The Future Hospital in Global Health Systems

Future hospitals must be able to adapt in many ways to the changing demands on their roles and functions within evolving healthcare delivery infrastructures. These include changing population structures and needs, new models of healthcare provision, technological advances, and innovations in design, all while enhancing their environmental sustainability. 

This article sets out the issues that those determining healthcare policy and designing future hospitals must consider if they are to become and remain fit for purpose within the wider health and social care system. It also examines the need for, and challenges to, strategic healthcare planning, creating future hospitals that are sustainable, net‐zero carbon organisations, and ensuring resilience in the face of a range of potential shocks. 

• Future hospitals play a crucial role in healthcare worldwide, regardless of the country's income level. 
• Hospitals cannot be viewed without broader health system changes, infrastructure, community and cultural factors, staffing and other considerations. 
• Future hospitals will enhance population health in all settings and support the move towards more consumer‐centric healthcare. 
• Future healthcare organisations must not only promote health and well-being but also protect their communities through thoughtful building and organisational design
• Planning the hospital system of the future must take a systems approach, making use of the increasingly sophisticated models of healthcare demand, while incorporating sufficient flexibility for a range of possible, but unpredictable scenarios.
• Future hospital function requires sufficient trained healthcare staff, digital literacy for both staff and patients, and adequate education and training

Open acces article (2025)

Sebire NJ, Adams A, Celi L, Charlesworth A, Gorgens M, Gorsky M, Landeg O, Nagasawa Y, Nimako KT, Onoka C, Roder-DeWan S, Watts N, McKee M. The Future Hospital in Global Health Systems: The Future Hospital Within the Healthcare System. Int J Health Plann Manage. 2025 May;40(3):741-751. doi: 10.1002/hpm.3891. Epub 2025 Jan 15. PMID: 39815953; PMCID: PMC12045726

Photo Jordi Soldevila. Homenatge a Toni Catany Bol Japonès

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Is competitive pressure essential for sustaining quality in primary care services?

The authors Eduard Brüll, Davud Rostam-Afschar, and Oliver Schlenker study how the threat of entry affects service quantity and quality of general practitioners (GPs).

They leverage Germany’s needs-based primary care planning system, in which the likelihood of new GPs reduces by 20 percentage points when primary care coverage exceeds a cut-off. They compile novel data covering all German primary care regions and up to 30,000 GP-level observations from 2014 to 2019. Reduced threat of entry lowers patient satisfaction for incumbent GPs without nearby competitors but not in areas with competitors. They find no effects on working hours or quality measures at the regional level including hospitalizations and mortality.

While entry restrictions aim to ensure equitable access to care, they can unintentionally reduce service quality by weakening competition. Policymakers must navigate this trade-off carefully, ensuring that access does not come at the expense of quality. By preserving competitive incentives even in regulated markets, healthcare systems can achieve both equitable and high-quality care.

IZA Discussion Paper No. 17534

Access to working paper 2024 (pdf)

Photo Jordi Soldevila. Merry Christmas

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Centering Equity in the Implementation of Emerging Digital Health Technologies: AI, genomic medicine, digital media

Despite unprecedented spending on health in the United States and the rapid expansion in types and innovations of digital health technologies, many populations still get sick and die at higher rates than others. 

To address these persistent health inequities in the US, it will be crucial to center health equity in the implementation of digital health technologies, such as artificial intelligence or personalized genomic medicine. As the two nascent fields of health equity and digital equity find their footing after rapid implementation and scale-up in the post–coronavirus disease 2019 pandemic world, a focus on equitable implementation is particularly important to ensure that digital health technologies do not perpetuate or create new health inequities. However, to date, these fields have had a limited or siloed focus on equitable implementation.

This paper is the inaugural report in the RAND Center to Advance Racial Equity Policy Methods Volume series. This paper will be the first to center health equity in the implementation of digital health technologies by adapting a methodological framework for its implementation to support the planning and evaluation of digital health technologies. Without an explicit focus on equitable implementation, digital health technologies run the risk of further exacerbating existing health inequities or creating new ones. This paper offers approaches to policymakers, implementation scientists, clinical scientists, government regulatory bodies, and those working in the health and digital technology fields to take the lead in centering equity.

The paper, first describe the persistent health inequities in the United States and how the rapid adoption of digital health technologies can perpetuate those inequities. Then they discuss challenges and limitations of Implementation Science (IS) in centering equity in the rapid adoption of digital health technologies and translating these technologies into equitable improvements in public health. Next, they provide examples of how IS process and evaluation frameworks can be adapted to focus on digital and health equity to leverage emerging health technologies to course correct and address inequitable health outcomes.

