United States can “afford” to spend on health care, or what level of spending on Medicare is “sustainable”?


To illustrate, according to the latest report from the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds,1 spending on the federal Medicare program currently is 3.6% of a GDP per capita of about $58 000. That leaves $55 912 of non-Medicare GDP for all other spending. The trustees project that by 2050, Medicare will account for 6% of GDP. Assuming a low future rate of growth of only 1% per year for real GDP per capita, spending on Medicare will be 6% of a projected inflation-adjusted GDP per capita of $80 544 (with the 6% spending leaving the contemporaries living in 2050 a non-Medicare GDP per capita of $75 500). That amount is 35% higher than non-Medicare GDP per capita today. So will a spending level of 6% of GDP per capita in 2050 be affordable? Is Medicare sustainable?


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Will Silicon Valley Startups & Empowered Patients Replace #BigPharma? #hcsmeufr #esante

Will Silicon Valley Startups & Empowered Patients Replace #BigPharma? #hcsmeufr #esante | Co-creation in health |

"We don't want to miss the train of digital health" is a phrase Bertalan Mesko, MD, PhD, has heard many times since he started working with pharmaceutical companies. Well, I have good news, says Mesko. They cannot miss it, because there are no trains to catch anymore. Instead, we should be looking to futuristic spaceships. If the pharma industry doesn't deal with disruptive technologies, it won't have an industry at all.

It might sound like a bold statement, but major trends suggest a future in which medical innovations come from a garage or a small startup company. For hundreds of years, innovation belonged to the R&D departments of pharma companies. A few technological developments might change that forever – and we are not happy about it.Bertalan Mesko, MD, PhD

Via Pharma Guy, Lionel Reichardt / le Pharmageek
Pharma Guy's curator insight, October 20, 2015 8:02 AM

Denise Silber commented:

"Complex question indeed that you raise about the transformation of pharma. So far, pharma has mostly missed out on the opportunities to 1) communicate in an engaging way on social media 2) to be involved in mobile apps that are used in a significant way 3) to transform their relationship and the sales process toward healthcare professionals 4) to transform internal processes in general. So, that's a poor scorecard indeed.

"However, if we look at, for example, Silicon Valley start-up accomplishments in health, there have been hiccups as well. 

--Companies without pharma/device experience such as 23&Me and now Theranos turned out to have made premature announcements, probably to satisfy investors, and then faced setbacks. 

--Healthcare connected objects and apps, even when not suffering from restrictive pharma marketing policies, confront high abandonment rates and seem to have difficulties in demonstrating clinical value.

"For the moment, even monster Google seems to want to partner with pharma rather than go it alone, (although this can change once Google has learned how everyone works from the inside).

"Wouldn't it be fair to say that new, disruptive ideas have always started with individuals or tiny teams. Many pharma compounds were the work of external researchers that were licensed or brought in.

And pharma is now taking a close look at start-ups and finding ways to collaborate with them as they would have with academic researchers in the past."

A good example of pharma collaborated with start-ups is Bayer's Grants4Apps™ program, which invites health app developers to submit their innovative app ideas for novel software that contributes to improving health outcomes. For more on that, see: 

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Claudio Magris: «Quei 418 messaggi che non ho letto» -

Claudio Magris: «Quei 418 messaggi che non ho letto» - | Co-creation in health |

In meno di tre giorni si sono accumulati nel mio cellulare (uno di prima generazione) 418 messaggi. Anzi, messaggini, secondo il lessico lezioso e vezzoso che adorna di fiori di carta le gabbie d’acciaio della tecnologia. Telefonini, messaggini, ditini che battono tastini. Non so cosa dicano, quei 418 appelli in una bottiglia, perché non sono capace di leggerli e dunque di rispondervi. Non è una stolida posa antitecnologica, sempre falsa e patetica, non solo perché si disconosce con supponenza l’aiuto che la tecnologia reca alla vita — basta pensare alla medicina e alla chirurgia — ma anche perché si crede che la tecnologia sia solo quella recente, quella che è piombata nella nostra vita già adulta, e si identifica la cosiddetta natura con la tecnica che c’era già quando si è venuti al mondo. La radio, ad esempio, mi sembra più «naturale» della televisione, perché quando sono nato i suoi suoni erano già nell’aria, come gli altri rumori della realtà, mentre la televisione è entrata a casa mia quando finivo il liceo. Nessuna psicosi o civetteria antitecnologica dunque, da parte mia. Semplicemente soffro di disabilità digitale, che è un handicap ma non una colpa, e invoco rispetto per questa mia «diversa abilità» digitale, come si dice in politically correct, così come chiedo comprensione perché non sono più in grado di fare le belle escursioni in montagna di una volta.

