Our point of reference, is The Cluetrain Manifesto, a set of 95 theses put forward as a manifesto, or call to

action, for all businesses operating within the newly-connected marketplace.

What does Health Care have to do with this? Everything! The Cluetrain Manifesto tells us that the market is the

conversation ; the Internet facilitates the bypassing of formal hierarchies creating a more informed marketplace

and consumer through those conversations. Substitute “health care” for market place and healthcare

organizations for businesses, and we’re ready to move forward!

1. Health is co-creation 2. Health 2.0 is win-win: care actors are better trained to support a more informed patient. 3. Health 2.0 as a permanent round table between all actors in society for the creation of a citizenship of

health ... all members of the same team! 4. Social Media have been widely adopted throughout the world and healthcare professionals are no

different than other people in doing so. 5. “We are Smarter than Me” in coping with whatever diseases 6. Social Web is leading into co-creation of the new participatory medicine 7. From the former Isolation of the Illness to the We of the Wellness thanks to the hyperconnectivity 8. Physicians should understand the social changes and their changed role in healthcare systems, that in

many countries are in dire straits, the emergence of a new breed of patients. 9. Social media brings an unprecedented ability for people to collaborate continuously on a global basis.

This will enable scientists to quicken the pace of discovery and research leading to a greater understanding of disease with better treatments faster than ever before.

10. Social media includes the challenging issue wether the content complies with regulations. Social media will have to fall in line with the spirit of these regulations.

11. Social media offers us the advantage to reach out across multiple generations of patients to increase the dissemination of information

12. There is a need for an active and critical role in digital public space. 13. We need to “Mind the Gap” between SoMe networks of patients and those of healthcare

professionals. Bridging the gap will bring us a a step further. 14. It is patient-centric care that is a hybrid of Internet-based education, mHealth technologies,

telehealth, and provider supervision and visits. 15. The key is that the patient are the source of critical information and engagement. 16. SoMe are primarily used to teach and to learn and hardly at all to treat. Since treating patients is

Healthcare’s core business, SoMe have not reached that core enough yet 17. Health convos at the Social Web are driven by Generosity and the Joy Factor 18. World is flat, Healthcare is now Horizontal 19. There may be a need for more robust platforms for safe use of SoMe in healthcare. 20. We should not focus on technology too much and we should certainly not use this argument as a

reason to postpone innovation. 21. Diseases, treatments, healthcare actors are now convo´s at the Social Web 22. Adaptative Darwin Theory is fueling the healing connections at the Social Web, it´s not Serendipity,

nor forced or guided connections 23. Healthcare Social Networks and online convo´s are challenging and transforming the establishment

and status quo of the Healthcare arena controlling the power of education, professional and patient associations, etc

24. The question is not whether physicians or healthcare opinion leaders have to use social networks or have to blog, but if they are aware of challenges and social responsibility in times of epatients, ehealth and never ending online healthinformation.

25. The huge power of the healthcare convos will fall down the existing and constricting regulatory walls 26. A patient is not a diagnosis but a human being in need of compassion. 27. Health 2.0 should improve the quality of exchange and management of patients when involving all

stakeholders; professionals & patients 2.0. 28. Medical professionals of the future have to be team builders between social media, telemedicine,

patients, healthcare providers and healthcare insurances 29. We need to move from evidence based medicine to science based medicine and find a way to bring

the latest research directly to the patients, doctors.

30. The Internet is enabling conversations among patienst and doctors that were simply not possible in the era before the mass use of internet.

31. eHealth has to be globally acknowledged by medical professionals as a sound alternative for meeting the patient in his clinic.

32. With the introduction of eHealth medical professionals have to refrain from income driven perverse stimuli.

33. The internet provides us with new ways to bring the latest research directly to patients and the doctors are co-investigators in the search for the desired improvement of Health care.

34. These networked conversations are enabling powerful new forms of social organization and knowledge exchange to emerge.

35. As a result, patients are getting smarter, more informed, more organized. Participation in their treatmentchanged healthcare fundamentally.

36. Crowdsourcing patients and doctors have figured out that they get far better information and support from one another than from books and research. Health care in co-cretion is about adding value to the quality and speed of treatments for common and rare diseases.

37. “Stop just marketing, Start socializing”Bye Loneliness, Hello Community! 38. Patients who come to the medical appointment with information about their symptoms and are eager

to understand what needs to be done to cure their deseaese and are more actively engaged with their doctors.

39. There are no secrets. The networked crowd knows more than a doctor or hospital do about their own products. And whether their treatment is good or bad, they tell everyone.

40. “Stop just marketing, Start socializing” 41. The legalistic requirement of EBM, such as its insistence on treatments that have met the “gold

standard” of “well-designed, large-scale, double-blind, randomized, placebo-controlled, clinical trials”, actually prevent doctors from effectively diagnosing and treating patients.

