The development of the International Coproduction of Health Network (ICoHN)

During 2013 & 2014, interest in exploring the “coproduction of healthcare service” and other human services grew. This led to:

  • Research and publication of foundational articles describing coproduction of health services
  • Explicit suggestions leading to further development of our understanding of coproduction
  • Interest from granting agencies
  • Support from The Dartmouth Institute, Jönköping Academy

Research and publication of foundational articles describing coproduction of health services

In response to the Robert Wood Johnson Foundation's request for information about promising international efforts, Eugene Nelson, Mary Dixon-Woods, Paul Batalden, and Staffan Lindblad published a paper exploring a model that linked information in patient registries with the coproduction of healthcare service in a learning health system.[1] Concurrently, representatives of the Cincinnati Children’s Hospital and Medical Center’s Anderson Center, Institute for Healthcare Improvement Fellows, Maren Batalden, and Paul Batalden were working to explore some of the origins and activities of the "coproduction community" in diverse fields and considering the implications in healthcare service.[2]

Explicit suggestions leading to further development of our understanding of coproduction

Many who were familiar with these early explorations encouraged further development, including people in Sweden, the UK, and the US. Preliminary conversations were held during 2014 with Boel Andersson-Gäre of the Jönköping Academy about the possible development of an international cooperative effort of the Jönköping Academy and The Dartmouth Institute for Health Policy and Clinical Practice. The conversations began to explore strategies that would simultaneously develop the idea and test feasibility in working settings using Etienne Wenger's concept of linked communities of practice in a digital habitat.[3]

Interest from granting agencies

The Rx Foundation, Robert Wood Johnson Foundation, the Institute for Healthcare Improvement in the US, and the Regional Development Program in Jönköping all expressed interest in further development. Applications were prepared, submitted, and funded.

Support from The Dartmouth Institute, Jönköping Academy

Additional startup funding was provided by The Dartmouth Institute and Jönköping Academy in 2015. A decision was made to start with a website (ICoHN.org) to support communities of practice and research activities based at Dartmouth and at Jönköping. The emerging digital habitat includes an internet platform and a supportive software system.[4,5] A steering group was formed which includes leaders in Sweden and the US.

Paul Batalden, MD
Active Emeritus Professor, Dartmouth
Senior Professor, Jönköping


[1] Nelson EC, Dixon-Woods M, Batalden P, et al. Patient focused registries can improve health, care, and science. BMJ 2016;354:i3319 doi: 10.1136/bmj.i3319 (Published 1 July 2016)

[2] Batalden MK, Batalden PB, Margolis PJ et al. The Coproduction of Healthcare Service. BMJ Qual Saf 2016;25:509–517.( Published Online First 16 September 2015)

[3] Wenger E, White N, and Smith JD. Digital Habitats: stewarding technology for communities. 2009; Portland, OR: CPsquare.

[4] Zoom.us.

[5] Microsoft Teams, Office 365.

Learning network chart