What true collaboration looks like when the goal is improving health

Nine organisations have joined Wellthcare to debate and plan how to make creating health the norm. Last week was the first meeting. For the time-being the group is being called the ‘Creating Health Incubation Group’. 
The organisations are:

• Columbia University’s Earth Institute
• FSG
• Guy’s and St Thomas’ Charity
• HICCup
• The Institute for a Sustainable Future
• The Institute of Medicine’s Collaborative on Global Chronic Disease
• The Mayo Clinic’s Center for Innovation
• The University of Strathclyde
• The University of Toronto’s Women’s College Hospital

The meeting was the key deliverable of the grant that we received in January 2014, and marks not only the end of this phase of our journey, but the start of the next. While I’m thankful for their time, I am more thankful for their willingness to go into unchartered territory, share their thinking, listen to what others are doing, and then suggest what they might want from future meetings if we’re to help make creating health the norm.

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I started putting this group together after spending most of March and April on the road talking to numerous stakeholders about how we can value health beyond the narrow definitions of the health care industry. As I’ve shared before, the industry tends to work from the bio-medical model in which it sees people solely as individuals rather than as members of communities, and tends to only intervene once people are sick (or have the potential to become sick as in the case of prevention).

The discussions I had on the road also helped me to hone my thinking. I think it’s fair to say the term ‘wellth’ has its admirers and its haters; the former like the word play, while the latter seem tired of yet more terminology in health, an arena that is already incomprehensible for most. I’ve started to say ‘creating health’, and, in a recent post for the Mayo Clinic, shared this very simple diagram of the role of the health care industry and community in caring for the sick, preventing disease, and creating health.

I could have invited 10-15 other organisations to join the Incubation Group, such was the interest in ‘creating health’ during my road trip. However, what defines those mentioned above is their desire to try new things. Of course, a conference call between ten organisations is only ever going to be more talking but the aim is to start meeting, exploring what it is that we can do, and then not only getting on with it but also helping others to too.

There was much overlap in the discussion, but also enough nuance to make clear that this was not a group that wanted to reduce the challenge of health in society to simple one-size-fits all approaches (thankfully). Health care financing was described as an oil tanker and part of what we needed to do was find the tugboats to help it change direction. There was talk of all of us being children of the bio-medical model, which is partly why we find it hard to see health outside the narrow definitions of health care. One participant wondered if the American Dream was getting in the way of understanding health, given its very individualistic core. Another asked if health was even the aim; surely what people want is to function within their contexts, health being only part of what’s needed? One participant talked about courageous local initiatives designed to reduce visits to Emergency Departments and conceded that it wasn’t clear if the outcome was of value or meaningful to patients. And, one participant suggested that health be seen as an emergent value in reform, not the aim itself.

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As I said: overlap and nuance.

In parallel to building the Incubation Group, I have (finally) created a page on our website listing the ‘Wellth Creators’ we have come across to date. To be honest, there are many more that I want to share but I hope the current list starts putting some meat onto the bones of what creating health might be.

The next phase of work is about getting practical. Fine, we all want to help make creating health the norm but how? What are the challenges? And of the challenges, which are the ones where we can have a material impact? How might that impact be structured to seamlessly help others in their work locally? There is a lot to discuss, a lot to unpack, and plans to be formulated. We’re formulating the agenda for the first meeting right now.

I’d like to take this moment to thank both my consultancy and Guy’s and St Thomas’ Charity for funding the work to this point. I hope that as we better understand how we can create something useful we can make the case for others to support the journey ahead. Certainly, we have no intention of being an exclusive group, we’re just the ones willing to debate and plan what it’ll take to make creating health the norm.

Acknowledgements: Thank you to the organisations listed above for letting me mention them in this article, even though we’re not yet sure what we’re going to do and how. Note that the Institute of Medicine are collaborators with the Group rather than members, and will not be developing or endorsing any conclusions or recommendations that the group may issue. The participants in the meeting were: