A Lisbon agenda on health innovation

A distinctive feature of our times is the emergence of a knowledge society and economy where innovation plays a fundamental role.¹ Innovation is not, essentially, about technology. It is about managing change in the knowledge society. The notion of innovation, in this context, refers to ideas, goods and services recognized as new and useful, that result from a creative process where knowledge is a key ingredient, implying strong social drivers and producing economic value.

Seeing innovation as a major change engine in contemporary societies, invites us to reflect on its public health implications.^2–4 With this purpose in mind, it is here suggested that public health innovation may be perceived in two different but complementary dimensions: (i) health policy innovations led by legitimate public authorities and (ii) product, service, process innovations, driven by community innovation stakeholders.

Health policy innovation is seen here as a paradigm shift that is likely to include changes in mind-frame, citizen orientation, governance principles, organizational philosophy, information and knowledge management, outcome orientation, and is supportive of community driven innovation. Primary health care reforms have been good examples of policy innovation: they represent a major health systems shift from institutional to community care, from a segmented and specialized response to an integrated and generalist approach to patient needs while advocating more attention to community participation.

Currently two major thrusts of policy innovation are ‘citizen centeredness’ (health promotion and health literacy) and ‘outcomes/results orientation’ (health services value chains focused on results). Together, they elicit a new health systems cultural framework, better governance and radical changes in information and knowledge management. Important public health developments, such as the EU Health Strategy ‘Together for Health’⁵ can be analysed and discussed in reference to the health policy attributes indicated above.

However, it is possibly in the area of community driven, product, service or process innovation, where more groundbreaking developments can be found. It is suggested that this kind of innovation, seen from a public health perspective, includes the following elements: (i) a creative process, requiring imagination and entrepreneurship, (ii) that translates knowledge into tangible products, services or procedures, (iii) resulting in adding value simultaneously to at least three different domains:

• health, as a value in itself, as a resource for individual and social development, as an outcome of value-adding community and service networks;

• enabling social interactions and individual empowerment and responsibility, by redesigning the public sphere through better literacy, ‘constructive conversations’ and engagement among social actors, and transparent governance;

• economic growth, through investing in health, supportive physical and social environments and health-centered technologies.

Citizen-centered health information is likely to emerge as major health systems change engine. Electronic personal health information systems, owned and operated by citizens, interacting appropriately with their health systems environment (community information resources, professional information systems, and technological platforms) illustrate well the underlying principles of community driven health innovation—they contribute to better health, change interactive patterns between key health players, have economic value and are likely to stimulate the appearance of new professions on knowledge translation and brokerage. This is also a privileged area for collaborative (open) innovation and for citizen involvement, as they assume ‘lead innovator’ roles.

This also applies, for instance, to wellness industries, such as Spa's and similar centers, as they tend to evolve from a collection of distinct, hard-ware centered practices to integrated, human-ware centered, participatory quality of life programs. Supportive environments (household interior architectures) and enhanced communication capacities (simplified communication devices) for improving the quality of life of the aged provide another relevant example.

Public health innovation brings together social and economic development (health and wealth), in the spirit of the European Union's Lisbon Agenda—rather than widening the gap or establishing a hierarchy between ‘social’ and ‘economic’ policies. It applies both to health promotion and health services, reinforcing a public health umbrella concept in health systems thinking. The European Public Health Association has decided to take up ‘health and innovation in Europe’ as the key theme of its 2008 Conference.⁶

References

Announcement

The 2008 EUPHA Conference—Lisboa, 6–8 November, prepared in close collaboration with ASPHER, will cover, through its plenary sessions, major aspects of public health innovation:

• European Health Strategy—implementation challenges and innovation;

• Innovation in health systems: future health care organizations in the knowledge society

• Health and wealth—health innovation in markets

• Health literacy and innovation—knowledge transfer from genomics to citizens

• Health and innovative leadership: public health education and social entrepreneurship.

The 2008 EUPHA Lisbon Conference will feature an innovation fair organized around a Health Innovation Bank (i-health bank), aiming at collecting, organizing, studying, disseminating and promoting public health innovation.

Author notes