Invited speech of Dr. Totti Könnölä, CEO inf Insight Foresight Institute in the scientific conference 'Bioengineering for Healthy Ageing. Adding Life to Years' November 9th 2017, CosmoCaixa Barcelona. Future personal health ecosystems encompass various areas of application such as chronic disease management, life-style management, independent living and emergency services. Such future systems assist in the provision of continuous, quality controlled and personalised health services to empowered individuals regardless of location and provide a horizontal development area across variety of patients, clinical specialties, technology fields and health services. Hence, the development of such ecosystems requires transformative governance that enable coordination and federation of diverse stakeholders.

1. Transformative Governance of
Personal Health Ecosystems
Dr. Totti Könnölä, CEO
Insight Foresight Institute
Bioengineering for Healthy
Ageing. Adding Life to Years,
B Debate, November 9th
2017 CosmoCaixa
Barcelona
Transforming Innovation Ecosyste

2. 2

4. Climate change &
Volatility of commodities
Digitalisation, Industry
4.0, AI, bio-nano-info-
cogno convergence
Inequility &
Exponentials
Social media & Sharing
economy
Conflicts & post-truth
politics
Volatility, Uncertainty,
Complexity & Ambiguity
(VUCA)
INNOVATION ECOSYSTEM
A RESPONSE TO ‘VUCA WORLD’

5. PERSONAL HEALTH SYSTEMS
FORESIGHT
5
www.phsforesight.eu

6. FUTURE PERSONAL HEALTH
ECOSYSTEMS
Devices,
ambient,
wearable
and/or in-body
Intelligent
processing,
data analytics
and expert
knowledge
Personalised
prevention,
diagnosis,
treatment and
rehabilitation.
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7. APPLICATION AREAS
7

8. MARKE
T Use/ younger age Patient / older age
Public
Public PHS services for
prevention
 Mostly users with risk factors
 In widespread diseases (public health)
 Requires health literacy on part of
patients
 Requires change in public health care
systems to more preventive care
 Long innovation cycles (adoption 5-10
years)
Public PHS services for therapeutic
use
 For the unhealthy, elderly, disabled, mentally
declined
 Most likely in widespread diseases, (public
health)
 Demand mediated by public actors, difficult
acceptance in the system
 Long-term development and adaptation of
technology
 Large firm involvement more likely because of
long innovation cycles and financial burden
involved
 Long innovation cycles (adoption 5-10 years)
Private
Life-style PHS products/services
 young, dynamic, stylish, cheap, web-
based applications;
 demand difficult to foresee, may be viral
in adoption and in dropout
 Very short innovation cycles
PHS products/services for home care
 Addressing the unhealthy, elderly, disabled,
mentally declined
 Users hard to reach through advertising
 Demand through informal carers, also depends
on acceptance by patients
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9. HIERARCHY OF PHS
SOLUTIONS
Hierarchy Definition
Technology Sensor
Technological
system
Sensor + Device + Network
Health application Solution (Sensor + Device + Implementation)
Health care service Service (Solution + Management + Business
model – Clinical)
Health care service
ecosystem
Ecosystem (Services + Platform +
Interoperability)
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10. TRANSFORMATIVE
GOVERNANCE
Agent
Platform
Platform
ecosystem
Economy
Platforms
Agents
• Policentricity
• Connectivity
• Diversity
• Redundancy
• Directionality
• Federation
• Coordination
• Value through scale and scope
• Activity
• Structure
• Governance
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11. International
National
Regional
Local
Creation and Diffusion of
Knowledge
Enhancing Relations and
Networking
Development of Capabilities
Multiple Layers of
Innovation Ecosystems
1. Issues:
• Societal challenges
• Coordination challenges
5. Outcomes
• Relate to objectives
across different layers
6. Impacts
• Relate to societal and
coordination challenges
across the layers
3. Inputs and implementation
• Use of human, financial, technical
etc. recourse across the layers
• Modular and scalable foresight
design
4. Outputs
• Relate to inputs and
implementation across
the layers (deliverables,
e.g. documents)
2. Foresight Objectives
2. Objectives
Horizontal Vertical
Temporal Intersystemic

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13. MULTI-LAYERED LANDSCAPE OF
PERSONAL HEALTH SYSTEMS
Layer Challenges
Transnational
innovation
systems
Fragmentation of PHS initiatives
Duplicity of efforts
Lack of standards and interoperability
Room for further coordination
National
innovation
systems
National health systems reluctant to new product service systems
Barriers to market access
Rigidities in reimbursement models
Lack of interoperability, fragmentation of health data
Dublicity of efforts
Promising private sector initiatives
Regional
innovation
systems
Promising pilots that often suffer from lack of sufficient scale
Difficulties in streamlining PHS efforts with the national health system
Innovation eco-
systems
Promising public sector pilots
Promising private sector initiatives
Difficulties in engaging all relevant stakeholders including e.g.

14. 2030 SCENARIOS, NOT
PREDICTIONSSCENARIO ALPHA: “THE DREAM SCENARIO”
The government has moved to a steering role, overseeing outcomes and
stimulating compliance through soft methods. Its direct intervention in and
financing of healthcare has been substantially reduced, except for acute
problems.
SCENARIO BETA: “TRANSITIONAL SCENARIO”
Social gaps with respect to health consumerism, access to, and
confidence in technologies have persisted (constraining take up and
mainstreaming of PHS and other eHealth innovations), the role of
government related healthcare institutions and basic financing
mechanisms have not changed but rising costs are de facto eroding the
full public coverage.
SCENARIO GAMMA: “SHARED RESPONSIBILITY FOR A HEALTHY
SOCIETY”
Although pervasive health consumerist attitudes and behaviours became
dominant, the outbreak of acute crisis management have led the 14

15. INDICATORS FOR PHS
SUCCESS SCENARIO
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visits to health centres/hospitals by people with chronic diseases
professionals educated into PHS
budget spent on chronic diseases saved by PHS use
hospital mortalities of elderly admitted for emergency care
patients with long term conditions monitored
electronic health records, in a common format across the EU
people suffering acute episodes whose EHRs can be accessed by emergency care
adults active in a patients’ groups
people with PHS for advice in everyday
PHS tools scientifically proven as reliably advantageous
spending in PHS funded by private consumption/enterprises
population with PHS systems that are integrated with EHR systems.

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18. TRANSFORMATIVE
GOVERNANCE CONCLUSIONS
Ecosystems - all players in, try foresight
To scale-up think platforms and accept
disruption
Federate and coordinate the ecosystem
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19. www.if-institute.org
info@if-institute.org
phsforesight.eu
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Dcha. 28001 Madrid, Spain
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