Tuttavia, direbbe Musil, in ogni più c’è un meno e in ogni meno un più. Se ne fossi stato in grado, avrei letto quei 418 dispacci e avrei risposto ad ognuno, come faccio con ogni lettera cartacea, almeno una quindicina al giorno. Calcolando 2,30 minuti per ogni lettura di sms e risposta, probabili controrisposte e mie relative repliche, avrei impiegato, credo, circa sedici ore. Due giornate di lavoro pieno, e verosimilmente altrettante nei tre giorni successivi e via di seguito. Dove resta il tempo per il lavoro col quale — a parte i pensionati, i milionari, i carcerati, i malati o i disoccupati — ci si guadagna di che vivere, e per leggere, passeggiare, incontrare gli amici, fare all’amore? Ai tavoli di ristoranti e caffè si vedono persone che non parlano tanto fra loro quanto con invisibili interlocutori al telefono e non solo un paio di volte, come sarebbe naturale, ma per quasi tutto il tempo che scorre fra l’antipasto e il dessert. Quando i due — o i quattro o cinque — cominceranno a parlare fra loro?


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Pay for performance: a dangerous health policy fad that won't die

Pay for performance: a dangerous health policy fad that won't die | Co-creation in health |
The evidence is clear: It's time to terminate pay for performance, the catchall term for policies that purport to pay doctors and hospitals based on quality and cost measures.

Via Marc Phippen
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Social security is a provision paid for by the public to support the public ‘from from the cradle to the grave’ when they fall on hard times

Social security is a provision paid for by the public to support the public ‘from from the cradle to the grave’ when they fall on hard times | Co-creation in health |

Some logical gaps in government rhetoric

The government claim that more people are in employment. However, the government have ensured via systematic deregulation that the ‘supply-side’ labour market is designed to suit the wants of employers and not the needs of employees. Supply-side policies include the promotion of greater competition in labour markets, through the removal of ‘restrictive’ practices, such as the protection of employment.

For example, as part of supply-side reforms in the 1980s, trade union powers were greatly reduced by a series of measures including limiting worker’s ability to call a strike, and by enforcing secret ballots of union members prior to strike action.

Via britishroses
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The Ethics of Influence: Government in the Age of Behavioral Science - Cass R. Sunstein

The Ethics of Influence: Government in the Age of Behavioral Science - Cass R. Sunstein | Co-creation in health |
In recent years, 'nudge units' or 'behavioral insights teams' have been created in the United States, the United Kingdom, Germany, and other nations. All over the world, public officials are using the behavioral sciences to protect the environment, promote employment and economic growth, reduce poverty, and increase national security. In this book, Cass R. Sunstein, the eminent legal scholar and best-selling co-author of Nudge (2008), breaks new ground with a deep yet highly readable investigation into the ethical issues surrounding nudges, choice architecture, and mandates, addressing such issues as welfare, autonomy, self-government, dignity, manipulation, and the constraints and responsibilities of an ethical state. Complementing the ethical discussion, The Ethics of Influence: Government in the Age of Behavioral Science contains a wealth of new data on people's attitudes towards a broad range of nudges, choice architecture, and mandates.
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"La stanca umanità del mito. La Grecia di Ghiannis Ritsos"  Oreste - UOMINI E PROFETI con Moni Ovadia

"La stanca umanità del mito. La Grecia di Ghiannis Ritsos"  Oreste -  UOMINI E PROFETI con Moni Ovadia | Co-creation in health |
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The dialectic of human development - Pierre Levy

The dialectic of human development - Pierre Levy | Co-creation in health |

The algorithmic medium

Before the algorithmic medium was the typographical medium (printing press, broadcasting) that industrialized and automated the reproductionof information. In the new algorithmic medium, information is, de facto,ubiquitous and automation now concentrates on the transformation of information.

