Month: March 2011

Investment in Innovation: Lessons Learned from China

Investment in Innovation: Lessons Learned from China

President Obama was right to focus on innovation and job creation in his January 2011 State of the Union speech. There is a need to create and fill new jobs in an increasingly competitive global marketplace, and investments in innova- tion will enable businesses using virtual reality and other healthcare technology to be part of a new, much-needed job creation engine.

If U.S. government funding for innovation and education does not increase, China may eclipse the United States in research and development funding within the next 20 years.1 By August 2010, China’s economy had surpassed that of Ja- pan, positioning it as the second-largest economy behind the United States. Some predict that China’s economy will sur- pass that of the United States as early as 2017.2

The United States has enjoyed dominance in innovation for the past 40 years, but that landscape is changing quickly with the globalization of R&D. Not just China but Korea, India, Russia, and Brazil are all investing in R&D at higher rates than the United States, Germany, and Japan.1 Relatively high labor costs in the European Union presage low R&D invest- ments over the next decade, with southern EU states such as Greece, Italy, and Spain investing at a lower rate than their northern counterparts.

Another result of R&D globalization is a reversal of the flow of funds, now flowing from some less developed to more developed countries. For example, China has made investments outside the country in telecommunications, as has India in pharmaceuticals.1

China’s leaders understand the importance of R&D. ‘‘Eight of the nine members of China’s Standing Committee of the Political Bureau, including China’s current President Hu Jintao, have engineering degrees. Of the 15 U.S. cabinet members, only one, Secretary of Energy Steven Chu, has a technical degree—a doctorate in physics.’’3 Consequently, the Chinese government has an innovation policy designed to encourage Chinese companies to create and own tech- nologies. The policy also encourages technology transfer from abroad and establishment of Chinese R&D facilities in exchange for foreign company access to China’s high- volume markets. As a result, a number of multinational technology and pharmaceutical companies have taken ad- vantage of this policy, some transferring facilities from India.

The Chinese government owns all top-ranked academies, including universities, and has tripled its investment in ed- ucation in the past 12 years.3 Of the five million students graduating per year, about one million are research students.

Furthermore, China’s academicians file more patent appli- cations than those in any other country—16% compared to 4% in the United States.

In addition, the Chinese government plays a direct role in investing in 150 companies, providing 27% of their funding in 2007, the latest year for which data are available.3 Universities partner with industry, and about the half the universities’ R&D funding, primary in technology transfer, comes from industry.

In the United States, a recent survey shows that venture capitalists expect their industry to decline over the next 5 years.4 VCs in France, Israel, and the UK also predict a drop, while those in China, Brazil, and India expect growth. What is most discouraging for U.S. business is that most U.S. VCs expect the available amount of venture capital to decrease by at least 30%.

In the United States, small companies—those most in need of venture capital—perform 19% of the nation’s R&D.5 Over the past 25 years, the most dramatic growth in U.S. federal R&D spending has been in health, which accounted for 52% of nondefense R&D in FY2008.

Given the data cited in this editorial, it should come as no surprise that China, India, and Brazil may surpass the United States in innovative healthcare delivery over the next de- cade.6 The United States has the patient populations neces- sary for research, but the rate of growth in financial support and education of researchers has not kept pace with that of developing countries.

President Obama has declared ‘‘innovation in healthcare’’ one of three national priorities for FY2012. With Congress unlikely to approve any initiative that adds to the federal budget deficit, can he deliver on his promises of increased funds for innovation and education?


1. Battelle. 2011 Global R&D Funding Forecast. R&D Magazine 2010 (Dec), p. 24. Featured_Articles/2010/12/GFF2010_FINAL_REV_small.pdf (accessed Jan. 30, 2011).
2. Euromonitor International. Top 10 largest economies in 2020. Euromonitor Global Market Research Blog 2010 (Jul 7). http:// economies-in-2020.html (accessed Jan. 30, 2011).
3. Battelle. 2011 Global R&D Funding Forecast. R&D Magazine 2010 (Dec), pp. 27–29. Featured_Articles/2010/12/GFF2010_FINAL_REV_small.pdf (accessed Jan. 30, 2011).
4. Smith R. Venture capitalists in U.S. expect VC industry, funding to shrink. Local Tech Wire 2010 (Jul 14). http:// post/7959577/ (accessed Jan. 30, 2011).
5. National Science Board. Chapter 4. Research and Develop- ment: National Trends and International Linkages. In Na- tional Science Foundation, Division of Science Resources Statistics, Science and Engineering Indicators: 2010, p. 4-4.
6. (accessed Jan. 30, 2011). PwC Medical Technology Innovation Scorecard Highlights. www innovation-scorecard/index.jhtml (accessed Jan. 30, 2011).
Brenda K. Wiederhold


2011 Spring Editorial

Journal of CyberTherapy & Rehabilitation

Spring 2011, Volume 4, Issue 1



There is an emerging body of literature about the proliferation of social networking sites (SNS) and their effects on mental health. To date, much of it has focused on investigating the possible negative effects of SNS, such as Internet addiction. However, research also supports the benefits of SNS in mental health, addictions, stigmatized identities, trauma and violence recovery, and grief support. As clinicians and researchers, we are just beginning to harness the power of SNS to promote mental well- being.

