CASA 3 December 2014 Claus Duedal Pedersen Chief Innovation Officer Odense University Hospital cdp@rsyd.dk.
OUH - A National Centre for Health Care 1 of 3 major national health care centres Covers approximately 1.6 million citizens Highly specialised - Covers all surgical and medical areas in 50 clinical departments Approx. 10,000 employees; 1,400 doctors and 3,900 nursing and care personnel. The operating budget is approx. 790 million a year (2012). Approximately 93,000 patients are hospitalised at OUH every year. OUH has 1100 beds, and hospitalised patients spend an average of 3.8 days in hospital.
No. of. Being digital isn't going to magically solve the problem Burning platform Treatment options Chronic conditions Elderly Citiziens Demands on therapy Health professionals Public financing Time
Nye hospitaler nye udfordringer, måske særligt for kommunerne?
The innovation & documentation process Publications Center for Innovative Medical Technology Ensuring knowledge at all levels
Er teknologien klar? Adgang til data Kommunikation mellem parterne Kommunikation med borgerne 6
SmartCare SmartCare focuses on integrated care delivery. More than 20 European regions and over 40 partners participate in SmartCare. The Region of Southern Denmark is contributing to the SmartCare project with its Shared Cared platform that ensures a standardised treatment plan for a specific patient group. The Shared Care platform ensures a cross-sectorial collaboration between the municipality, the general practitioners and the hospital.
From this scenario Tele-interpretation to this
Telemedicine for Diabetic Foot ulcers 2006 pilot study 2009 National evaluation program Regional (and now national) decision to implement PhD project, clinical trial with 400 patients (381) Results expected in 2015
Combining health, industry and science: COPD Briefcase 2005: Clinical problem: Better treatment options for COPD patients 2006: OUH and GiTS collaborate to develop a mobile solution to offer monitoring in own home after discharge. End product: A 'briefcase' with only three buttons; Power, Connect and Volume: 2007-2009: Pilot project: Patients and staff reported satisfaction, initial evaluation was good. 2010-2013: To obtain solid documentation of the service, it was rolled out on small scale and included in a large European research project and a PhD project (incl. Randomised Control Trial). 2012: The service is implemented in the daily operations at OUH for the benefit of patients and staff. 2013: Expansion in use of briefcase: COPD rehabilitation (live demo later), heart patients, other areas
OUH Find Vej Pilot med Direktionen og Woerk Udfordring: Op mod 20% af patienterne udebliver eller kommer for sent til deres behandling. En af grundene er at det er svært at finde vej på OUH og Svendborg Sygehus. Løsning: OUH Find Vej har en indbygget skanner og via indkaldelsesbrevene skanner man QR kode og enten downloades OUH Find Vej eller hvis den er installeret i forvejen viser appen vej til den rigtige indgang. I søgefunktionen kan afdelinger og indgange nemt findes.
Etablering af viden Resultater Processer
Documenting ehealth services MAST Model for ASsesment of Telemedicine 1. Health problem + technology 2. Safety 3. Clinical effectiveness 4. Patient perspectives 5. Economic aspects 6. Organisational aspects 7. Socio-cultural, ethical, legal aspects http://www.mast-model.info/ Health care as a discipline is based on scientific evidence!
Næste skridt Etablering af en Europæisk forening MAST EEIG Udvidelse af modellen til at omfatte andre områder Integrated care Telepsykiatri Predictive modeling
Processer MOMENTUM projektet har set på succeser og fiaskoer af implementeringer af telemedicinske projekter i EU Stor spørgeskemaundersøgelse med projekter fra hele EU Workshops med implementeringsfolk Arbejdsgrupper med eksperter
MOMENTUM: Critical Success Factors (1) Assure that there is a cultural readiness for the telemedicine service Ensure leadership through a champion Coming to a consensus on the advantages of telemedicine in meeting compelling need(s) Pull together the resources needed for deployment Address the needs of the primary client(s) Involve healthcare professionals and decision-makers Prepare and implement a business plan Prepare and implement a change management plan Put the patient at the centre of the service
MOMENTUM: Critical Success Factors (2) Assess the conditions under which the service is legal. Identify and apply relevant legal and security guidelines. Involve legal and security experts Ensure that telemedicine doers and users are "privacy aware" Ensure that appropriate information technology infrastructure and ehealth infrastructure are available Ensure that technology is user-friendly Put in place the technology and processes needed to monitor the service Maintain good procurement processes Guarantee technology has the potential for scale-up
Introduction to the TREAT tool The TREAT assessment is based on the key assumption that telemedicine solutions provide value for citizens, providers, and payers: They improve access to services They reduce costs They improve quality
Components of the TREAT tool
The online TREAT tool Pre-formatted questionnaire, 3-5 questions per concept Each section contains questions on baseline issues necessary for a telemedicine service, and a section on existing desirable tools which could be leveraged to develop a telemedicine programme in situations where the baseline is poorly developed In the online tool, each question is answered on a simple 1-5 scale where 1 = do not agree and 5 = fully agree
Adapting the TREAT tool for MOMENTUM
mhealth
App Acute Pilot med Afd D, Afd V, Afd H & Woerk Klinisk udfordring: Ved akut kejsersnit skal barnet være forløst indenfor 15 min ved akut sectio grad 1 og 30 min ved sectio grad 2. I dag ringer overlægen 7-9 numre for at melde kejsersnittet, hvorefter patienten transporteres fra 3. til 1. sal. Løsning: Via push notificeres alle klinikere og de accepterer kaldet, hvorefter den koordinerende jordemor via en ipad kan se hvem der har meldt tilbage og herefter vælges stue. Det er muligt at scanne patientens armbånd og indtale memoer alle kan høre inden indgrebet.
