New York City is helping officials better understand and respond to public health needs by putting data at their fingertips. The NYC Macroscope uses information captured routinely in the doctor’s office to paint a picture of health for the entire city—quickly, accurately and inexpensively. This powerful use of electronic health records has the potential to transform public health decision-making across the country. Learn more in this NewPublicHealth interview with the NYC Macroscope’s Carolyn Greene, MD. — Brian Quinn

As Beth Israel Deaconess Medical Center (BIDMC) begins its institutional rollout of OpenNotes, it's becoming clear that we've moved into a new phase of the diffusion of this innovation. I've been in discussions with OpenNotes co-directors Tom Delbanco, MD and Jan Walker, RN, MBA about the idea of opening up physician notes to patients since 2008, when it was a bold, controversial idea that needed to be tested. The landmark study that Tom, Jan and their colleagues conducted over 2011-2012 and published last fall made it quite clear that the idea had merit: overwhelming percentages of patients found it helped them better understand their conditions, feel in more control of their health and even take their medicines more regularly. 99 percent of patients in the study wanted to continue with the practice. As for physicians, their fears went largely unrealized. It simply wasn't a big deal.

Recently we've seen more leading institutions climb on board with the practice of sharing medical notes: the VA is adopting OpenNotes, as is Group Health Cooperative; Geisinger, one of the original study sites, is expanding the practice throughout much of its system; the Cleveland Clinic announced its intention to share visit notes; and you can now read your doctor's notes at the Mayo Clinic. More will undoubtedly follow in the months and years ahead. As we move into the implementation phase at these and other institutions, the questions will shift from whether the idea is good to more practical inquiries around how well it fits certain specialties (like psychiatry) or departments; whether there are patterns in the types of patients (or physicians) that flourish under this approach; and how to manage the cultural changes that OpenNotes implies.

We’re always willing to hear your ideas for how to innovate health and health care—and to change the world in the process. We accept brief proposals through our website 365 days a year. And we read them, every single one, looking for the big idea that has not yet been considered or the seed of an exploration that could lead to that big idea.

On October 16, we’re going to try a little experiment—a new way for you to share your ideas with us: We’ll be hosting our first-ever Pioneer Pitch Day in New York City. Over the course of two hours, eight teams will tell us their vision for how they want to change the world of health and health care—and how they plan to go about doing so. They’ll be peppered with questions from me, my colleagues on the Pioneer team, our grantees and from a few of our friends, including Esther Dyson. Thomas Goetz, the Robert Wood Johnson Foundation’s entrepreneur-in-residence, will be our emcee. (Update: We are excited to announce that Fast Company staff writer Ben Schiller, NPR science correspondent Shankar Vedantam, Games for Health co-founder Ben Sawyer, PatientsLikeMe co-founder and president Ben Heywood, Rhode Island School of Design President John Maeda, and IDEO Life Sciences Chief Strategist Rodrigo Martinez will be joining us as judges. Stay tuned for additional updates.)

“Information wants to be free.” That’s the mantra of Internet culture, which is increasingly indistinguishable from culture at large. What does this cultural shift mean for a foundation seeking to fund innovation? Specifically, what does it mean for Pioneer?

My colleague, Nancy Barrand, and I have been thinking about this a lot lately. Clearly, the existence of this blog, and of our website and various social media channels, are all proof that we share more information outside the walls of this Foundation than we ever did before. But we still keep one part of our process under lock and key: proposal review.

Each year, thousands of organizations submit proposals to RWJF, and only the fraction of them that receive funding are ever shared publicly. This is less a comment on the quality of the ideas than it is on the specificity of our funding strategy, and, of course, the fact that our budget is finite. Increasingly, we’ve wished we could share the ideas we don’t fund with a wider audience, so they could benefit from the collective intelligence of our growing network.

Today, the Health Care Incentives Improvement Institute, Inc. (HCI3®) released “Improving Incentives to Free Motivation,” a report developed with support from the Robert Wood Johnson Foundation (RWJF), that makes a bold assertion: Financial incentives won’t fix our payment problems in health care.

In a guest post on The Health Care Blog today, I outlined why simply throwing more carrots and sticks at doctors and patients won’t improve the quality or affordability of our health care:

Until we get [the] human motivators right in health care, we can try all sorts of complicated, elegant payment models and formulas and still ultimately not get to the goal of sustainable high value. It will always be just over the horizon. Let's absolutely be smart about incentives in health care, but let's also get away from talking about simple carrots and sticks. Instead, let’s find the right mix of motivators to promote the creativity we need to get the best care every single time.”