eHealth-enabledInnovative Care Model

Marc Lange, Secretary General

eHealth Seminar of COFACE 219 April 2012

European Health TELematics

A cross-(any)border and multidisciplinary collaboration forum

Sustainable and large scale eHealth deployment

requires engagement and synergies

eHealth Seminar of COFACE 3

Some of our Publications

19 April 2012

Soon

Empowering the Citizens

Ethics and eHealth

Deploying eHealth and Telemedicine

Policy lessons learned

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Our platform enables an overview

5eHealth Seminar of COFACE

The Landscape: an Ageing Europe

Why eHealth?

Enabling the transformation of health care systemsTo better answer to the demand for

• Quality and Patient Safety

• Equitable and Improved Access• Cost Containment

While the demand is rising up because of• Ageing population, chronic diseases• Rising health care expenditures• Shortage of health professionals

19 April 2012

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The Landscape (...)

Why eHealth

Council Conclusions on Safe and efficient healthcare through eHealth (December 1st, 2009)

[...]7. RECOGNISES the importance of eHealth as a tool to

improve quality and patient safety, to modernise national healthcare systems, to increase their effectiveness and make them more accessible to all and better adapted to meet the individual needs of patients, health professionals and the challenges of an ageing society;

8. [...]

19 April 2012

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Changing the care process

Does it work?Data from a recent study by Gartner for the

Swedish Presidency of the EU determined that through the use of Telemedicine and Home Health Monitoring, 5.6 million admissions to hospitals for chronically ill patients could be avoided collectively in six member states that were analysed (Czech Republic, France, the Netherlands, Sweden, Spain and the United Kingdom)

Study: eHealth for an Healthier Europe! http://www.sweden.gov.se/sb/d/574/a/129815

19 April 2012

8eHealth Seminar of COFACE 19 April 2012

Telemedicine servicesQ

ualit

y o

f Li

fe

€10,000€1,000€100€10€1Adapted from Intel

Specialty Clinic

Community Hospital

ICU

Acute Care

Assisted Living

Skilled Nursing Facility

Residential Care

Independent, Healthy Living

Community Clinic

Chronic DiseaseManagement

Doctor’s Office

Tele-homecare

Innovative Care Models

Pilot siteType of service Pathology Veneto Southern

Denmark Norrbotten NorthernNorway Catalonia South

Karelia Thessaly Carinthia Berlin

Cluster 1Medium-term health coaching and life-long monitoring

Diabetes SEE MORE SEE MORE SEE MORE SEE MORE

Cluster 2Life-long monitoring

Diabetes SEE MORE SEE MORE

Cluster 3Ulcer monitoring

Diabetes SEE MORE

Cluster 4Short-term follow up after hospital discharge

COPD SEE MORE SEE MORE SEE MORE

Cluster 5Life-long monitoring

COPD SEE MORE SEE MORE SEE MORE

Cluster 6Medium-term health coaching and life-long monitoring

CVD SEE MORE SEE MORE

Cluster 7Remote monitoring of Congestive Heart Failure

CVD SEE MORE SEE MORE

Cluster 8Remote monitoring of implantable cardiac devices (ICD & PM)

CVD SEE MORE

19 April 2012 eHealth Seminar of COFACE

• 16 services under multidisciplinary scientific trials

9

Some practical examples

• Visit at home– Tele-monitoring to support patients with COPD

(Veneto Region, Italy)– Tele-Ulcer care (Southern Denmark)

• Remote monitoring– COPD Home Monitoring (Southern Denmark)– eHealth and eWelfare in South Karelia (Finland)

• Tele-Health Coaching– The Diabetes Health Motivation Service (North of

Norway)

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Visit at home for COPD (IT)

Synchronization

Synchronization

Ambulatorio AD

Web based software

AD Manager

Client-server application19 April 2012 eHealth Seminar of COFACE 11

Tele-Ulcer care (DK)

• By means of tele-care, the visiting homecare nurse is able to communicate with a physician/medical specialist at the hospital, transfer images by use of a cell phone with camera and share notes and information in a shared care ulcer database.