Finally, they discuss how these adapted IS process and evaluation frameworks can be applied to address the pitfalls—and realize the promise—of three emerging fields at the intersection of racial and digital health equity: (1) genomic medicine, (2) artificial intelligence (AI) (specifically large language models [LLMs]), and (3) participatory digital media (e.g., blogs, digital stories).

Photo Jordi Soldevila. Gaza. Geometries de la injustícia

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Health Care 2030: the transition from hospital-based systems to primary care, community, and social care–based systems.

Health Care 2030: The Coming Transformation (2021) by Eyal Zimlichman, Wendy Nicklin, Rajesh Aggarwal, and David W. Bates

The problems in our health care systems include subpar quality and patient safety, a misplaced focus on acute care rather than on prevention and population health, inadequate person centeredness, and unsustainable cost.

The next decade will see considerable transformation in how health systems are designed, propelled by opportunities such as digital health, growing consumerism, and mounting financial constraints.

The Covid-19 pandemic has also necessitated and accelerated significant transformations.

The authors discuss gaps and barriers in the current design of health and health systems, and the needed escalation of transformation including transition from hospital-based systems to primary care, community, and social care–based systems.

They also assess the future evolution of payment systems leading toward sustainable health, changes in provider roles, and the entrance of new nontraditional players

Photo Jordi Soldevila. Homenatge a Toni Catany Austeritat

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The state of science in Catalonia

The Catalan Foundation for Research and Innovation (FCRI), a private organisation set up in 1986, that disseminates research and innovation among society to promote scientific culture, careers in science and Technology and public-private relationships and entrepreneurship publishes its first report about the state of the science in Catalonia

The report starts from the analysis of the key elements that have allowed Catalonia to become a pole of knowledge and talent in Europe over the last two decades, both in the scientific research carried out in the universities and in the research centers, large scientific infrastructures and scientific parks.

The report highlights the main strengths of the Catalan research system, in terms of scientific publication and the management of research projects and the training of research staff. It also values ​​the capacity of the Catalan system for attracting Spanish and European competitive funds, and the fact that the research policies entrusted to 25 years have allowed Catalonia to be recognized internationally as a center for knowledge and talent.

The document also highlights five conditions in favor to the research ecosystem such as 

• the approval of the National Pact for the Knowledge Society, 
• the recovery in Catalonia de Department of Research and Universities, 
• the European strategy of the European Green Deal, 
• the Next Generation projects 
• the future Catalan Science Law. 

The report puts the attention to the measures that should be introduced into the knowledge system to guarantee the continuity of scientific quality indicators and the ability to attract competitive research funds: 

• the increase public and private investment in R+D+I, 
• support for the professional career of researchers 
• improve in the field of transfer and innovation. 

In the areas for improvement, the work points to the aging of the teaching and research staff, the difficulty for young people to start and consolidate a scientific career and the more than difficult reconciliation of family and work, which mainly affects female talent. The report is in favor of more internationalizing the workforce and encouraging the recruitment and retention of international talent. 

In terms of funding, the report emphasizes the need to substantially increase public and private investment in R+D+I, currently below the European average indicators. The report also recommends the necessity to connect the research and innovation ecosystem (the universities, research centers, sicentific parks...) with industrial and technological companies.  

Web access: https://estatciencia.fundaciorecerca.cat/

Report and indicators

photo Jordi Soldevila. Homenatge a Toni Catany. Plat Pobre

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Health care technology and COVID-19: what will happen in the long term?

Research published by the Health Foundation in march 2021 explores the challenges of implementing health care technologies and investigates patient and staff experiences of technology during the first phase of the coronavirus (COVID-19) pandemic. It draws on learning from the Health Foundation’s programmes and YouGov surveys of over 4,000 UK adults and over 1,000 NHS staff conducted in October 2020.

During the pandemic, there has been increased NHS use of both established and newer technologies to reduce face-to-face contact and manage demand. Phone consultations dominate, followed by some well-established uses of technology, such as booking appointments by phone or using the NHS website. But some emerging or less established uses of technology, including several explicitly promoted by national bodies, are also apparent. For example, accessing care records electronically, devices for home monitoring, video consultations, and the NHS app.

The research finds that while most of those who used technology more during the early phase of the pandemic found the experience positive, half of these users aged 55 and older (50%) and nearly half of those with a carer (46%) – groups that may have higher need for health care – thought these technology-enabled approaches made for worse quality of care.

Furthermore, the report finds that while 49% of the public and 61% of NHS staff surveyed thought the NHS should be looking to use technology-enabled approaches more in future, a significant minority of both public (36%) and NHS staff surveyed (31%) were unconvinced about the long-term use of these approaches.

