The Act@Scale program: why size matters when it comes to population health (and what to do about it)

CK: How have patients reacted to these pilots?

Prof. Newman: Traditional healthcare is very paternalistic. Young people - and increasingly the elderly - no longer subscribe to that approach; they want to know what their risks are, what the likely health outcomes are, and what they can do about it. When you get patients involved in self-managing their condition - which we call 'citizen empowerment' in the Act@Scale handbook -- then this is where the real gains can come from.

CK: Which pilots stood out for you and what can we learn from them?

Prof. Newman: I think the Spanish projects are worth highlighting because of the way they integrated political and financial support from regional government. The Basque Country multi-morbid integration program successfully scaled up to 16,000 patients with multiple conditions across the region by integrating a diverse set of programs that combined clinical monitoring with patient self-management.

CK: What are the next steps for the Act@Scale program?

Prof. Newman: I think that this program has answered skeptics' comments about whether it's possible to make changes on a large scale. You certainly can and it's vital that we do. From here, I want to prioritize funding for mutual visits to the best examples from other countries so that we can inspire each other.

For more information on ACT@Scale, visit http://www.act-at-scale.eu and download the full ACT@Scale handbook for more detail on best practice analysis, examples and results here.

[1] This quote is variously attributed to Yogi Berra and the computer scientist Jan L.A. van de Snepscheut. The earliest known appearance of the quote in print is Walter J. Savitch, Pascal: An Introduction to the Art and Science of Programming (1984), in which it is attributed as a 'remark overheard at a computer science conference'.