Talk at the plenary session of Digital Public Health in Marseille Nov 2020

1. © 2019 CGI Inc. 1
Public Health – Do we need
an ecosystem approach?
“Digital Technologies in the Humanitarian
Context” (Plenary*)
Marseille, 21st Nov 2019
Francis D’Silva,
CGI Norway
* https://www.acm-digitalhealth.org/daily-agenda/plenary2/

2. © 2019 CGI Inc. 2
Topics
Context Smart CareEcosystem

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WHO’s “People-Centred Integrated Care” framework
advocates an ecosystem approach
“Integrated people-centred
health services is an important
new way to empower patients,
fight health system
fragmentation and foster greater
coordination and collaboration
with organizations and providers
across care settings, to deliver
health services that are
aligned with the needs of
people.”
Source: https://www.who.int/servicedeliverysafety/areas/people-centred-care/ipchs-what/enWHO’s People-Centred Integrated Care Framework

4. © 2019 CGI Inc. 4
What is a health technology?
Source: https://www.who.int/health-technology-assessment/about/healthtechnology/en/
“A health technology is the
application of organized
knowledge and skills in the
form of devices, medicines,
vaccines, procedures and
systems developed to solve a
health problem and improve
quality of lives”

5. © 2019 CGI Inc. 5
An ecosystem enhances and drives complementarity
“In an enterprise ecosystem, actors
collaborate using non-generic
complementary offerings that
depend on each other's activities;
the actors are not hierarchically
controlled and ensure multilateral
dependencies through commons
and shared protocols of
engagement that reduce or
eliminate the need for bilateral
contracts.”
A definition based on the author’s project
experiences and own research
“Towards a theory of ecosystems” https://onlinelibrary.wiley.com/doi/full/10.1002/smj.2904
Strategic Management Journal, Volume: 39, Issue: 8, Pages: 2255-2276, First published: 02 May 2018, DOI: (10.1002/smj.2904)

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Society in a nutshell
Households
MarketGovernance
• Commercial
• Not-for-profit
• Publicly owned
Services – Goods – CommoditiesLegislation – Regulation – Infrastructure
• Local
• Regional
• Federal
• (Business Associations)
Digital
Commons
See also: Sovereign Digital Platforms (ECIS 2018)
FundingResearchEducation
• Individuals
• Families
• Neighbourhoods

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Consumer Services
Public Health brings together a wide array of actors
Policy and Quality
Research and Education Manufacturing
Self-enablement
Bridge-making and Innovation
Care Management and Delivery
Informal
caregivers
People (Care Beneficiaries)
Healthcare Professionals
Digital Developers (Content Managers | Instruction Designers)
HealthTechnology(ServicesandProducts)
DisseminationandQualityManagement
• Fjeldstad, Ø. D., Snow, C. C., Miles, R. E., & Lettl, C. (2012). “The architecture of collaboration” Strategic Management Journal, 33(6), 734-750.
• Gulati, R., Puranam, P., & Tushman, M. (2012). “Meta‐organization design: Rethinking design in interorganizational and community contexts” Strategic Management Journal, 33(6), 571-586

8. © 2019 CGI Inc. 8
Consumer Services
Public Health brings together a wide array of actors
Policy and Quality
Research and Education Manufacturing
Self-enablement
Bridge-making and Innovation
Care Management and Delivery
Informal
caregivers
People (Care Beneficiaries)
Healthcare Professionals
Digital Developers (Content Managers | Instruction Designers)
HealthTechnology(ServicesandProducts)
DisseminationandQualityManagement
• Fjeldstad, Ø. D., Snow, C. C., Miles, R. E., & Lettl, C. (2012). “The architecture of collaboration” Strategic Management Journal, 33(6), 734-750.
• Gulati, R., Puranam, P., & Tushman, M. (2012). “Meta‐organization design: Rethinking design in interorganizational and community contexts” Strategic Management Journal, 33(6), 571-586

9. © 2019 CGI Inc. 9
Ecosystems can be created using technological assets that enable
service-aggregation and data-sharing. Standards are a prerequisite.
Knowledge
sharing drives
learning,
innovation and
research
“Care Interconnect”
Healthcare MobilitySocial Care and
Wellness
Nutrition and
Pharmacy
Home & Energy
Integrated Care
Inter-regional trade and policy cooperation secures cross-border care delivery (national and transnational), enabled by standards
…
Healthcare Services
Consumer Services
Technology Assets
Regulatory Agencies
Knowledge Institutions
“Smart Care” – A conceptual architecture for People-centred Integrated Care

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A people-centric healthcare system needs a needs-based
approach and a supporting socio-technological infrastructure
Service Providers
Platform Operators
Active
Citizenship
“Integrated people-
centred health services
means putting the
comprehensive needs
of people and
communities, not only
diseases, at the centre
of health systems, and
empowering people to
have a more active role
in their own health.”
- World Health Organization
https://www.who.int/servicedeliverysafety/
areas/people-centred-care/en/
Patients, informal care-
givers and care
professionals are
encouraged to collaborate
to obtain the best
outcomes
Secure and safe digital
tools for all - patients,
formal and informal
caregivers are built on a
knowledge-based public
health infrastructure that
supports complementarity
“Smart Care” – A conceptual architecture for People-centred Integrated Care

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Thank you!
Francis D’Silva
Director, Consulting
CGI - Health & Life Sciences
francis.dsilva@cgi.com
+47 908 26 049
@francisds