While technologies were rolled out with impressive speed, some aspects of implementation – such as evaluation, co-design and customisation – will necessarily have been shortcut, and will need revisiting after the emergency phase of the pandemic is over. Furthermore, many technologies were rolled out specifically to serve pandemic response objectives such as social distancing, so will need to be ‘reoriented’ and developed to serve wider quality and productivity objectives in future.

Through a refresh of the NHS long term plan and other national strategies, policymakers will need to support front-line teams to revisit aspects of implementation and 'reorient' technology-based interventions to serve longer term quality and productivity objectives. Central to this will be evaluating their impact on care quality and developing a vision of ‘what good looks like’.

Access to pdf article (2021)

photo: Strawberry Thief, furnishing fabric, designed by William Morris, made by Morris & Co., 1883, © Victoria and Albert Museum, London 
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Public engagement for technological innovations: new evidence

 

 

With the promise to improve lives, and the offer of abundant opportunities, technological innovation is regarded as a crucial enabler for the advancement of societies and economies at large.

Technologies and their applications, however, also present an array of social, economic and regulatory challenges. How to harness the benefits of technological innovation while addressing the risks associated with these developments is the subject of much discussion by governments, regulators, industry, academia and the general public.

A key aspect associated with these discussions and debates is public engagement, which is increasingly being recognised by stakeholders as a critical instrument to encourage transparency and openness, increase representativeness, and build trust in decision making and the technologies themselves. Public engagement is a broad term that is used in a variety of sectors (e.g. in research, healthcare and policymaking). In the context of technological innovation, public engagement is used to describe the involvement of a diverse group of people (the general public, but also other key groups such as lobbyists, civil society organisations and social influencers) in discussions and debates about potential applications of new and emerging technologies, their governance, regulation and the wider issues that could arise from the way that they are developed and adopted.

Better Regulation Executive (BRE), a unit from the Department for Business, Energy and Industrial Strategy in Uk commisioned a report to find recent evidence, in the form of a literature review and case studies, on the use of public engagement for technological innovation.

BRE Report (2021) PDF and data

The report describes the evidence including:

• Existing examples of public engagement techniques and ten case studies to illustrate how public engagement has been applied around technological innovation
• The impact of the public engagement techniques on, for example, the design of regulatory frameworks, business models, technology adoption and public trust
• Formal evaluation of the effectiveness of the public engagement techniques around technological innovation

The report offer some cross-cutting lessons:

• The use of multiple techniques over the course of the public engagement process can help to engage different ‘publics’ appropriately.
• Spreading public engagement over time allows for reflection and embedding of concepts.
• Having an impact on trust in technologies and technological innovation requires time and considered debate to increase accountability and more systematic public engagement.
• A multi-stakeholder, collaborative approach to public engagement helps to develop informed and considered judgements.
• Using online and digital-enabled public engagement techniques can potentially increase the speed, scale, inclusivity,and geographical coverage of engagement.
• Using some atypical techniques can potentially render public engagement more tangible and user-friendly and could also increase the diversity of participation.
• Having an impact on outcomes such as regulation, policy and market adoption of technological innovation typically requires buy-in and engagement with the right stakeholders.
• It is important to build evaluation into public engagement processes to track impacts and outcomes over time.

photo:NASA (Jan 29, 2021, the day after its full Moon phase. International Space Station orbited 264 miles above China near the Mongolian border.

How to build effective teams in primary care

 

Teamworking is fundamental to the future of general practice. Practices are coming together at scale in primary care networks and new roles are being introduced, creating multidisciplinary and multi-agency teams. Making these teams function effectively is a complex task. King’s Fund published a guide with insights from research, policy analysis and leadership practice.

What are the fundamentals of effective teams?

• A small number of meaningful objectives
• Clear roles and responsibilities among team members
• Reflect on how the team is working together
• Introduce new roles into the teams
• Create a multidisciplinary team
• Ensure good communication within your teams.
• Effective information-sharing systems
• Re-design the physical space into shaered working spaces
• Clinical supervision
• Gather feedback from colleagues and patients
• Access to learning and development
• Give space for team members to talk about their experiences

Access Publication: Effective teams in General Practice (january 2020)

Merry christmas and happy new year 2021. Stay safe.

photo: Children’s Christmas play, 1958. (Nina Leen / The LIFE Picture Collection) ______________________________________________________________________

healthcare organisations struggling to improve quality

Identifying characteristics associated with struggling healthcare organisations may help inform improvement.

The article published in BMJ Quality and Safety in july 2018 is a systematic reveiw of qualitative studies that evaluated organisational characteristics of healthcare organisations that were struggling as defined "by below-average performance in patient outcomes (eg, mortality) or quality of care metrics (eg, Patient Safety Indicators)".

