THE VITALNESS FRAMEWORK
THE HEALTHCARE SYSTEM IS BROKEN. DO WE KEEP FIXING IT OR LOOK AT DRAMATICALLY DIFFERENT APPROACHES
At present, what we have is an illness care system, based in hospitals and clinics, that is too expensive, ill-suited for the dominant public health problem of managing chronic diseases, ineffective at prevention and behavior change, and largely inaccessible to many low-income and rural populations. Most importantly it is now emerging that Health and Wellbeing has very little to do with Health “Care”.
Health care and the healthcare industry are in the midst of a fundamental transformation. Communicable diseases are still a problem, with deadly virus outbreaks in a few places and rising antibiotic resistance in many places. More daunting is the tidal wave of malnourished children and adults contributing to the parallel explosion of non-communicable diseases — for which behavior change and chronic disease management are poorly executed by existing healthcare systems. The advent of new remote diagnostics and monitoring, genome-based precision medicine, and mobile technology and big data to extend access and enable more personalized care are increasingly cited as potential solutions. But the real impact has yet to be seen – particularly for the billions of disadvantaged people around the world.
Despite widespread mobile access, increased penetration of broadband networks and smart devices, and proliferation of inexpensive sensors across the globe, healthcare lags behind many other sectors in making innovative use of such IT tools. The health field is subject to change and overdue for a disruptive revolution. Cloud-based IT businesses increasingly displace established economic models; will such innovation for healthcare come from within the sector, or from the outside? How likely is an “Uber” or “iTunes” of healthcare?
Beyond specific therapies, a broader transition is underway from an almost exclusive focus on illness care toward a more holistic, person-centric emphasis on the wellbeing of people. This plan includes prevention and advanced disease management strategies – a transition to what we call vitalness. Cost and efficacy pressures are driving a transition from providing care primarily in facilities – doctors’ offices, clinics, hospitals – to population health strategies. This model provides non-acute and wellness care to people within their community – at home, school, or work – which is where prevention and effective behavior change actually occur.
The focus of vitalness is on enabling and empowering individuals to become changemakers in their own lives, by adopting healthy lifestyles and managing their own health with the help of frontline health coaches and smart digital devices, so that they learn better in school, are more productive at work, and prevent or manage chronic disease. Vitalness is an emerging trend, rooted in the transition from curative approaches, to prevention and further to holistic health in the future.
Introducing the Vitalness Framework
Our fundamental belief is that we have to start looking at health from a lens much broader than absence of physical illness. WHO in its definition of health says that health is a state of complete physical, mental and social well-being and not merely the absence of disease (WHO, 1958). However since this definition was proposed, worldwide we have moved away from this principle and it is important that we anchor our focus back to this concept.
We call this approach of looking at healthier living and not just absence of disease, Vitalness.
From our analysis of key players in the sector and the various approaches to Vitalness, we gleaned four key principles of Vitalness. The transition towards Vitalness involves these four principles as key for success. And most importantly, all four principles are interlinked to each other and an approach where one of the principles is neglected, could lead to limited impact of the initiative.
The four principles of the Vitalness focused approach that we observe are the following:
- Everyone Plays: Empowers actors who are not traditionally experts, most cases leveraging technology, eg putting Nurses at the centre of care, Empowering community members to care for each other, trained health worker to diagnose early (moves the world toward a everyone a changemaker world). Healthcare has traditionally been driven by experts like doctors and specialists in the field. The new game calls for everyone – nurses, technicians, support staff, patients themselves and their families to step up and play and equal role
- Expands the Playground: Takes a significant part of the care outside of the hospital domain eg, at home, at workplace, at schools and even at religious places (breaking down barriers). The more care is concentrated in the hospitals, it will continue to be driven by old rules and notion of illness focused care. When care goes out of the hospitals, into the communities, it helps to expand the boundaries of what can be included as part of care. More importantly it makes the individual more and more accountable for their own Vitalness and not be dependent on others.
- Invites new Players: Creates connections and collaborations between different and many times, new players in the health ecosystem, eg working with organisations in agriculture, education, energy and even entertainment sectors (collaborative entrepreneurship). The future of Vitalness depends on new players entering this industry and challenging deep rooted assumptions an bring new thinking. Any organization focused on Vitalness has to necessarily leverage this opportunity and create an open platform for new players to contribute or participate. Playing by the old rules with the same players will not change the game.
- Changes the rules of the game: Goes beyond illness care or preventive care of individual diseases, and focuses on overall wellbeing (shift in current paradigm and move towards Vitalness). Vitalness oriented organizations understand that at the core of ownership of one’s Vitalness is the mindset shift in individuals. And enabling this mindset shift is the fundamental focus of their organisation.
In this book, we attempt to highlight the innovations around the world and the people behind them who are already transitioning towards this new normal of Vitalness. This has important lessons for the medical community, healthcare industry, Insurance and our own communities.
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