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Promoting an open and people-powered approach to health and care through DSI

24th January 2018

Zoe Romano from WeMake introduces DSI4EU's Health and Care cluster.

We all know that healthcare systems across Europe are under unprecedented pressure. Among the tools explored by policymakers, digital and “people-powered” approaches are gaining traction, even if they have not yet entered the mainstream.

We believe that digital social innovation, which brings together technology and people to deliver social impact, holds great potential for the future of health and care. In particular, we’re excited by the growing role of “maker” approaches which use tools like digital fabrication and open-source technologies to improve people’s lives.

But what is it that makers can actually “make” to support alternative ways of improving health and care, and to create and spread innovations that deliver positive social impact?

This is a question we’ve asked ourselves many times, and it’s becoming increasingly clear that the maker movement, and makerspaces, are places not just for physical making but also for prototyping new approaches to the future of health and care. Makerspaces are environments where “newbies” can contribute by bringing not only solutions but also new mindsets; moving on from the literal definition of makerspaces as “spaces equipped with digital fabrication tools to make almost anything”, we can see them more broadly as fertile environments in which people interact with each other, discuss ideas, and create solutions to tackle health and care challenges in ways that we could not imagine before.

We know this because, since 2016, WeMake has been contributing to a series of projects about health and care with a bottom-up approach within the  EU-funded project Opencare.

With healthcare spending having risen faster than economic growth in all OECD countries over the past twenty years, and with public expenditure set to increase to 14 per cent by 2060, there is an urgent need for individuals to better self-manage their care, and for data and information to be better collected and used. Alongside this, institutions, companies, non-profits and grassroots movements are imagining and beginning to experiment with new care systems, new visions of welfare with open approaches to technology and community engagement at their heart. These approaches recognise the value of relational goods and social commons, for both personal and social wellbeing.

The Opencare project is one of these approaches. Opencare.cc is a platform for discussions about the future of health and care, where, over two years, we have hosted almost 5,000 posts on 800 threads. These conversations have enabled online and offline interaction and prototyping, using tools like open data, open software/hardware and open design to enable active participation, collaborative decision-making and trust-building to deliver better health and care.

One of the prototype actions facilitated by Opencare was OpenRampette, which tackled the problem of low accessibility to shops for disabled people. A full year after the City of Milan passed new legislation to overcome architectural barriers to retail spaces in the city, only 2,000 out of 18,000 local shops were found to be compliant. Our approach was to apply the co-design process, which we are used to deploying in the fablab, at the city level to see if it could help scaling. Our makerspace in Milan hosted the process of commoning and became a prototyping and testing environment, fostering new relations and interactions between policy makers and citizens which we started to call Agile Policymaking. and operated as a translator of multiple needs coming from individuals, shop owners and the city council. Through this process, we could simplify the bureaucratic procedure to register as a compliant shop and together we could imagine and prototype a new way to think about accessibility in the city.

The results have been a large-scale experiment of a new relationship, addressing the development of a care system where different actors (experts and non-experts) are empowered to play relevant roles and get public recognition for their contribution.

Opencare is part of a growing movement of entrepreneurs, hobbyists and designers who are using maker approaches to improve health and care.

Some projects are using electronics and 3D printing, for example, to make prosthetics more accessible to a wider public. One of these, Open Bionics, for example, has made the creation of artificial limbs twenty times cheaper. Other initiatives such as Open Insulin and Nightscout are challenging the proprietary approach of incremental innovation to bring forward the possibilities of radical innovation.

Elsewhere, the growth of digital social innovation, as well as increasing concerns about the dominance of big tech platforms, data practices and concentration of power, are bringing to the fore the importance of decentralised economic and data models. Now, the topic of decentralisation is as relevant to health and care as any other field - a topic which needs to be discussed publicly, and which the maker movement also contributes to.

It is this vision which encouraged WeMake to join the DSI4EU consortium as lead for the Health and Care cluster. We aim to foster a vision of health and care which takes inspiration from the bottom-up approach of maker culture. On the one hand, we will work to support the definition of policies that can help a network of new projects to flourish; on the other hand, we will foster the creation of strategies and tools to support such growth.

We still have more lessons to learn, and much work remains to be done. Our cluster activities will focus on supporting the maker community to support designers, technologists, policymakers and citizens. We will help this community of practice to embed new meanings and perspectives into co-designed services and products, to advocate for open principles in software, hardware, data and design, to build solutions which fulfil community needs, and to develop the skills to turn these solutions into viable social businesses.

We’re looking forward to working with a consortium of partners focusing on different social challenges to support digital social innovation to grow and scale. If you’d like to find out more, please sign up to the DSI4EU newsletter or email [email protected]. And if you’d like find out more about upcoming DSI4EU activities in Milan, drop us an email. We look forward to hearing from you!

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