33 articles from multiple countries and settings (eg, acute care, outpatient) with a diverse range of interviewees (eg, nurses, leadership, staff) were included in the final analysis.

Five domains characterised struggling healthcare organisations: 

1. Poor organisational culture (limited ownership, not collaborative, hierarchical, with disconnected leadership), 
2. Inadequate infrastructure (limited quality improvement, staffing, information technology or resources), 
3. Lack of a cohesive mission (mission conflicts with other missions, is externally motivated, poorly defined or promotes mediocrity), 
4. System shocks (ie, events such as leadership turnover, new electronic health record system or organisational scandals that detract from daily operations), 
5. Dysfunctional external relations with other hospitals, stakeholders, or governing bodies.

Many characteristics shared by struggling organisations were counter to characteristics associated with high-performing organisations. For example, while disconnected leaders and non-collaborative environments were frequently found in struggling organisations, engaged leadership and a collaborative organisational culture are associated with high performance. Furthermore, a ‘flat’ or team-based approach to problems is often associated with high performance, whereas they found hierarchical culture in struggling organisations.

System shocks’ was a domain unique to struggling organisations. Although not all change necessarily causes disruption, being unprepared or unrealistic about the effort required can demotivate and anger staff. To prevent disastrous consequences, shocks must be anticipated and addressed. When shocks cannot be anticipated, leaders may directly address shocks to reduce negative consequences and potentially create positive change.

The study has important implications. The findings suggest that health systems preparing for large-scale organisational change should adequately prepare in order to prevent system shocks, which, counterintuitively, may impede change. Also the study underscores the importance of context, organisational climate and related factors in determining hospital performance. 

Open access article: Characteristics of healthcare organisations struggling to improve quality: results from a systematic review of qualitative studies (2019)

photographer: Leopoldo Pomés (1931-2019). Foto Colectània 
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what works in wellbeing

What Works Centre for Wellbeing is an independent organisation from UK that produce robust, relevant and accessible evidence on wellbeing.

• They define the wellbeing concept as a way to understand what’s needed and how best we can all work together to improve our lives in a complex world. It brings together economic, social, environmental, democratic and personal outcomes and avoids focusing on specific areas at the expense of others. We can be better at measuring what matters and using what we know to create a better society. It is about engaging citizens in meaningful deliberation about what better society could look like. 

The What Works Centre for Wellbeing is part of the What Works Centre network. A What Works Centre is a bridge between knowledge and action for decision-makers.

I would like to focus on the report: Good work, wellbeing and changes in performance outcomes. This report published in december 2017 illustrates the effect of good people management with an analysis of National Health Service Trusts in England. The evidence says that the extensive use of good people‐management practices can have benefits for organisational performance and employee wellbeing.

Good people‐management practices are those which, for example:

• provide opportunities for workers to influence their work directly and allow staff to have input into decisions about their wider working environment;
• have clear roles and responsibilities for staff;
• encourage staff to communicate respectfully with each other, to collaborate, to be supportive of each other and to work effectively in their teams.
• enhance workers’ skills and support workers with access to learning and development opportunities;
• improve their motivation to perform well, provide feedback on their work through fair, accurate, supportive and effective performance management processes;
• encourage managers to support their people, through, for example, encouraging staff, giving advice and providing help with work problems.

Key findings
They found that NHS Trusts that made the most extensive use of good people‐management practices were:

• Over twice as likely to have staff with the highest levels of job satisfaction compared to NHS Trusts that made least use of these practices.
• Over three times more likely to have staff with the highest levels of engagement.
• Over four times more likely to have the most satisfied patients.
• Over three times more likely to have the lowest levels of sickness absence.
• No link was found between people management practices and patient mortality.  