Mit Forløb App - Hæmatologisk Kræft App Pilot med Afd X og MedWare Udfordring: Vægt, temperatur, værdier af hvide og røde blodlegemer, blodplader, CRP værdier er altafgørende for patienterne på Afd X og der mangler et redskab til monotorering af disse data. Løsning: Patienter kan selv notere data i appen og medbringe dem til undersøgelser.
Mit Forløb App - Mig & Min Baby Pilot med Afd D2 Svendborg, Afd D2 og MedWare Udfordring: Efter fødslen føler mange forældre usikkerhed om hvad de skal gøre i forskellige situationer. Derfor kontakter de personalet hvilket er meget resoursekrævende. Løsning: Via log-in kan patienten chatte, sende billeder og video af situationen de ønsker vejledning omkring. Personalet får besked via deres app og kan hver 4 time svare fra backenden og korrespondencen sendes via ONBASE til COSMIC. Der er 30 videoklip og 30 flyers, som guider patienter.
Mit Forløb App - Gynækologisk Kræft App Pilot med Afd D6 og MedWare Udfordring: Gynækologiske kræftpatienter efterspørger digital information og de ønsker at have mulighed for at chatte med afdelingen. Løsning: Via log-in kan patienten chatte, sende billeder og video. Personalet får besked via deres app og kan hver 4. time svare fra backenden og korrespondencen sendes via ONBASE til COSMIC. Der er relevante pjecer og artikler patienten nemt kan navigere mellem.
Sociale medier
Patientfælleskaber
Hvor er vi på vej hen? Psykiatriområdet Den fællespatienter Personaliseret medicin
MasterMind in a nutshell Target population Adults suffering from mild, medium or severe depression Both inpatients and outpatients Two different services ccbt Collaborative care facilitated by videoconference Blended care and stepped approach to treatment
OBJECTIVES Upscaling the ICT-based mental health care services (in regions/countries where these have been already successfully piloted) Triggering the uptake of the services (in regions/countries new to ICT-based mental health care services) Demonstrating the cost-effectiveness of the services (confirming that the clinical outcome obtained through the services is not inferior to that of traditional care and checking their usability) Reducing the waiting lists for access to mental health care
Partners & pilots Country 1 st wave ccbt 2 nd wave ccbt Video conference (collaborative care) Regions/partners Denmark X X RSD Scotland X NHS24 Netherlands X X GG ingeest VU University Amsterdam Germany X X Schoen Clinic Friedrich-Alexander University Norway X X Norwegian Centre for Integrated Care and Telemedicine Wales X X Powys Health Board Institute of Rural Health Spain Italy X X X X X X X X X X X X Aragon (Servicio Aragones de Salud) Basque Country (Kronikgune & Osakidetza) BSA (Badalona Serveis Assistencials SA) Galicia (Servizo Galego de Saúde SERGAS) Veneto (U.L.S.S. 9) CSI Piemonte Azienda Sanitaria Locale Torino 3 Turkey X Middle East Technical University (METU) Estonia X Tallinn University of Technology Greenland X Agency for Health and Prevention Total 5 9 12
Video conference Collaboration with other sectors Discharge conferences Specialist consultations to GPs
Personaliseret medicin
Reklame
Innoevent themes Participating Institutions: Lillebaelt Academy of Professional Higher Education, Odense University Hospital From 2012 also University College Lillebælt 2010: Communikation with patients 2011: Games in the hospital ( Gamification) 2012: Patient safety 2013: New OUH 2014: New OUH
Young innovatorers
If this is possible - anything is!