1. Cultural and behavioural changes to support patient empowerment activities within the EIP Dr David Somekh: Network Director European Health Futures Forum (EHFF) Supporting the collaboration between the Reference Sites Collaborative Network and the Empathie Network for patient empowerment European Summit on Innovation for Active and Healthy Ageing: Brussels Mar.10 2015

2. The Reference Sites Collaborative Network represents over 30 examples of good practices linked to local communities. What the pilot collaboration with the Empathie network seeks to do is to derived added value from a small number of these sites working together on an emerging theme in current health policy – patient empowerment. We hope to demonstrate a good example in practice of the coming together of health technology and other health service delivery mechanisms in the interests of citizens and patients, via partnership relationships across Reference sites, with the support of a relevant network of specialist expertise.

3. A recent publication from the European Commission: ‘EMPATiE - Empowering patients in the management of chronic diseases (final report)’ provides a definition, literature review, discussion of issues of transferability of good practice and a proposal for options for future European Commission involvement in the topic area. http://ec.europa.eu/health/patient_safety/key_documents/index_en.htm On the basis of that material as background, what this presentation very briefly examines is the human factor issues that complicate implementation of scaling-up of innovation considered by the excellent paper on scaling-up for the EIP published in December.

5. We know that for any scaling-up process, the implementation process will be a lengthy one. The EIP, with the commitment that the Action Area participants and the Reference Sites have shown, has made a great start. But good will and commitment is not sufficient to achieve the overall aims of the EIP. Nor does shiny new technology provide a sufficient answer. Inevitably, there is a need for substantial change management expertise to be deployed by the various organisations. Here, we simply identify some of the human factors which represent real barriers to that change, which need tackling robustly. And the foremost of these, on our opinion, as illustrated in the previous cartoon, is PATERNALISM, a trait that exists throughout healthcare, overtly or more covert.

6. Health Professionals, like everyone else, feel threatened by change

7. Ironically, at a recent Conference on Mobile Health, Industry experts report that in their opinion, it is resistance from clinicians that is a major barrier to implementation of mHealth solutions

8. Communication skills, or the lack of them, remains a major need, thinking especially of health professionals education

9. But learning to communicate and to listen effectively represents a two-way street: citizens aren’t exempt! Indeed effective methods to increase the health literacy of the population represent a major challenge

10. and finally: a challenge for technology developers – There is a lot of glib talk about ‘patient empowerment’ in the Industry which could be interpreted as barely concealed paternalism – the customer is always right, but in truth, we know what the customer really needs – our product! Equally, ‘co-creation’ is vaunted, but rarely paid more than lip-service to. Not out of any dubious motivation, but through a mind-set that it is both risk- and change- averse, despite the hype of new technology and also being simply ignorant of how users of service could be involved at the earliest stages of product development, to provide a needs-led rather than technology-led outcome.

11. www.ehff.eu