Breakthroughs to Cures

Today, one in three Americans lives with chronic and life-threatening diseases. Finding treatments for these diseases is not cheap—more than $90 billion is spent on medical research and development every year. Yet, new drug approvals and cures have not come close to keeping pace with neither the investment nor cost to society.

Due to misaligned incentives among those that fund, conduct, commercialize and regulate medical research, the number of new treatments and cures for chronic and life-threatening diseases has stagnated since the 1950’s. And few, if any, forums exist where people operating both inside and outside the current system can generate and discuss solutions that may lie in multiple innovations. Until now. The Myelin Repair Foundation (MRF) has harnessed the combined interactive natures of game playing and social media to tap into the transformative power of idea crowdsourcing.

With funding from the Robert Wood Johnson Foundation’s Pioneer Portfolio, MRF deployed a new social networking-based game that brought together a virtual community to help solve a fictitious public health crisis. On two separate occasions—October 7-8, 2010 and November 9-10, 2010—more than 400 people interested in transforming medical research and development played the game and contributed to a robust, collaborative dialogue.

The game’s rules were simple: A public health crisis is pending and no cure is in sight, due to the slow pace of medical innovation. Players were tasked with coming up with solutions to that scenario by playing one of two “cards”—either “positive imagination,” for a good result to the scenario, or “dark imagination” for a bad result. Each card also allowed the player to add their own thoughts—up to 140 characters—as to what they “forecast” will happen. In turn, other players then played one of four response card, which enabled them to add their own thoughts and evolve the narrative. As they played cards, players earned points based upon their level of engagement and quality of ideas. Staff and invited guest experts guided the game play by highlighting the best cards (ideas), giving special awards to players, and blogging key themes as they emerged in real time.

At the conclusion of both games, MRF summarized the ideas and strategies players produced in a detailed analysis. The full report, Breakthroughs to Cures: Promoting Novel Ways to Accelerate Medical Research, documents the results of the crowd-sourced ideas and strategies that could lead to more effective and efficient ways to fund and conduct medical research, as well as ideas for policy change.

Executive Summary

On October 7–8, and November 9–10, 2010, Institute for the Future (IFTF), in cooperation with the Myelin Repair Foundation (MRF) and the Robert Wood Johnson Foundation (RWJF), hosted a Foresight Engine thought experiment called Breakthroughs to Cures.

Designed as an open, nonpartisan environment where models for innovation in medical research can be freely explored and developed, the purpose was to generate “outlier” ideas and strategies that could lead to more effective and efficient ways to fund and conduct medical research with the goal of speeding up the development of patient treatments and cures. Foresight Engine is a crowdsourcing platform designed to engage people from all over the world in participatory forecasting. It involves a three-step process of scenario development, community engagement in creation of micro-forecasts, and analysis of themes emerging from those forecasts.

The Breakthroughs to Cures game took place over two trial periods. During the two games, more than 400 players including students, professors, and corporate executives participated with other players in North America, South America, Asia, Europe and Australia. Between the two trials, players generated approximately 3,000 ideas—brief, 140 character brainstorms—about how to accelerate medical research.

The following is a representative sample of some of the key ideas that emerged from the two trials:

Bring mobility to clinical trials to make them more accessible. The issue of very rapid, large-scale clinical trials was addressed with two main strategies: a mobile lab and mobile patient. Mobile labs could be centered around vans, and participants also suggested the use of Skype video, in-home tele-monitoring, and body sensors that automatically report back to centralized data repositories. In addition, mobile health coaching could support clinical trials in a variety of ways, including real-time responses to in-home sensors. Finally, the group looked at mobile tools as a way to organize crowdsourced approaches to the study of disease and its treatment.

Use open and linked data standards to develop broader health records. While there is widespread agreement that health outcomes stem from a broad range of environmental, social, behavioral, and biological factors, health and medical researchers lack access to anything but a small sliver of one of these data sets. Players saw opportunities in linking these data sets into a broader database to create more robust data sets that transcend these traditional research silos. Critically, game players saw opportunities for individuals to contribute their own details—from self-tracked health information to social networking data—as new forms of information that could be used as the basis of advanced data mining and to pinpoint hidden contributing factors to disease progression and cure effectiveness.

Design, build, and maintain a global nonprofit public knowledge garden. One person suggested the idea of a “knowledge garden”—a global topic map of the Internet that enables people to draw links between concepts and ideas—that was supported by many participants. This focus on topics and their relationships distinguishes the knowledge garden from an encyclopedia like Wikipedia. While most participants argued for a public knowledge garden (or gardens), others noted that it could also be developed as a private resource within an organization.

Use spare capacities to enable new research projects. A variety of projects outside of health care—such as peer-to-peer car sharing and food sharing networks—have emerged as ways for people to collectively make more efficient use of resources. Borrowing from this concept, many game players identified other spare everyday and infrastructure resources that could be used to advance medical research. For example, several players suggested enlisting computers in sleep mode to help process and analyze large, complex datasets. Others looked at physical resources and suggested that lab spaces and other facilities be opened up to graduate students and hobbyists to make more optimal use of powerful and expensive equipment.

Facilitate cross-disciplinary and other creative research through fun, informal exchanges. Many players suggested offering researchers opportunities to break from intense independent work to experiment in more enjoyable, less formal settings. Ideas in this vein ranged from encouraging virtual gameplay in worlds such as Second Life to the creation of more open physical spaces designed for researchers in different fields to socialize and consider each other’s work. These ideas focused on using gaming and social spaces to facilitate discussion, interaction, and brainstorming in less pressure-filled and more open ways.