On clinical, philosophical, ethical and behavioural concepts for personalised insilico medicine supporting "co-production of health"

Abstract

Telemedical technology is constructed with the purpose ofcompensating distance in delivery of healthcare provisions within institutional frameworks utilizing supply-side-driven service models and ICT to "organise the delivery of healthcare". The aim of this paper is to outline "a framework of understanding" (clinical, philosophical, and ethical concepts) that uses technology to deliver personalised insilico medicine for use in daily demand-driven "Coproduction of Health" - and hence, take advantage of distance from healthcare resources and make health management of a chronic medical condition inclusive and pervasive in society; however, still founded in evidence-based medicine including use of computer-supported behavioural science models to "organise the consumption of health". Personalised insilico supported "Co-production of Health" encompasses the five levers of change compiled by the high level eHealth2020 task force of the EU - #1: My data, my decisions, #2: Liberate the data, #3: Connect up everything, #4: Revolutionise health, and #5: Include everyone. The framework uses the WHO definition of health and the concept of "health capital" and introduces the "Digital Health Continuum" from 100% citizen to 100% patient and the associated ranges of "professional healthcare delivery" and "co-produced health management"- thus fusing and augmenting current supply-side driven service models with an ICT-supported and demand-side driven service model. Insilico personalised medicine implemented through the Coproduction of Health service-model is to be seen as a paradigmatic example of mobilizing - for the individual - all available health resources within social hubs empowered by design of innovative and collaborative frameworks to align otherwise conflicting, silo-shaped, and scattered interests. © 2014 Springer International Publishing.