The algorithmic medium is built from three interdependent components: the Web as a universal database (big data), the Internet as a universal computer (cloud), and the algorithms in the hands of people.

IEML (the Information Economy MetaLanguage) has been designed to exploit the full potential of the new algorithmic medium.

IEML, who and what is it for?

It would have been impossible to have designed IEML before the automatic-computing era and, a fortiori, to implement and use it. IEML was designed for digital natives, and built to take advantage of the new pervasive social computing supported by big data, the cloud and open algorithms.

IEML is a language

IEML is an artificial language that has the expressive power of any natural language (like English, French, Russian, Arabic, etc.). In other words, you can say in IEML whatever you want and its opposite, with varying degrees of precision.

IEML is an inter-linguistic semantic code

We can describe IEML as a sort of pivot language. Its reading/writing interface pops up in the the natural language that you want with an IEML text that self-translates in that specific language.

IEML is a semantic metadata system

IEML was also designed as a tagging system supporting semantic interoperability. Its main use is data categorization. As a universal system addressing concepts, IEML can complement the universal addressing of data on the Web and of processors on the Internet.

IEML is a programming language

An IEML text programs the construction of a semantic network in natural languages and it computes its relations and its semantic differences with other texts.

IEML is a symbolic system

As with any other symbolic systems, IEML is a result from the interaction of three interdependent layers of linguistic complexity: a syntax, semantics and pragmatics.


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Pierre Levy: From deep learning to deep meaning

Pierre Levy: From deep learning to deep meaning | Co-creation in health |
I put forward in this paper a vision for a new generation of cloud-based public communication service designed to foster reflexive collective intelligence. I begin with a description of the current situation, including the huge power and social shortcomings of platforms like Google, Apple, Facebook, Amazon, Microsoft, Alibaba, Baidu, etc. Contrasting with the practice of these tech giants, I reassert the values that are direly needed at the foundation of any future global public sphere: openness, transparency and commonality. But such ethical and practical guidelines are probably not powerful enough to help us crossing a new threshold in collective intelligence. Only a disruptive innovation in cognitive computing will do the trick. That’s why I introduce “deep meaning” a new research program in artificial intelligence, based on the Information Economy  MetaLanguage (IEML). I conclude this paper by evoking possible bootstrapping scenarii for the new public platform.
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Dark chocolate is now a health food. The Mars company has sponsored hundreds of scientific studies to show cocoa is good for you.

Dark chocolate is now a health food. The Mars company has sponsored hundreds of scientific studies to show cocoa is good for you. | Co-creation in health |

The Mars company has sponsored hundreds of scientific studies to show cocoa is good for you.

A year after James Cadbury, the 30-something great-great-great-grandson of the British chocolatier John Cadbury, launched his luxury cocoa startup in 2016, he introduced an avocado chocolate bar.

Cadbury Jr.’s newest confection loaded just about every buzzy health trend into a fresh green-and-white package: vegan, ethically sourced, organic dark chocolate and creamy, superfood avocado. The company promised to deliver the nutrition of avocados — in a chocolate bar. Journalists were dazzled.

Wait, what? Make no mistake: This vegan avocado chocolate bar is candy. With nearly 600 calories and 43 grams of fat per 100-gram serving, the bar packs more fat and calories than Cadbury Dairy Milk, and just a little less sugar.

So how in the world could a chocolate bar be convincingly sold as a health food? You can thank a decades-long effort by the chocolate industry.

Over the past 30 years, food companies like Nestlé, MarsBarry Callebaut, and Hershey’s— among the world’s biggest producers of chocolate — have poured millions of dollars into scientific studies and research grants that support cocoa science.

Industry funding in nutrition science is not uncommon — grape juice makers and walnut growers sponsor studies showing these foods improve driving performance or cut diabetes risk. But Big Chocolate’s foray into nutrition research is a great case study in how industry can steer the scientific agenda — and some of the best minds in academia — toward studies that will ultimately benefit their bottom line, and not necessarily public health.