Things to consider in order to introduce good people management practices

1. Review where you are at now. Is there a problem with wellbeing, absence, staff turnover or engagement? Are jobs as secure and remuneration and other benefits as good as other similar
2. Get senior management sponsorship and support for changes to people management practices. Make sure senior management buy into the idea of improvements for the sake of sustainable performance and staff wellbeing and are prepared to make the necessary commitments to make improvements in jobs. Senior managers may publically sign pledges, but also involve senior managers in project management and make regular reports to the senior management team.
3. Get support and commitment from line managers, HR and relevant management teams. Management commitment to the changes is important at all levels. Involve senior managers in getting commitment from other management groups. It might be useful to hold workshops with managers to discuss why changes are necessary, how the changes might affect them and how they will benefit. Review performance management and other people management practices to ensure managers are also supported appropriately.
4. Open a dialogue with workers about their jobs to find out what they see as important in the way they do their jobs, how they feel they are managed and how they are supported. Show workers that the changes are intended to have business and personal benefits, and that one of core values underpinning the changes is improved wellbeing. Be specific in identifying what can be changed and how to make jobs more interesting and satisfying, and look for changes that will improve wellbeing and performance. Also, gather information on who is best placed to make the changes. For example, workers themselves are often best placed to know what needs to change but they may not know how to make the changes themselves without appropriate support and training. Workshops and focus groups can be helpful to gather information, and larger organisations may find staff surveys useful.
5. Identify what needs to change and who is best placed to make the changes. Use the information from the dialogue with workers to identify what can be improved. This is also the stage to make cost‐effectiveness or return‐on‐investment projections to help choose between different courses of action. Improvements need to be feasible and acceptable to the different parties, so it is worth checking and refining plans at this stage. Check that workers have the right skills for any new roles or responsibilities and that their performance requirements are compatible with the changes. Introduce additional training and development and change other people management practices to ensure compatibility. At this stage, also decide on who is best placed to make each of the changes. This might entail a combination of groups, with staff and line managers making changes to how work is done and HR managers making changes to training, development and performance measurement/appraisal practices. Be mindful that you may need to make changes to other practices. Be sure that the changes will not work against other businesses processes and practices. For example, this could be the case if an organisation allows people the chance to use more intellectual skills and to take decisions that affect their work, yet management information systems restrict access to relevant information.
6. Once you have identified what needs to be done, the changes need to be made. To do so, empower and support those best placed to make the changes. Make sure there is a level of accountability for making the changes. This means that there should be regular, timely and appropriate feedback on how the changes are progressing given to all concerned including senior managers.
7. Therefore, at the same time, monitor, evaluate, review and revise the changes if necessary – are they delivering wellbeing and other business benefits? Are the changes sticking? What could be done to improve implementation? Through reviewing, revising and monitoring, it is possible to build a continuous improvement cycle so that initial improvements to jobs, performance and wellbeing can lead to cumulative improvements in jobs, performance and wellbeing over time as workers and managers gain more knowledge, capabilities and confidence in making incremental improvements in their work areas. In some organisations it may be possible to introduce changes in one area to see if changes are working, and then take lessons learnt to introduce changes in another area a few months after the initial changes have had chance to bed down.

photo: Jaume Plensa the Heart of Trees, Installation view at Yorkshire Sculpture Park, Wakefield, UK 2011 
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breaking the hospital model

The hospitals have to move from the concept of “repair shop” function to a "hub" in their community: providing social services, improving education and becoming aware of their significant economic role in communities. Hospitals have the potential to affect the economic model and the social determinants of health by leveraging their hiring, purchasing, investing, and other operational assets more intentionally.

• HUB means an organization or institution that is a focal point in a community and helps blend together a range of stakeholders and services that improve the health and economic mobility of residents. It does not necessarily lead activities or function as the sole focal point—often it is a partner with other institutions. But through partnerships and its own services it enables organizations and people with particular skills, assets, and connections to work more effectively together to improve the neighborhood.

Some recomendations to promote a Hub:

Data
Improve the collection, use, and sharing of data among sectors to facilitate partnerships. Hospitals as data warehouses centers for the community, assuring interoperability and data governance including detailed demographic data, and other information to build a picture of the community.

Partnerships
Make greater use of intermediaries. Hospitals, are often seen by many community organizations as remote yet powerful institutions, and a lack of trust arising from little or no history of partnerships. Hospitals has to build trust inside their community. Intermediaries are organizations or individuals that provide specialized skills or “connecting” functions that facilitate partnerships,

Leadership
Widen the skill sets of hospital leaders and key staff. Train the leaders and the staff. The full potential of hospitals as hubs requires leaders in these institutions to have a broad vision and set of skills, to manage the delivery of less traditional services, and to work with partners and intermediaries.

Essay and error
Government has to increase the promotion of the pilot projects and programs in different communities and encourage the impact evaluation. Also, they should give more flexibility in the hospital's payment systems being less oriented to outputs and more to outcomes. Take steps to facilitate the braiding and blending of public and private resources from multiple sectors and sources.

Access to the article: Hospitals and Schools as a Hubs (2016)
Authors: Stuart Butler and Carmen Diaz

photo: Third and Colectivo Rua
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health technology/expenditure relationship

The effect of insurance expansion on the diffusion of new technologies is not a well-understood phenomenon.

