Fraggl: Nudging You To Think Differently

By far the greatest need in health care is for its leaders to think differently. It seems highly unlikely that more health care, as we know it today, will be sufficient to meet the rising demand for care. And yet, when was the last time you went to an innovation event that really changed how you think about what health care is ad what it might become? I have no doubt that in recent times you’ve been impressed, perhaps with digital toys or amazing visualisations, but do these things ever represent anything fundamentally new? Rarely, I suspect.

It’s hard to think differently. Firstly, when you try you’ll often find the norms of the current world crowd out any new thoughts you could have had. Secondly, if you do manage to see things in a new light, sharing it with others is hard because they’re so blinkered by the current world. Thirdly, if you do find a willing audience they may actually be threatened by your thinking, especially if it questions the current economic model and hence their livelihood. So where do you start? 

I was lucky. I was forced to think differently by Lisa Shufro, the former Managing Editor of TEDMED. Lisa asked me questions that routinely broke my head. At first I tried to dismiss them; she didn’t have a background in health care so she didn’t ‘get it’. But soon I realised that what I thought I ‘got’ was actually just a collection of beliefs, packaged into a dogma that is the current approach to health care. In time, I learnt that answering her questions required thought, time, a fair pinch of self-belief, and an environment in which one can share one’s nascent ruminating.

In due course, this impacted my reading. I used to leaf through hundreds of journal articles and blog posts every week but soon I realised they were just reinforcing the now. Sure, emerging approaches to health care look different. We now have digital health, mobile health, genomic medicine, and good ol’ big data. But what is the real difference between digital health and yesterday’s great hope, health IT? Isn’t mobile health just digital stuff on a phone or a tablet? And what can we do with genomic medicine, fuelled by big data, other than have yet more things to seek health care for? 

Over the last couple of years I have completely changed what I read and today you’re getting the opportunity to go on that journey too. Today, I’m announcing a new service called Fraggl Health, on which I have collaborated with my commercial partners, Adaptive Lab, a digital innovation company here in Shoreditch, London. Fraggl creates a daily email. It’ll contain 10 of the most interesting articles in health (not just health care). You can see an example and sign up here. 

While Fraggl is a very modern solution to the very modern problem of information overload, it is also an opportunity to be exposed to thoughts and ideas that are not part of your usual reading. It works through a blend of human, social, and algorithmic curation, the brainchild of its founders Neil Perkin and James Haycock (James is also the Founder of Adaptive Lab). 

Yours truly does the human curation; I have supplied Fraggl with a list of the people on Twitter that I trust. Fraggl then considers how many followers they have (audience) and how many people they follow (engagement). Each time they share a link in a tweet, Fraggl monitors how often that tweet is favourited and/or re-tweeted. That combination of audience and engagement is the social curation. Fraggl then uses these social signals in combination with other factors related to the content’s quality, along with a set of weights, to give each link a score; that’s the algorithmic curation. The final result is a list of articles – hopefully well-written, informative, trustworthy articles from sources that you’re either not exposed to or don’t usually have time to stay on top of. 

It’s fun to be asked who is worth reading out there on the Internet. You can rest assured that the noisy re-tweeters that create the echo chamber that plagues Silicon Valley, Twitter, health care, and health innovation have not been included. Instead, there are individuals like Leslie Kernisan, one of the wisest thinkers on ageing, and Jay Parkinson, a doctor both thinking hard and (more importantly) doing lots to change the approach to care. There are some movements, such as Choosing Wisely and Less Is More. There are collections of great writing, such as The Incidental Economist and The Health Care Blog. There are also incubators, health care corporations, providers, think tanks, philanthropic funders, investors and journalists. And there are some stalwarts of the health information world, medical journals; The Lancet and the New England Journal of Medicine being just two of the few that are included. 

Fraggl Health is, to my mind, a beta service. In the same way that I constantly iterate what I read, I’ll also be keeping an eye on what makes it into your daily email. I’m sure there’ll be some odd articles (indeed, I’ve chosen some left of centre sources, such as Somatosphere, to see what happens) but what I hope is that every day, or perhaps every other day, there is something that piques your interest, makes you think a little differently, and nudges you towards a different way of doing things. We welcome your feedback.

Acknowledgements: My thanks to Mark Priestley of Adaptive Lab for patiently explaining how the social and algorithmic curation works, only some of which has made it into this article.

Competing interests: I have a commercial relationship with Adaptive Lab made up of a retainer and revenue share. While Fraggl is currently a free service, I have a revenue share relationship that will kick in if Fraggl becomes pay-for.