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Admission Installation Equipment Consultation

• ”Digitalization” of ” the nurse - consultations led by specialized nurses

• Vital sign data uploaded to hospital directly from measurement devices (separate system)

• Close collaboration with homecare staff

Home Monitoring for COPD (DK)

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Diabetes DiaryThe Few Touch Application (NO)

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Innovative Care Models

Pilot siteType of service Pathology Veneto Southern

Denmark Norrbotten NorthernNorway Catalonia South

Karelia Thessaly Carinthia Berlin

Cluster 1Medium-term health coaching and life-long monitoring

Diabetes SEE MORE SEE MORE SEE MORE SEE MORE

Cluster 2Life-long monitoring

Diabetes SEE MORE SEE MORE

Cluster 3Ulcer monitoring

Diabetes SEE MORE

Cluster 4Short-term follow up after hospital discharge

COPD SEE MORE SEE MORE SEE MORE

Cluster 5Life-long monitoring

COPD SEE MORE SEE MORE SEE MORE

Cluster 6Medium-term health coaching and life-long monitoring

CVD SEE MORE SEE MORE

Cluster 7Remote monitoring of Congestive Heart Failure

CVD SEE MORE SEE MORE

Cluster 8Remote monitoring of implantable cardiac devices (ICD & PM)

CVD SEE MORE

19 April 2012 eHealth Seminar of COFACE

• 16 services under multidisciplinary scientific trials

15

Some practical examples

• Visit at home– Tele-monitoring to support patients with COPD

(Veneto Region, Italy)– Tele-Ulcer care (Southern Denmark)

• Remote monitoring– COPD Home Monitoring (Southern Denmark)– eHealth and eWelfare in South Karelia (Finland)

• Tele-Health Coaching– The Diabetes Health Motivation Service (North of

Norway)

19 April 2012 eHealth Seminar of COFACE 16

Visit at home for COPD (IT)

Synchronization

Synchronization

Ambulatorio AD

Web based software

AD Manager

Client-server application19 April 2012 eHealth Seminar of COFACE 17

Tele-Ulcer care (DK)

• By means of tele-care, the visiting homecare nurse is able to communicate with a physician/medical specialist at the hospital, transfer images by use of a cell phone with camera and share notes and information in a shared care ulcer database.

19 April 2012 eHealth Seminar of COFACE 18

Admission Installation Equipment Consultation

• ”Digitalization” of ” the nurse - consultations led by specialized nurses

• Vital sign data uploaded to hospital directly from measurement devices (separate system)

• Close collaboration with homecare staff

Home Monitoring for COPD (DK)

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Diabetes DiaryThe Few Touch Application (NO)

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eHealth Seminar of COFACE

Integrating health and social care• Social alarms and other

social services• Telemonitoring systems for

patients with COPD

Integrated eCare in Milton-Keynes (UK)

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Results – End User Perspective SF-12

• decline in physical functioning (PCS) • increase in mental functioning (MCS) over the trial.• significant gender differences in PCS + MCS

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Snapshot on evaluation

89 people completed the client exit questionnaire on user satisfaction.

Positive benefits• 79% said they had experienced major benefits.• 17% said they had experienced minor benefits • 3% said they had not experienced any benefits

Benefits identified by service users included:• ‘increased control/self-management’ • ‘family reassured’ • ‘having readings to give to the GP’ • ‘GP attendance reduced’ • ‘gets me out of bed’

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eHealth Seminar of COFACE

Heart failure patient

Telephone

telecare

telehealth

GP post GP/Nurse

Medical and social questions

Alerts (e.g. falls)

Daily telemonitoring of weight, BP and health status

Communication with GP office

Integrated eCare in Veldhoven (NL)

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The pilot - Quotes

Patient:

“Before this project I had heart rhythm problems. Since I joined this project, I feel safe and do not experience these problems anymore.”

Informal carers of a patient:

“It reduces the workload for us, because we feel more secure about the safety of our father. There are no disadvantages for us, and for our father.”

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Trikala’s INDEPENDENT Schema (GR)

ICT in support of informal carer

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IP Video Phone IP Video Phone

Electronic Health Record

Electronic Health Record

Telecare centerTelecare center KAPI centerKAPI center

Relative’s homeRelative’s homePatient’s homePatient’s home

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Hospital monitoring nurse

Social carer (onsite)

Client

record

Documents delivered care

Indicates need for unplanned care

Assisted person

Service

repository

Relative

Searches/books services

Updates on delivered care

Hull (UK): The shared living solution

Email messages

Email /telephone

telephone

Community nurse/GP

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Thank you for your attention

More at• www.ehtel.eu• www.renewinghealth.eu• www.commonwell.eu• www.independent-project.eu

Marc LangeSecretary general

EHTEL AssociationM.E.P.S. 50, rue d’ArlonB-1000 Brussels BelgiumTel: +32 (0)2 230 15 34Fax: +32 (0)2 230 84 40Mobile: +32 (0)475 27 71 45Marc.Lange@ehtel.orgwww.ehtel.org

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