Burton A. Weisbrod published in 1991 in the Journal of Economic Literature: The Health Care Quadrilemma: An Essay on Technological Change, Insurance, Quality of Care, and Cost Containment. The Weisbrod proposition in his article is that the expansion in health care insurance produces a cost increasing in new technologies and how new technologies induces demand for insurance. There is an inexorable link between the broadening and deepening of health insurance coverage and the development of new health-care technologies.

Joan Costa-Font and Alistair McGuire  and Victoria Serra-Sastre published in 2012 The “Weisbrod Quadrilemma” Revisited: Insurance Incentives on New Health Technologies

In their study, they attempted to produce empirical tests of Weisbrod thesis and find supportive evidence. The paper presents evidence of a link between insurance and technology diffusion using OECD panel data and taking advantage of a dynamic specification structure. The empirical estimates indicate that higher degrees of private expenditure on health care correlate with higher levels of R&D in health care, consistent with the hypothesis forwarded by Weisbrod that increasing insurance coverage boosts technology adoption. However, their findings also suggest that increasing public funding of health care appears to lower technological adoption, which is consistent with the exercising of monopsony power and an objective of cost containment.

photo: (*) Photosolde
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Time loop in Day Surgery (groundhod day)

In 1998 I presented my PH.d in Health Economics. Some of the articles presented were about Day Care Surgery Free access thesis.

I said in the introduction: "The concept of day surgery is new in the Spanish health care system, but this innovatory practice has incentives to be further developed in the context of the reform of the NHS. It is often said that it reduces expenditure on health care or increases surgical activity within a given budget, whilst at the same time maintains or improves the quality of care offered to patients (The Royal College of Surgeons, 1992; The Audit Commission, 1992; Beech and Morgan, 1992). Day case surgery appears to be an ideal altemative to inpatient care, from the point of view of the purchasers (those who pay for medical care, the NHS) as well as for those who provide it (hospitals and health professionals), and fínally the patients."

15 years later data in Catalonia (2013) shows that the number of surgical procedures being performed as day surgery is 47,8% (substitution index) 2013 Results Centre Reports*. In Denmark 70-75%.

An European Report (2013) Day Surgery policy brief (2013) says:
" Day Surgery constitutes a missed opportunity for the improvement of surgical services, especially within the public sector component of many health systems, typifying the huge know-do gap between clinical and organizational evidence and service provision. In the future, European health systems will increasingly face an ethical and political dilemma regarding approaches that assure sustainable and equitable access to effective and safe procedures. Day Surgery adoption is part of the answer to such complexity.

The question "Is this patient suitable for day surgery’ should be replaced by ‘Is there any justification for admitting this case as an inpatient?"

* Next month the 2014 data will be available 

2014 Results Centre Reporta:
Substitution index 2013: 57,5%  Why this difference? (47,8% published in 2013)
Substitution index 2014: 58,4%
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Data: the most valuable commodity

Data is becoming a "commodity". The important point today is HOW we USE the data NOT the data itself. The data itself is like a barrel of oil: It's basically the same product regardless of the producer.

If we believe in this idea we could understand also that the current definition of "personal data" is evolving. The report published by World Economic Forum in collaboration with The Boston Consulting Group in 2013 Unlocking the value of personal data: from collection to usage (2013) explains how the world and the use of personal data are changing:

"What is considered personal data is increasingly contextual; it changes with personal preferences, new applications, context of uses, and changes in cultural and social norms. Traditionally, organizations have used a variety of techniques to de-identify data and create value for society while protecting an individual’s privacy. Such data was not subject to the same rules as the Personal Identificable Information (PII) as an individual could not be identified from it.

Today technological advances and the ability to associate data across multiple sources is shifting boundaries of what is or is not PII, including potential re-identification of previously anonymized data.

This issue is the subject of significant debate with some arguing that this means that all data is effectively personally identifiable and should be treated as such. Others urge caution, arguing that this would curtail many of the beneficialuses of anonymous data with minimal gains in privacy. A shift in approach to thinking less about the data and more about the usage could offer a way forward.

If the usage impacts an individual directly it would require different levels of governance than data which is used in an aggregated and anonymized manner.

• Related post: data is now touching everyone lifes

photo: (*) Photosolde
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International Day Surgery activity: how many doctors are interested in looking that?

OECD Health Statistics 2014 (the new name of the online database OECD Health Data) offers the most comprehensive source of comparable statistics on health and health systems across OECD countries. It is an essential tool to carry out comparative analyses and draw lessons from international comparisons of diverse health systems.