Here at Vox, we examined 100 Mars-funded health studies, and found they overwhelmingly drew glowing conclusions about cocoa and chocolate — promoting everything from chocolate’s heart health benefits to cocoa’s ability to fight disease. This research — and the media hype it inevitably attracts — has yielded a clear shift in the public perception of the products.

“Mars and [other chocolate companies] made a conscious decision to invest in science to transform the image of their product from a treat to a health food,” said New York University nutrition researcher Marion Nestle (no relation to the chocolate maker). “You can now sit there with your [chocolate bar] and say I’m getting my flavonoids.”

Amid a historic obesity epidemic, this new niche of nutrition science has helped build a solid aura of health around chocolate — and grow consumer demand. Chocolate retail sales in the US have risen from $14.2 billion in 2007 to $18.9 billion in 2017, the market research group Euromonitor International found, at a time when candy sales overall have been waning.

Big Chocolate’s investment in health science was a marketing masterstroke, catapulting dark chocolate into the superfood realm along with red wine, blueberries, and avocados — and helping to sell more candy.

Health-conscious consumers now increasingly seek out “premium” dark and gourmet chocolate, Euromonitor found, the success of which “stems partially from the health benefits associated with a higher cocoa content.”

But despite the industry effort to date, cocoa still has never been proven to carry any long-term health benefits. And when it’s delivered with a big dose of fat and sugar, any potential health perks are very quickly outweighed by chocolate’s potential harm to the waistline.

That’s something consumers all too easily forget in the face of delights like the vegan avocado chocolate bar.

How Mars helped turn chocolate into a heart healthy snack

In 1982, Mars Inc. — the company that has brought us M&M's, Snickers, and Twix — established the Mars Center for Cocoa Health Science in Brazil to study, in part, the biology of cocoa and its impact on human health.

Since then, mainly through the company’s scientific arm Mars Symbioscience, established in 2005, it has flooded journals with more than 140 peer-reviewed scientific papers.

Mars’ initial focus on studying the health benefits of chocolate has shifted to studying a group of compounds called flavanols. Flavanols are micronutrients found in many fruits and vegetables, including cocoa. These “phyto” — or plant-derived — chemicals have antioxidant properties and seem to promote vascular health (more on that later). Researchers suspected flavanols might be one of the reasons fruits and vegetables are so good for the body.

Companies selling flavanol-rich products have been on a quest to find out what flavanols do — and how they can be hyped. One of the earliest Mars papers, published in the Lancet,demonstrated that chocolate was a great source, even compared to flavanol-rich tea. “As a result,” the candy company claims on its website, “Mars started a research program to identify and isolate flavanols from cocoa, and to use these cocoa flavanols in the study of human health benefits.”

In addition to the science Mars generates, the company has also endowed a chair in nutrition science at the University of California Davis, and sponsored research conferences that focus on subjects like “The Potential Use of Cocoa Flavanols in Preventing Cardiac and Renal Disease.”

To find out what kind of conclusions Mars-sponsored studies come to, Vox searched the health literature and identified 100 original cocoa health studies funded or supported by the chocolate maker over the past two decades. (We also found dozens more Mars-supported cocoa studies that weren’t health-related and systematic reviews of the research evidence.)

Among the findings in the Mars-sponsored health studies: Regularly eating cocoa flavanols could boost mood and cognitive performance, dark chocolate improves blood flow, cocoa might be useful for treating immune disorders, and both cocoa powder and dark chocolate can have a “favorable effect” on cardiovascular disease risk. The institutions that received Mars support stretch across the US and all over the world — from UC Davis to Harvard and Georgetown universities, from Heinrich Heine University in Düsseldorf, Germany, to the University of Buenos Aires, Argentina.

All told, nearly every one of the studies came to positive and favorable conclusions about cocoa or chocolate.

Javier Zarracina/Vox
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MoiPatient : jamais la parole des patient-e-s n'a été aussi importante  #esante #hcsmeufr #epatient #moipatient

MoiPatient : jamais la parole des patient-e-s n'a été aussi importante  #esante #hcsmeufr #epatient #moipatient | Co-creation in health |

Afin de mieux comprendre le ressenti et les besoins des patient-e-s et de mieux y répondre, la recherche médicale doit évoluer, pour les impliquer directement : elle doit devenir participative.

La prise en compte des savoirs et des expériences des patient-e-s sera une des prochaines grandes révolutions de la médecine et de la démocratie en santé : elle permettra que leurs voix et la réalité de leurs vécus soient enfin entendues;

Tel est l'objectif de la plateforme, qui sera lancée par Renaloo dans quelques mois (1). 


MoiPatient vous proposera de :

- Contribuer à la production de nouveaux savoirs, issus directement des patient-e-s et de leurs proches, centrés sur votre expérience et votre vécu

- Participer à l’évaluation et des évolutions de notre système de santé, en témoignant de votre vie avec la maladie et les traitements et en faisant entendre votre voix sur les questions qui vous préoccupent


En pratique

MoiPatient vous permettra de contribuer à l’amélioration des connaissances et de la qualité des soins, en apportant vos propres données (dont vous resterez propriétaire) sur votre santé, vos traitements, votre relation au système de soins, l’accès aux droits, l’impact de votre pathologie sur votre vie quotidienne ou celle de votre entourage, etc.


Imaginer la recherche de demain

Vous pourrez dialoguer directement avec des chercheurs, participer à la définition des priorités de recherche et proposer des thématiques d’étude, en fonction de vos préoccupations.


Participer à des études

Enfin, MoiPatient vous permettra de participer, selon vos souhaits, à toutes sortes d’études (épidémiologiques, cliniques, organisationnelles, sociologiques, économiques, etc.), réalisées par des acteurs publics, privés, ou institutionnels, après validation des projets par un comité « d’intérêt des patients ».

Vous pourrez choisir les thématiques sur lesquelles vous souhaitez être sollicité-e. 
Vous serez informé-e-s des promoteurs et des finalités de chaque enquête et vous pourrez bien entendu décider d’y participer ou non.


Les données par et pour les patient-e-s

A l’heure où les données de santé font l’objet de toutes les convoitises, MoiPatient a pour ambition d’apporter à ses participants toutes les garanties, éthiques, de sécurité et de confidentialité sur les usages et la protection de leurs données (2). Elles seront utilisées de façon anonyme et exclusivement au service de l’intérêt collectif des patients, conformément aux valeurs de Renaloo (1), responsable du traitement des données.


Nous nous engageons à vous tenir systématiquement informé-e-s du déroulement et des résultats de toutes les études auxquelles vous aurez contribué.


Nous vous proposons dès à présent de participer à une première enquête, qui est nécessaire pour identifier et mieux connaître les patient-e-s et proches qui pourront contribuer à cette plateforme et donc à des études à venir.


MoiPatient, c’est l’opportunité que nos points-de-vue et nos expériences comptent et que nos voix soient entendues. Plus nous serons nombreux-ses, plus nous serons écouté-e-s, mieux nous pourrons agir pour une meilleure médecine, ensemble.


Via Giovanna Marsico, Lionel Reichardt / le Pharmageek, Géraldine GOULINET FITE
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How online patient portals are transforming health care

How online patient portals are transforming health care | Co-creation in health |
Patient portals — secure websites that give people access to medical information — now let you easily check doctor visit summaries, test results, prescriptions, and other personal data, all with a few clicks of a mouse. Some patient portals also give you the ability to directly email questions to your doctor, fill out necessary forms, pay bills, or schedule future appointments. Convenient!More and more health-care providers are beginning to offer patient portals. The Office of the National Coordinator for Health Information Technology (ONC), which is part of the U.S. Department of Health and Human Services (HHS), reports that 64 percent of hospitals had some type of online patient portal in 2014. Another survey found that, in 2016, 58 percent of health-care providers were offering portals.
Via Alex Butler
Denise Silber's curator insight, December 11, 2017 5:16 AM
How inclusive is the data in that portal? (What % of the patient's data does it represent?).
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Ci manchi

Ci manchi | Co-creation in health |

Gianfranco Domenighetti, Docente di Comunicazione e Economia Sanitaria, Università della Svizzera Italiana.


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