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The Health Rosetta Principles
Healthcare is going through radical change. It’s been called a “Gutenberg moment” or “Copernican Moment”. Our frame of reference is moving individuals moving toward the center of control, and the change is welcome. Healthcare in its present state is a design failure in light of the money, smarts and compassion that we invest; it rewards the wrong activities. We pay for illness and treatment, and we get more illness and treatment. The Health Rosetta defines a blueprint for wise healthcare purchasing that is allowing health services to be purchased for 20-55% less than the status quo while improving benefits.
New incentives and payment structures for providers, along with better access to information with new consumer technologies, are enabling the shift. Various pay-for-value incentives are driving us to look for ways to optimize health and prevent illness. These incentives will be enabled by the democratization of healthcare, where it benefits all to have access to the same information, much as the printing press enables a common understanding of the world, and a scientific revolution. Now, ubiquitous internet connectivity is creating pervasive intelligence, and with the opportunity to see systems as a whole. This new socio-technical environment will drive a new kind of health science with new opportunities for health innovation that brings together the formerly disparate notions of healthcare, genomics, economics, sociology, and nutrition and more. The health world is flattening while it is becoming more unified.
We outline a set of guiding principles to break the cycle and deliver a reinvented health system. The purpose of this is to invite the best thinkers in healthcare’s enlightenment to share their thoughts on what the guiding principles of a redefined health landscape will be, outlining a set of guiding principles to prepare for a health landscape with individuals at the center.
What led to the creation of the Health Rosetta Principles is that we are frequently asked by organizations developing new technologies, health plans, healthcare delivery models, health benefits packages, service offerings and more for a set of guiding principles for how to proceed. This led us to curate this list of principles from the ideas we have heard from the leading thinkers in health and wellness. Many of them are doctors though they cut across the spectrum from all types of clinicians to individual citizens.
A key component of the emerging, more democratic, landscape is a commitment to openness, feedback and learning. To rapidly innovate, we need open source and open innovation to drive our a learning health system. Therefore, these principles are open source. Grab them, add to them, refine them and use them as you’d like. We invite others to take these principles and run with them however they choose. Similarly, we encourage readers to re-purpose this content in many more ways and in many more forms, just provide attribution and a link back since that’s the nice thing to do. We’ll be curious to see what you create.
Where we hope to go from here
We are in the process of turning the principles into a book. We’re super excited about getting some of the most interesting people in healthcare, science, public health and policy being willing to contribute. Individuals such as Esther Dyson, Susannah Fox, Bill Gates, Eric Topol and many others have embraced this project. Each principle will be expanded upon by the thought leader. We welcome any feedback on who the most compelling individual would be for each principle.
Even as we’ve narrowly shared the Principles, we’re gratified with the kind of response we are getting. One of the influential voices in the healthcare social media community, Colin Hung, made the following statement which hits the notes we were hoping to achieve with the principles.
When I read the Health Rosetta Principles, I got the same goosebumps that I did when I read the Cluetrain Manifesto in 2001. Cluetrain was an amazing collection of ideas and thoughts on what the future of business was going to look like given the business and Internet memes of the time. Cluetrain is as relevant today as it was 14 years ago when it was first published. To me, The Health Rosetta Principles is to healthcare what Cluetrain is to tech businesses.
Principles outlined here are in part corollary to some open source projects. One we’re calling the “Health Rosetta” and another “YouBase” as a part of unpatient.org. As the names would imply, the idea behind the Health Rosetta is to build an open, standards-based platform to decode what works and what doesn’t work in this new environment. It will be initially focused on health benefits design. Over time, the intent is to extend into improving the access and efficacy of new healthcare delivery models and define units of value beyond what underpins legacy payment systems (“Relative Value Units”). For example, a concept such as “Patient Value Units” could develop out of this that captures the elements identified in the Quadruple Aim. You can think of the Health Rosetta is the “what” whereas the Health Rosetta Principles are the “how” that will lead to success in the future.
In addition, a subset of the principles which relate to access to personal health information has become part of the Health Data Ownership Manifesto at unpatient.org. The goal of unpatient.org is to empower individuals with better access, ownership and control over personal health information through open source and new approaches to digital ownership, control and property.