42. Social is Healing 43. Imagine a world where every individual had the option to speak to the best doctors in the world,

where getting multiple opinions or an average opinion on a condition was possible 44. Collaboration medicine will change the level of care some third world patients receive 45. The internet had the catalyst role of democratising medical knowledge that was till a few years ago

only in the realm of health professionals 46. In just a few more years, the distant "voice" of doctors—as the sound of the medical professionalist —

will seem as contrived and artificial as the language of the 18th century French court. 47. The recognition of a problem or situation mostly lead to innovations that have bigger positive impact

on a society than high-tech health innovations 48. Healthcare organizations that think it’s enough for a healthcare organization to just be online

misunderstand the big potential of an deployed an optimized mobile website, for their communication with the patients and future patients

49. Health care workers that don't realize their markets are now networked person-to-person, getting smarter as a result and deeply joined in conversation are missing their best opportunity.

50. Mobile internet access is not a mere fad – widespread adoption of mobile communications means an investment in mobile development now can set your healthcare organization apart.

51. Hospital websites that are optimized for smartphone browsers Better attract new patients 52. Hospital websites that are optimized for smartphone browsers boost their patient satisfaction scores. 53. Co-creation and transparency are key 54. Medical care should be easily accessible at all reasonable hours 55. A patient must able to get in a doctors advise within a 48 hours. 56. Social Media and mobile access are the tools to finally share information between care givers and care

takers, for (big) pharma the opportunity and obligation to communicate with patients and doctors in stead of pushing their products for their on profit focussing stakeholders.

57. Patients can now access a huge amount of high-quality information. Information that can be used for self-care and to understand when to seek professional care.

58. Access to information will increase a patient’s ability to affect the course of their disease and decrease their need to use the established healthcare system.

59. Key point for eHealth is the public access and use of the information about health (diseases, diagnostic, treatments…), but the huge quantity of information to patients and general public are difficult to be correctly interpreted, because of the lack of medical education.

60. Through eHeath information patients have the ability to access, view, monitor and communicate with the medical community tha can have a profound impact on QOL scores and have a positive healthcare economic impact

61. Medical information on the internet with a substantial proportion of inaccurate information or not applicable to a patient’s specific situation can result in people believing they are informed when they are not.

62. Inaccurate medical information will lead to greater morbidity and mortality across patient populations as misinformation is spread uncontrolled or without certification.

63. The internet and eHealth are excellent tools in the hands of healthcare policy makers: they offer the possibility to quickly adapt to changing scientific and socio-economic conditions in healthcare

64. Decisions on policies that regulate public health must be submitted to the public, so that citizens express their opinions freely.

65. Expressed the views of citizens on a decision of public health policy must be subject to assessment in order of their inclusion

66. The internet is the most suitable means to encourage public participation in evaluating the decisions of public authorities.

67. With the use of eHealth, SoMe, self-management in Health Care, productivity gain can so 1 billions of euros will be saved

68. eHealth reduces the amont of nurses, doctors, psychiatrists and thus smaller staff shortages in health care.

69. eHealth limits the growth of health spending: Large-scale investment in e-health and self-management concepts provide significant savings for business and insurances.

70. E-health, telecare and self management are available outside work hours for lower costs than normal daytime healthcare. Significant productivity gains will be realized.

71. The potential of e-health and self-management is underused. 72. Innovation-Driven Health Care, is Health Care that devellops care in co-creation with patients 73. One human is much different than the other, the physician should see the person in front of him in

connection to any guideline and not vice versa 74. The internet enables communities to form and people within those communities to communicate. 75. The internet enables the support of patients by patients, particularly in certain disease areas like rare

diseases where there may not be anyone with the disease nearby. 76. The internet enables the interpretation of the wealth of information based on personal experience so

patients can understand the difference between the information and misinformation (but it can propagate misinformation).

77. The internet helps patients to be more informed and better supported, again without using the established healthcare systems.

78. Smartphones now have more computer power than most medical devices. 79. Smartphones are enabling remote monitoring and investigation. This will change healthcare by

removing the need to visit healthcare centres and enable the monitoring of a patient’s condition continuously.

80. Smartphones will change the way diseases and their burden on patients are understood, leading to new treatments and better care.

81. Public Relations does not relate to the public. Healthcare companies are afraid of communicating with all their patients: happy and unhappy patients

82. Compassion for care is not a parlor trick. It can't be "picked up" at some conference. 83. Command-and-control management styles both derive from and reinforce bureaucracy, power

tripping and an overall culture of paranoia. 84. Paranoia kills conversation. That's its point. And lack of open conversation kills healthcare

organisations. 85. Patients have real power and they know it. 86. Patients like this Health 2.0 much better. In fact, the are co-creating it. 87. Patients have got some ideas for you too: some new skillsyou need, some better service and lots of

new tools for telecare. New stuff that saves time and money. 88. We know some doctors. They're pretty cool online. Do you have any more like that you're hiding in

hospitals and healthcare institutions? Can they come out and play? 89. When patients have questions they turn to each other for answers. If doctors didn't have such a tight

paradigm maybe they'd be among the people we'd turn to.