Digital Economy4 July, 2008. BMA House

Paul Luff

Gordon Brown £100m into digital economy

Digital eceonomy

Energy Nanoscience Essential platform Securing he fuure

£46m (2008-9) standard – large (£10m)

types of projects -    phd studentships (10-20 at a time; each one is 100 students – 400 total)

fund large centres (2-6 of them), around £20m each, possibly multi-institutional -    call in mid-july

identify funamental areas key to future research capabiity in digital economy -    transport -    creative industries -    healthcare -    (finance) -    (government) -    (services)

develop networks of researchers to define how spend money -    these clusters are for this

research clusters -    innovative media for a digital economy (oxford) -    e-Health+ (Manchester) -    inclusive digital economy supporting olrder and disabled people (Dundee) -    DIADEM (Queen Mary)

What’s the grand challenge?

IMDE -    social technology systems -    user-generated content -    new forms of exchange and participation -    new approaches and kinds of research activities -    3 areas

aim to see links across 3 themes, then feedback

build consortia for clusters

creative industries – sample issues -    new economic models -    ipr -    trust, reputation and identity -    blurring of boundaries -    resource of atomisable content -    cultural history of production -    funding models (reactive, short term) o    3-4 year too slow for this area. Funding period must be shorter

Transport -    sustainability and info -    technologies to substitute for travel -    multi-model and seamless -    transititional communities -    cult context, social criticism and urban planners (‘imagined futures’) -    public engagement -    methods: expts, demonstrations, unfocus groups

recent devels -    phased future calls -    range of funding models -    july 2008-07-04 interdisciplinary and inter-institutional

EPSRC might want to spend a lot of this money v soon -    definitely inter-institutional

push to inter-disciplinary research

strong involvement of social scientists

don't have to be big centres, but smaller projects


involvement of industry

driven by problem on the ground

that’s why not theory of computer science, but applied -    new business models

‘what is industry/business in health care?’

patients and carers

elderly is a strong area

deadlines for proposals -    possibly December -    must commit funds by March 2009

Resources - - - o    between a blog and wiki

3 cards (blue) - 3 grand challenges to innovative care - with partner - decide which 4 are main, from 6 - write these on green card - connect with another couple, 8 cards - decide what are 6 main challenges

Setting the Context: NHS Direct Shirley Large

Aims to provide expert health advice for homecare 36 call centres – 8m calls per year 3m visits a month NHS Direct Digital TV – 18.9m (85% penetration

Research imperatives -    clinical -    organizational -    democratic

research priority areas -    advice and referrals -    long-term conditions -    new media and multi-channel -    public heath surveillance and response

how integrate with new media?

Emergency contraception pilot -    aim: understand how to integrat multi-chanaal -    social networking and im -    reach popn groups that have a partic public health need -    19 Apri – 1 June – Health Info Advisors -    delivered via applets o    Bebo o    Health centre eb at warwick uni o    Nhs direct -    (this was an advert) -    1,540 views -    661 IM chats -    446 (68%) NHS -    215 (32%) bebo -    average chat 12mins 32 seconds -    94% female -    57% 16-25yrs -    13% under 16yrs -    Reason for IM o    20% concern following intercourse wout cntractpin o    14% pregnancy o    10 failed contraction o    18 not worked -    62% of enquiries abut wider sexual health isse -    8% clinical symptoms -    highest referral to NHS Direct -    Questionnaire response 19% o    94% described chat as about right legngth o    85% found understand

ME: how did you establish demographic?

Bucks Shape 50+ Project: Health Connect Aviv Katz

Commissioned by oxford, Milton Keynes,

Citizen engagement aim

Older people from community -    cabinet members, local council

identify key issues -    HC not dealing with transport -    HC poorly equipped with info about how to get to surgery -    Lack of IT database -    (rural community)

vision – travel info service

not to create a new website, but a vision for integration

e-Health Plus David Wallom Northwest Instittue for BioHealth Informatiocs, Manchester

Aims -    healthcare usually too late in course of disease to make optimal solution -    lacks personalization of info -    digital eceonomy challnge: quickly assemble persuasive iformation from multiple sources, tailor to indiv and empower to make health choices

probs -    lack of prev and early healthcare -    poor/confusing info -    digital challenge providing personalized halth info

from illness to wellness

wellbeing not just managing illness

situational awareness of rising child-bmi – Wirral, 3-yr olds from 1988-2004 -    long term rise, since 1990s

gene association studies -    processing info

poor choices through lack of available information -    Klein, NEJM, 2006 – lipsuction – people will not know that the removal of surface fat does not reduce risk

How create system where can look at data

How make available?

