Overcoming Challenges In Codifying And Replicating Complex Health Care Interventions.

The complex nature of many health care interventions poses challenges for successful replication. This article presents insights on tackling these challenges primarily drawn from recent research and programs in the UK. These insights include the need to codify complex interventions in ways that reflect their social, context-sensitive, and dynamic nature; to capture learning as the intervention is implemented in new contexts; and to design programs in ways that respect adopters' role in the spread process. We argue that program leaders should have familiarity with theoretical approaches for conceptualizing complex interventions, that a discrete testing-and-revision phase should be recognized as part of the spread process, and that programs should be designed in ways that build and sustain adopter commitment. These perspectives complement the traditional focus on the innovator in models of spread by highlighting the role adopters play in adapting interventions and generating learning, and they have implications for the design of programs to spread innovation.

Developing public policy to advance the use of big data in health care.

The vast amount of health data generated and stored around the world each day offers significant opportunities for advances such as the real-time tracking of diseases, predicting disease outbreaks, and developing health care that is truly personalized. However, capturing, analyzing, and sharing health data is difficult, expensive, and controversial. This article explores four central questions that policy makers should consider when developing public policy for the use of "big data" in health care. We discuss what aspects of big data are most relevant for health care and present a taxonomy of data types and levels of access. We suggest that successful policies require clear objectives and provide examples, discuss barriers to achieving policy objectives based on a recent policy experiment in the United Kingdom, and propose levers that policy makers should consider using to advance data sharing. We argue that the case for data sharing can be won only by providing real-life examples of the ways in which it can improve health care.

Antimicrobial resistance: addressing the global threat through greater awareness and transformative action.

Antimicrobial therapies have played an unquestionably important role in advancing modern medical and surgical care, treating animals, reducing the global burden of communicable disease, and prolonging human life expectancy. These transformational benefits are threatened because of the rapidly advancing phenomenon of antimicrobial resistance. As a result of complex factors across many sectors and international actors, the global impact of antimicrobial resistance is an escalating economic and health crisis. This article draws on the collective expertise and summit report of the Antimicrobial Resistance Working Group from the 2013 World Innovation Summit for Health, in Doha, Qatar. It defines a framework of principles and tasks for key policy makers to raise international awareness of antimicrobial resistance and lead transformative action through policy-driven improvements in sanitation, antimicrobial conservation, agricultural practices, and research and development.