One interesting area to compare is the surgical procedures, specially the variations between countries using day surgery. OECD compares data from 1990 until now of a short list of surgical procedures like cataract, tonsillectomy, repair of inguinal hernia or cholescystectomy... showing the total number of procedures performed as inpatient cases, day cases or in certain instances, as outpatient cases. Also as a percentage and per 100.000 population

Some questions a doctor observing data should ask himself:

• Why our country is different from countries like us?
• Why are we doing less/more day surgery than others?
• Are these variations reflecting innapropiate use of inpatien rates?
• Are we under-use some recommended practice?
• Are the incentives payment affect our surgical decisions?
• Is the property of hospital affecting? public vs private hospital
• Is an organizational matter? how the hospital is organized
• Is a problem of my department?

Related Publications: OECD 2012. How many surgical procedures performed as inpatient and day cases

Definition: Day surgery.

• Day-care discharge: Is the release of a patient who was formally admitted in a hospital for receiving planned medical and paramedical services, and who was discharged on the same day.
• Outpatient: Procedures on patients who are not formally admitted in hospital or in any other health care facility: 1) Procedures performed in outpatient departments in hospitals;: 2) Procedures performed in emergency departments; 3) Procedures performed outside hospitals (ambulatory sector).

Photo: W. Eugene Smith—Time & Life Pictures/Getty Images
Dr. Ernest Ceriani makes a house call on foot, Kremmling, Colo., 1948. __________________________________________________________________________

how to avoid innovation policy evaluation simply end up on shelves unread or ignored

New World Bank-OECD 214 publication.Making Innovation Policy Work: Learning from Experimentation

This book explores emerging topics in innovation policy for more inclusive and sustainable growth, building on concrete examples. It develops the notion of experimental innovation policy – which integrates monitoring and feedback at the policy design stage, and occurs continuously to improve impact and implementation. This approach should help improve the quality and efficiency of public expenditures supporting innovation policy.

Special mention to the chapter 8 (by Eric Oldsman): Making evaluations count: Toward more informed policy: Read online

The chapter explores the role and the difference of monitoring and evaluation and its influence on policy design.

Recognising the importance of innovation, governments around the world have launched policies aimed at accelerating the development and application of technology. In many instances, the allocation of resources has been accompanied by calls for meaningful measurement of results and greater accountability. This is particularly true in an era of tight budgets and fiscal austerity.

Organisations are therefore placing greater emphasis on trying to measure their performance. Reciting the mantra – “what gets measured gets done” – more and more organisations are picking particular aspects of performance to measure and then devote significant resources to collecting data and reporting results. However, there is evidence that much of this effort may be wasted. To be useful, the right things need to be measured in the right way.

As importantly, data need to be turned into information, information into insights, and insights into action. This implies that performance measurement should be embedded in a broader evaluation system, which fosters critical thinking and continuous improvement as part of a policy cycle.

Organisations need to make sure to count what is important and count it correctly. However, while necessary, organisations need to go well beyond simply measuring performance. They need to focus attention on determining the factors that underlie performance, diagnosing the root cause of any identified deficiencies, in order to take appropriate corrective action. They also need to consider a broad range of issues that do not lend themselves easily to measurement. More generally, critical thinking – an ability to state questions clearly, marshal valid and reliable information, weigh evidence, assess the strength of arguments, recognise implicit assumptions and values, and draw reasoned conclusions – needs to be encouraged throughout the organisation.

Formative evalutions are critically important. They provide an opportunity for organisations to examine accepted truths, questioning the justification for specific claims and calling attention to unstated assumptions.

Clearly, organisations need to establish the technical capacity to undertake evaluations successfully. As importantly, to realise the full promise of using evaluations to inform policy, senior managers must actively support the process and cultivate a culture of learning.

photo: NASA
After launching on March 3, 1969, the crew of Apollo 9 spent 10 days in low Earth orbit. On the fifth day of mission, Jim McDivitt and Russell Schweickart separated the Lunar Module from the command ship and flew it for the first time — 145 miles over the Atlantic Ocean. 
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What if countries competed with each other to become the most socially innovative in the world?

 

The Social Progress Imperative, is a nonprofit in the United States created in 2012. They are the autors of the Social Progress Index launched in April 2013.

The Social Progress Index offers a measure of the multiple dimensions of social progress, benchmarking success, and catalyzing greater human wellbeing.

The methodology for the Social Progress Index was developed and refined under the leadership of Social Progress’s Advisory Board Chair, Professor Michael Porter of Harvard Business School, with guidance from Advisory Board members Matthew Bishop, Judith Rodin of the Rockefeller Foundation, Hernando de Soto of the Institute for Liberty and Democracy, and Scott Stern of the Massachusetts Institute of Technology. The conceptual underpinnings draw heavily on the work done by Joseph Stiglitz, Amartya Sen and Jean-Paul Fitoussi for France’s Commission on the Measurement of Economic Performance and Social Progress.

