Moving healthcare to your fingertips

Transkript

1 15. September Århus Klaus Phanareth, e- læge Moving healthcare to your fingertips

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3 Politiske signaler om forandring

4 Hospitals without bed and walls The $451 million U.S. Navy hospital being built near San Diego will have only 67 beds. We are reshaping outpatient care and establishing leading practices that provide Montefiore's world- class treatments through multidisciplinary teams at a hospital without beds. Dr. Steven Safyer, president and CEO of Montefiore Medical Center By A ndis Robeznieks Posted: January 2 6, :01 am ET

5 Publikationsrate for Telemedicin og kronisk sygdom > publikationer TM,TH,TC) siden 1994 > 1324 publikationer med TM o g kroniske sygdomme > 80 systematiske reviews Fathei et al J Tel & Tcare 2012 Mange tidskrifter

6 Små studier med stor effekt i DK Sorknæs et al n=242) Dinesen 2012 n=105)

7 FAKTA KIH er et koordineret storskalaprojekt i regi af Fonden for Velfærdsteknologi FFVT). I projektet afprøves og demonstreres it- løsninger med hovedvægt pa integration mellem eksisterende it- systemer og telemedicinsk hjemmemonitorering samt andre løsninger, der understøtter patientens aktive inddragelse i eget forløb. KIH besta r af otte delprojekter: Diabetes Region Midtjylland) KOL Region Hovedstaden) Gravide med komplikationer Region Midtjylland) Gravide uden komplikationer Region Hovedstaden) Mave- tarminflammation Region Hovedstaden) Evaluering CAST/SDU og Socialstyrelsen) Teknik/standardudvikling MedCom) Programledelse MedCom) Projektet har en løbetid pa 24 ma neder og har et samlet budget pa 65 mio. med et tilskud fra Fonden for Velfærdsteknologi pa 33,4 mio. - Fakta fra Medcom

8 Klinisk integreret Hjemmemonitorering KIH)

9 Bornholm Summer 2014

10 E-CallCenter, Copenhagen Summer 2014

11 E-Citizen - Summer 2014 Medical box rescue medication e-health navigator e-health monitoring devices Health Care at your fingertip

12 Instant acces to core clinical data Real- time communication while having access to updated clinical data 3 2 1

13 On- line documentation real- time verification Communicating the network actors Citizen Aktivitetsdokument Municipality GP Pharmacy Hospital

14 Citizen centered proactive and preventive e- health

15 The Response and Coordination Center EpiCallACenter% E- Mobile Acute Team LungefunkDon%A%FEV1%% Personoplysninger% 72# FEV1% Addresse:#####Mangolian#Road#2# #######################2000#Frederiksberg# Tlf.:################+#45#39#20#34#45# Mobil:###########+#45#24#32#11#12## Tilstande% Sundhedsoplysninger%delt%med%EPITAL%SUNDHED% COPD:#2002#C#Severity:#Grade#3# Osteoporosis:#2009# Depression:#2010# # Medicin% 1.5# # # # # # 1.0# # # # # 0# FEV1% Pharmacy Dato% 20/8############################################################Sl#############################################################18/9# Min%helbredsDlstand% Min%EpiPlan% Sundhedsoplysninger%delt%med%EPITAL%SUNDHED% Symbicort#F#Tb:#2#x#1# Terbasmine#o,5#mg/dose:#2#x#1+#pn.# Spiriva#Respirmat#2.5μ/dose:#1#x#2# Salbutamol#inhaler#200μg:#2#x#2#+#pn.# # # One point of contact E- Technical Service Team Local in- bed clinic E- Clinical Service Team Citizens with chronic conditions E- Observation and home n ursing services Local rehabilitation u nits Empowerment - Network

16 A re- design of services and organisationusing telehealth technologies Stage&0& The&Epital&Care&Model&ECM)& Chronic Care Model Stage&1& ECM& &The&funnel& Stage&2& Stage&3& Stage&4& Stage&5& Healty'ci*zens'and/or'' ci*zen'with'undiagnosed6' or'unknown'chronic' condi*ons'' & Ac:ve&and&& independent&living& && ' Virtual'' assisted'living' ' Virtual'' assisted'living' with'home'care' mobile'nurses'' ' Outmi>ed ' '' Local' health' clinic'' Stage&6& Hospital'' Operational extension of the CCM Ci:zens&with&chronic&condi:ons&being&part&of&the&ECMInetwork& Mobile&ci:zen& Ci:zen&at&home& Ci:zen&out&of&home& Hospital&pa:ent&