Public good

How make sure that research on records see benefit of

Create federation rather than single database

Communities of best practice

Not single infrastructure

Beacon local health economies are ready to be connected, internally, towards t digital economy

Chain of health care prof with patient

Need more flexible relationship between patient and doctor

Personal healthcare system

Radical blogging: -    push projects and collaborations

public engagement, miniposters, competitions, networking,

personalized health care

eDiamond -    collab between health, industry and acadmia, to devel digital mammography improve diagnosis of breast cancer -    create library of comparison images -    access to many more radiographers -    automate first pass -    (did not succeed since NHS had already committed to another system)

My comments -    Open source -    Google Health -    Prob with UGC -    Establishing platforms as meaningful communities – not user generated content, but participant constituted platforms -    Significant aim should be to give priority to rare/poorly funded conditions -    Semantic web

Energy Balance Wristwatch -    informs about choices you can make

Personal Health Avatar -    second life -    how create second life avatar to examine presentation of health care info -    largest problem – how tell patient that may or may not see a doctor to be involved in a wellness culture -    inegate and present through various devices – scale – into ownenvironment

relationship to creative media cluster -    presentation, design, interface -    medical training: health care evolves rapidly, presenting training without removing from workplace must get used to

next meeting -    16th July, Manchester -    working towards first theme – personal devices for eHealth -    connectivity between devices, simulation and presentation

advertising not good enough -    ME: is there any study of which agencies are used for Health care advertising in the uk? Compare with marketing of pharmaceutical products to health care professionals.

Animal Agentz Mark Jones


phd at Great Ormond St Hospital

children go to website and learn skills

conditioning for subsequent interventions eg. vaccination

each animal has different skill

distraction cat

monkey – guided imagery

lion – cognitive behaviour therapy – saing positive things (for older child)

integrated on facebook, you tube, twitter,

ME: In what way is it on Facebook? How many users? What does it offer?

ADHD one possible app

IP -    patented

social software –

you tube – 143 views


twitter -    getting community to advise


Examples John Luff

- user participation - BBC Health - Organised Wisdom (wiki) - PatientsLikeMe (also gather stats) - BrainTalk (1993) - The Health Care Blog - Second Life – ‘A second life on second life’ – ‘Heron Sanctuary’ – MS - HealthVault - Google Health

1000 people, 200 returned

ensuring that the technologies protect patients/participants/clinicians

ensuring information is secure against

non-disclosed interests


the authority of STS  to guide people through peer consensus in the actions taken with their health

How do people share and access health information in STS communities? How do they constitute trust, privacy and knowledge systems and how can we inform this process?

How can we guide people?

How can people be empowered through guidance

Challenges and opportunities

What do we do to get there?



Cost of missed opportunity Funding timelines should be longer than 3-5 yrs Access various funding mechanisms Venture capital in uk absent Charity funding – lottery Sustainability of funding model How does model permit alteration of research design? Manage as portfolio of products Project management team Academic inertia: Pressures in academia – how innovate with career paths (corporate swap with scientist) Institutional inertia: estab process for successful diffusion Link practice back to research Need ‘sand pit’ / action field to try in different labs Project funding portal needed Need to be bigger risk takers in research How export findings globally? Enough time for reflection?


Too much info, not good Once try to provide info, what are consequences to doctor-patient relationship? Consequences to service provision Patient becomes an expert – what new demands? Fundamentally transform conventional relationship Consequences of having knowledge Change in citizenship How preserve idea that only clinicians are experts/gatekeepers

Questions & Answers What about people with diminished responsibility?


Renegotiate meanings


Definitions Control over access Indiv control over info Gift relationship If more control over info, more willingness to share info Linking with banks How authenticate? Bebo, facebook, myspace not authenticated -    sts too trivial, not critical to you as an indiv



Concern about wiring well people to technology Structured information Pilot projects – quickly expedited Standards Constantly horizon scanning rather than prescribing problem Do not let technology drive agenda Acceptability, reliability, usability Near-to-the-user research Design with not for users Quick prototyping

Questions & Answers Sharing of information