A Health Commons using a Peer-to-Peer (P2P) Approach

Considering the development of a MOOC (Massive Open Online Course) for people within health and social care, I have noticed that some of the ideas of a Commons, a Peer-to-Peer Approach and Connectivism are not well understood, so I thought it would be timely to see if I could make some sense of them in my blog.

First, before discussing Connectivism, I’d like to talk about a Health Commons and the technique to work towards it using a Peer-to-Peer (P2P) approach.

Michel Bauwens describes P2P

it’s a relational dynamic in which people exchange not with each other as individuals, but with a commons

Well. That sounds great, but what does he mean?

He is defining the idea of a Commons, that is, a shared resource that is held by a group of widely distributed people. For instance, we might regard the health of the nation as a health Commons, increasing health being the “product” of this work. By re-framing it in this way, we appreciate how the promotion of population level health initiatives could enrich us all because they result in a greater number of economically active citizens, a reduction in overall health spending, and most importantly, an increased level of health and happiness in the population.

One of the principles of the Commons is that we all have a stake in the outcome. Unlike when we rely on capitalist systems (such as purely private health delivery, where benefits must be made for the shareholders) or where we have entirely publicly funded systems (as in the traditional NHS, now vulnerable to people who say current spending levels are unsustainable, and subject to accussations of vested interests by Government), in health commons, we may see a collaboration between public and private organisations, and individuals, both based internally within and external to those organisations, working together as peers.

Why would they do this, you ask? Well, we all benefit from working towards a Commons (in this case, we all want to be individually as healthy as possible, and promoting health of our fellow citizens also benefits each of us individually and as a group). This idea leads on to the notion that we are all peers in the Commons, that we exist in a dynamic that is as flat (non-hierarchical) as possible when working in this way. Public health bodies want us to take responsibility for our health- it reduces costs, and it means we may focus resources on areas where we have to use expensive drugs and equipment. Private companies may still benefit indirectly from the development of skills by staff contributing within Commons work, but they are not allowed to take a direct profit from Commons products. They are allowed to advertise their products to be used by people and organisations contributing to the Commons communities.

As we move into a time where resources will be stretched, the new way of working represented by these ideas offers an alternative to the cuts-based solution so frequently enacted by organisations attempting to survive in the new climate. Where we are seeing transformational change within health organisations, we are not yet embedding a truly transformational way to enact new ways to enrich our health Commons, which if it was the default truly would transform our public services. Here is a short video, which talks about pharmaceutical drug development as aa Health Commons, but which shares the same theories I’m talking about.

This approach has already been trialed in countries with more intractable issues in population health than our own, for example, a quick Google search led me to this study based in New Mexico.

Social activists such as Dan Mcquillan has captured how to use these principles within health and social care, and indeed more generally within the public sector.

In the presentation, Dan is arguing that the problems within the health and social sevices cannot be solved within the traditional hierarchical structures we have developed. He argues that in order to work together effectively, it has to be within new spaces where status and power are distributed equally between peers. This can be facilitated by the use of digital technology- as we may have experienced if we are users of social networks such as Twitter!

Moving back to Bauwens, he believes that

 (digital) P2P technology allows for a new form of socialization that is changing how people behave towards each other

We could use non-hierarchical, peer-to-peer platforms and systems, which have developed in social movements using the net as a means to solve problems based within their communities. By using these ideas,  we can respond to the crisis we face in health and social care funding, by working towards a health Commons, together.

We can do this at the event I’m planning to put into action these principles. It will be a Digital Health Conference and Hack, based in Leeds, 29th and 30th June 2012. Please use #dhc12 to tag conversations about it, and register early interest by emailing digihealthcon@gmail.com.

The MOOC , currently titled #MedEdMOOC is planned to take place from mid-May to June 2012. See here, here and here for earlier blogs about it.

The Digital Health Conference and Hack #dhc12 will happen within the last week of the MOOC, and will be live-streamed to enable online participation by people who are unable to attend. It will also be archived along with the other MOOC content for future study.

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