Through this research and our extensive experience in the field, we have developed three concepts that, when used as lenses through which to view planning, may well help achieve sustainability.
eHealth programs to become sustainable, they must reach critical mass.
One of the most successful examples of this concept is the Human Genome Project. By leveraging the power of thousands of researchers, all working towards a common goal with a transparent approach, the project overcame massive challenges and has changed the way we understand our species.
Crowd accelerated innovation relies on three basic principles to succeed.
The first is that a clear goal must be identified and shared by participants; there must be a desire for the benefits of eHealth. All too often, governments, hospitals and health systems take a tempered approach to eHealth that cuts the program into single, short-term projects or focuses on a single disease category. Sustainability requires health leaders to be clear and committed to a larger change.
Secondly, for crowd accelerated innovation to work, the program must be fully transparent. Health leaders and governments must consistently and transparently communicate the benefits, progress, results, security, costs, and ultimate goals of eHealth across all stakeholder groups.
The final principle for crowd accelerated innovation is the need for critical mass. eHealth planners must strive to expand the audience for eHealth as much as possible to enhance adoption and gain value from the system.
Sustaining the eHealth transformation requires everyone to work together.
eHealth cannot focus on physicians alone, but must involve the active participation of patients, medical IT firms, insurance providers, governments and healthcare providers as well. This idea brings together long-held concepts in participatory medicine and integrated healthcare to move the healthcare delivery paradigm from one where the system is the arbiter of care to one that revolves around patient-centric personal healthcare.
Collaborative alignment - working together to achieve results
Collaborative alignment has been crucial to sustainability in many other industries, such as the auto industry, where suppliers and manufacturers align their operations and interests to produce better cars, but has yet to be widely adopted in the health sector.
For the health sector to embrace collaborative alignment, it must first consider the context from which each stakeholder approaches the program. The drivers for patients will differ greatly from those of insurance companies or governments; each will affect the way they participate in the project.
There must also be alignment in the level of maturity of each party, as more evolved groups tend to take a broader view of collaborative participation.
eHealth planners will also need to understand that sustainable and successful eHealth programs and participatory medicine tend to shift the power to the patient. Few stakeholders in the system are participating for purely altruistic motives, and each has a self-interest to gain from their participation. For patients and physicians, there is also the mutual benefit of better clinical outcomes. For insurance providers and governments, it also involves cost savings.
Creative dislocation: things are going to change.
To achieve real and lasting change, eHealth planners need to be bold and lead the transformation of business and economic models to allow the adoption of new technology and innovations.
Healthcare lags behind other industries, where structures, systems and incentives have made it far easier to embrace creative dislocation.
Creative dislocation is infeasible unless the replacement systems are affordable and have critical mass in the marketplace. This will require investment and innovation to reduce prices, and a certain level of standardization to enable new technologies to be successfully integrated. At the core, this requires healthcare operators to have the courage to identify and eliminate processes and technologies that are no longer relevant to the system, rather than finding ways to append eHealth components to existing systems.
Technology clearly represents one of the biggest and most expensive challenges in developing an eHealth system. Once again, respondents suggest that eHealth planners focus on developing the systems and processes that underpin the program.