Participation in SNS has increased dramatically over the past five years. A 2010 Pew report showed that 73% of online teens and 47% of online adults in the U.S. used SNS. Another survey conducted by Pew in April–May 2010 noted that Poland, Britain, and South Korea are close behind the U.S. in SNS usage, followed by France, Spain, Russia, and Brazil. Lower participation in other countries is due primarily to less-wired populations. No table exceptions are Germany and Japan, where Internet usage is high but SNS usage is low.

The European Union has been investing in e-Health since 2004, when outgoing Public Health and Consumer Protection Commissioner David Byrne said, “We need a … Europe where people have easy access to clear and reliable information on how to be in good health and about diseases and treatment options.” An outgrowth of the European Parliament hearing at which he testified was the creation of the ICT (information and communication technologies) for Health, enabling health service providers in different EU member states to work together to exploit these technologies. More recently, the First International E-Mental Health Summit in Amsterdam in 2009 organized by the Trimbos Institute in collaboration with the International Society for Research on Internet Interventions attracted 500 participants from more than 40 countries. In the U.S., the new healthcare reform law provides financial incentives for providers to use health information technology and electronic health records, and in March 2011 leaders in healthcare technology will share their innovations in San Diego and San Francisco, California for the Health 2.0 conference.

In one such innovation, a researcher used a GPS-enabled phone and a location-aware SNS to design a system to help trainees with cognitive impairment who felt lost to find a nearby caregiver. These individuals were enrolled in a supported employment program that provided them with a job coach to help them get to and from work for the first few weeks. The system was programmed to send text messages to the job coach and time and location alarms to help the trainee get to work on time. This type of SNS could enable parents, guardians, and caregivers to watch loved ones unobtrusively.

A recent study of 217 college-age participants in South Korea found that SNS network size was positively related to subjective well-being, and the results suggest that this is due to self-disclosure. In the SNS context, it is postulated that the positive association with well-being results from the self-disclosure “confession effect,” the expectation of mutual self-disclosure, and the expectation of social support.

A case study report found that deploying the Three Good Things positive psychology exercise as a Facebook ap- plication was viable, with a 1% dropout rate, which is similar to or better than other online wellness applications. In the exercise, people post three good things that happened, along with the reasons they think they happened. People found that sharing with others and viewing other’s posts were valuable, as long as they were able to choose which comments they made were public and which were private.

Specialized health SNS such as PatientsLikeMe and DailyStrength offer emotional support, social support, and
patient empowerment; some also offer physician Q&A, quantified self-tracking, and clinical trials access. PatientsLikeMe includes support for mental disorders such as anxiety, bipolar affective disorder, depression, obsessive-compulsive disorder, and Posttraumatic Stress Disorder; DailyStrength provides support for an even broader array of mental health issues. In an online SNS, inhibitions may be lowered, anxiety may be lessened, and anonymity may be increased. This presents the ideal 24/7 support for treatment of people with disorders such as depression. Indeed, the Pew report showed that teens look online for health information about issues they find are embarrassing to talk about such as drugs, sex, and depression.

Of course, there are cautions. One study found that people with depression who used an online SNS spiraled down if they had friends who were moderately or severely depressed and had a negative opinion of the SNS. The researchers concluded that the SNS could be helpful if people take a break from it if their posts elicit these reactions.

A position paper on pervasive healthcare concludes that “[provided-designed systems and services] should include help for people to access peer-to-peer social support sharing and caring in order to encourage sustained engagement with self management to build positive healthy identities for themselves.” Online health consumers are beginning to rely on “patient opinion leaders” for advice on chronic conditions such as mental disorders, and we need to be there with them. Of course, we must be mindful of issues such as privacy and data accuracy as we create tools to help SNS participants balance their needs to share information with their needs to manage self-presentation. Nonetheless, as clinicians and researchers, we should take advantage of SNS to extend the practice of evidence based medicine and mental health.



Brenda K. Wiederhold, Ph.D., MBA, BCIA

Editor-in-Chief, Journal of CyberTherapy & Rehabilitation

Virtual Reality Medical Institute