The Three dimensions of the social progress index

• Basic human needs: Does a country provide for its people’s most essential needs?
• Foundations of wellbeing: Are the building blocks in place for individuals and communities to enhance and sustain wellbeing?
• Opportunity: Iss there opportunity for all individuals to reach their full potential?

Some Findings

• Social progress is distinct from economic development, though correlated with it.Some countries with low GDP per capita are able to achieve surprising levels of social progress, while some relatively prosperous nations register levels of social progress lower than less wealthy countries. Explicitly distinguishing social progress from economic development allows us to gain deeper insight into each one.
• Some aspects of social progress are more closely related to the level of economic development than others.
• There is no single measure that captures all aspects of social progress.Each dimension is distinct from the others, and each component within each dimension is also distinct.
• Countries have relative strengths and weaknesses in social progress, both across dimensions and across components within dimensions. These strengths and weaknesses set the social progress agenda for each country.

Watch the video: Video
Social Progress Index 2014: Acces to 2014 data
Where are we?: SPAIN
photo: (*) Photosolde 
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data is now touching everyone lifes

Individuals are tracking a variety of health-related data via a growing number of wearable devices and smartphone apps.

More and more data relevant to health are also being captured passively as people communicate with one another on social networks, shop, work, or do any number of activities that leave “digital footprints.

Almost all of these forms of “personal health data” (PHD) are outside of the mainstream of traditional health care, public health or health research. Medical, behavioral, social and public health research still largely rely on traditional sources of health data such as those collected in clinical trials, sifting through electronic medical records, or conduct ing periodic surveys.

Self-tracking data can provide better measures of everyday behavior and lifestyle and can fill in gaps in more traditional clinical data collection,giving us a more complete picture of health.

With support from the Robert Wood Johnson Foundation, the Health Data Exploration (HDE) project conducted a study to better understand the barriers to using personal health data in research from the individuals who track the data about their own personal health, the companies that market self-tracking devices, apps or services and aggregate and manage that data, and the researchers who might use the data as part of their research.

Acces Report (pdf): PERSONAL HEALTH DATA
Website Project: HEALTH DATA EXPLORATION PROJECT

photo: (*) Photosolde 
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Think tanks ranking

 

A think tank (or policy institute, research institute, etc.) is an organization that performs research and advocacy concerning topics such as social policy, political strategy, economics, defense, science and technology, and culture. Most policy institutes are non-profit organizations. Other think tanks are funded by governments, advocacy groups, or businesses, or derive revenue from consulting or research work related to their projects

The University of Pennsylvania has published its 7th annual 2013 The Global Go To Think Tank Index (GGTTI). A ranking of more thant 6,500 thinks tanks all over the world. The Index has become the gold standard for think tanks and is widely cited by governments, donors, journals and policymakers as the foremost profile and performance of think tanks in every region of the world.

2013 GGTTI REPORT

Top Think Tank worldwide: Brookings Institution (United States)
Top Heath Policy: Cambridge Centre for Health Services Research (United Kingdom)
Top Science and Technology: Max Planck Institute (German)

In Spain:
Top think tanks worldwide:
#60 FAES
#64 CIDOB
Science and Technology: #28. Fundación de la Innovación Bankinter

photo: Robert W. Kelley—Time & Life Pictures/Getty Images
Ken Isaacs (front) and a colleague work on the outside of Isaccs' "knowledge box," Chicago, 1962
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Biocat 2013 report: Catalan life science statuts and analysis

The 2013 Biocat Report shows that the life sciences sector in Catalonia has reached a turning point.

We are facing two key challenges: generating and capturing value, on one hand, and promoting growth, on the other.  And this is at a difficult moment, marked by a profound economic crisis and changes in the research and production models that are affecting the sector.

The analysis in the chapters of the report identifies challenges for all of the stakeholders in the BioRegion, both public and private. The data shows:

• We must maintain support for innovation and entrepreneurship in the public arena —seeking out maximum efficiency in management of the knowledge generated and its transfer.
• We must also encourage companies —large and small— to participate in international research programs and public-private partnerships in order to bring innovation to the market and, in short, to the people.
• We must promote growth, establishing measures that facilitate market access and internationalization, but also guidance programs to support project maturation.

Europe will be key over the coming two years —launch of the Horizon 2020 program, defining RIS3 strategies, calls for the European Institute of Innovation and Technology’s KIC— but success will depend in large part on the players in the ecosystem aligning under a common vision.

Català Document complet (PDF)
English Executive Summary (PDF)  The full English version will be available shortly
Castellano Resumen Ejecutivo (PDF)








photo: © Dani: Creative Commons ShareAlike licence
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