17 Stage&0& The&Epital&Care&Model&ECM)& Stage&1& ECM& &The&funnel& Stage&2& Stage&3& Stage&4& Stage&5& Healty'ci*zens'and/or'' ci*zen'with'undiagnosed6' or'unknown'chronic' condi*ons'' & Ac:ve&and&& independent&living& && ' Virtual'' assisted'living' ' Virtual'' assisted'living' with'home'care' mobile'nurses'' ' Outmi>ed ' '' Local' health' clinic'' Stage&6& Hospital'' Ci:zens&with&chronic&condi:ons&being&part&of&the&ECMInetwork& Mobile&ci:zen& Ci:zen&at&home& Ci:zen&out&of&home& Hospital&pa:ent&

18 Borgers selvmålte lungefunktionsdata 150 målinger over 18 måneder

19 Changing the genome of healthcare Conventional paradigm Citizencentered paradigm patient diagnose disease treatment admitted Resignation of responsibility planned / controlled reactive System owned health data didactive activity volume) reimbursement sector segmented centralized Responsibility of treatment citizen pathway EPITAL' CARE' MODEL' condition monitoring / prevention outmitted empowerment available when needed proactive citizen owned health data consultant/coach value reimbursement sector neutral citizen centric Responsibility of service

20 The genome of citizen centered health care Epital Care Model genome citizen centricity The Epitope ecosystem) empowerment sector neutral proactivity citizen owned health data monitoring / prevention 1.th Epitope in the Municipality Lyngby- Taarbæk

21 Growth and proliferation of the epitopes Using the same building blocks Local Sharing solutions and ideas Abroad Rudersdal Epitope in Greenland planned) Gentofte Gladsaxe Epitope in Norway planned) Epitope in Skåne Sweden planned) 1.th Epitope

22 Conventional health care Citizen centered Health Care Conventional Health Care System

23 Epital Health - development Citizen centered Health Care Proactivity/prevention Conventional Health Care System

24 !!!!!!!! Citizen centered healthcare To be: Sygehusvæsenet Andre Selvstyrendeborger Understø3etborger1 Understø3etborger2 Styretborger Kontrolleretborger Empowerment! +!EpiCallCenter! +!Udgående!teams! Udlagt! Akut!plads! IT-!support! +!Synkron!TM! Selvbehandling! Asynkron!TM! DM2 Selvstyrendeborger Understø5etborger1 Empowerment! +!EpiCallCenter! IT-!support! +!Synkron!TM! Selvbehandling! Asynkron!TM! Understø5etborger2 Styretborger Kontrolleretborger +!Udgående!teams! Udlagt! Akut!plads! Empowerment! IT-!support! Selvbehandling! Asynkron!TM! KOL Selvstyrendeborger Understø4etborger1 +!EpiCallCenter! +!Synkron!TM! Understø4etborger2 Styretborger Kontrolleretborger +!Udgående!teams! Udlagt! Akut!plads! Understø3etborger2 Styretborger Kontrolleretborger +!Udgående!teams! Udlagt! Akut!plads! Selvstyrendeborger Understø3etborger1 Andre Empowerment! +!EpiCallCenter! IT-!support! +!Synkron!TM! Selvbehandling! Asynkron!TM! Hjerte svigt Selvstyrendeborger Empowerment! IT-!support! Selvbehandling! Asynkron!TM! Understø5etborger1 +!EpiCallCenter! +!Synkron!TM! Understø5etborger2 Styretborger Kontrolleretborger +!Udgående!teams! Udlagt! Akut!plads! Kontrolleretborger Akut!plads! Styretborger Udlagt! Understø5etborger2 +!Udgående!teams! Understø5etborger1 +!EpiCallCenter! +!Synkron!TM! Selvstyrendeborger Empowerment! IT-!support! Selvbehandling! Asynkron!TM! DM2 KOL Selvstyrendeborger Understø4etborger1 Empowerment! +!EpiCallCenter! IT-!support! +!Synkron!TM! Selvbehandling! Asynkron!TM! Understø4etborger2 Styretborger Kontrolleretborger +!Udgående!teams! Udlagt! Akut!plads! Hjerte svigt Selvstyrendeborger Understø5etborger1 Empowerment! +!EpiCallCenter! IT-!support! +!Synkron!TM! Selvbehandling! Asynkron!TM! Kontrolleretborger Akut!plads! Understø5etborger2 +!Udgående!teams! Styretborger Udlagt!

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26 Epital Care Model on TEDx Watch on YouTube: Moving Health Care to Your Fingertip