Evert Jan Hoijtink, Portavita.nl, pour la journée e-health 2013

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FP7-ICT-2011-7 Contract no 287841

C o l l a b o r a t i v e P r o j e c t

7th Framework Programme P r i o r i t y F P 7 - I C T- 2 0 1 1 - 7

I n f o r m a t i o n S o c i e t y Te c h n o l o g i e s Proposal No 287841

http: //www.commodity12.eu/

Sierre, June 7th, 2013 Evert Jan Hoijtink

CEO Portavita BV�

Patient oriented Integrated Care “Role of the Patient”

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Agenda

1. Short Introduction Portavita & COMMODITY12

2. Short History of Disease Management in The Netherlands Start, Finance and Issues

3. Diabetes Integrated Care Examples 1. Role of the Organization

2. Role of the patient

4. What is the added value!

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Introduction Evert Jan Hoijtink

Work

• Portavita BV – Founder & CEO

• MGRID BV – Founder & Director

• eMbrace – Founder & Vice Chairman

Functions / Standardization

• OIZ (Health IT Suppliers) – Vice Chairman (standardization)

• NEN (Dutch ISO chapter) – Policy Committee 303 Health IT

• IHE – member (Steering Committee)

• HL7 – member (RIMBAA Technical Workgroup)

• CIMI - Contributor

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1 | Introductie Portavita

• Founded 2002 by management en Agis Health Insurances;

• 48 employees;

• Software as a Service - Care Management System; • 70 medical organisations / accounted care groups:

• 380.000 patients of which ± 60.000 Self Management / Digital Patient

• 5.000 medical professionals

• ± 30 customer hits per second and 1.900 database transactions per second

• 3 countries: Netherlands, Germany and Russia;

• New in 2013: Switzerland, Poland and France;

• Treatments (Preventive & Care): Anticoagulation, Diabetes, Asthma/COPD, CVRM & Palliative;

• Individual Care Plan, Elderly care, ...

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Number of Patients NL Anticoagulation Diabetes COPD CVRM Total number of patients

Number of patients NL >380.000 (2%)

Tariff

CVRM

Start Diabetes

Self Management

Project funding

Tariff Anticoagulation

Self Management

Tariff

Diabetes & COPD

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COMMODITY12 | Consortium

IMPERIAL COLLEGE OF SCIENCE, TECHNOLOGY

AND MEDICINE United Kingdom

HAUTE ECOLE SPECIALISEE DE SUISSE OCCIDENTALE

Delemont, Switzerland

UNIVERSYTET MEDYCZNY W LODZI.

Lodz, Poland

BODYTEL EUROPE Bad Wildungen, Germany

CENTRE NATIONAL DE LA RECHERCHE CIENTIFIQUE

Paris, France

HOSPICES CANTONAUX CHUV

Lausanne, Switzerland

PORTAVITA BV Netherlands

DEUTSCHES FORSCHUNGSZENTRUM FÜR KÜNSTLICHE INTELLIGENZ

Saarbrücken, Germany

ROYAL HOLLOWAY AND BEDFORD NEW COLLEGE

United Kingdom

PORTAVITA Netherlands

Providing their leading Disease Management Module for Diabetes Mellitus I & II

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Moreover, the COMMODITY12 system will build a new level in

patient empowerment, providing the tools for self-management

support. Indirectly, this system will also help wider implementation of

Personal Health Systems, reinforcing leadership and innovation

capability of the European industry in that area.

COMMODITY12 | Vision

COMMODITY12 aims to design, build, and validate an intelligent

system for the analysis of multi-parametric medical data. It will

uptake the existing cutting-edge technologies and extend these

technologies by combining state-of-the-art networks, software

interoperation, and artificial intelligence techniques in order to realize

the concept of translational medicine by means of a Personal Health

System.

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Introduction of Integrated Care

• Start of Pilots for Diabetes in The Netherlands in 2006. 10 Care Groups ± 80.000 patients in a Government pilot

• Official Tariff since 2009;

• Currently around 90 Care Groups with Disease Management Software. Not all with Patient Self Management;

• In 2013 still lot of problems with Health Insurance companies to have it contracted;

• Health Insurance companies worry about the business case;

• Still a lot of General Practitioners do not want to work in a Disease / Integrated Care management system;

• Patients are enthusiastic;

• New Disease Management (COPD, CVRM) starts up slow.

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GP Centre

Before lack of coordination

Diabetes Treatment

Risk

Analysis

Lab

Research

Quarterly

Control

Eye

Check ....

Foot

Control

Diet

Advice

GP Centre Laboratory … Hospital

Diagnosis

Internal Medic

X Y X Z …

Communication on paper between the medical silo’s

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GP Centre

Disease oriented new Role & IT

Diabetes Treatment

Risk

Analysis

Lab

Research

Quarterly

Control

Eye

Check ....

Foot

Control

Diet

Advice


Central role: coordinating all participants in the treatment.

DMS

X Y X Z …

Central Treatment

Data. HL7

Version 3

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GP Centre

New Role(s) Patient: Self Management

Diabetes Treatment

Risk

Analysis

Lab

Research

Quarterly

Control

Eye

Check

Self

Control

Foot

Control

Diet

Advice


Patient & Medical Professional work together.

DMS

X Y X Z …

Home

DMS

Patient has her own Role in her

treatment. Access to all Treatment Data needed!

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COMMODITY Extension

Improving the current generic treatment algorithms to become more patient

specific advices using Artificial Intelligence

• Genetic Data

• Sensor / Continuous Monitoring Data

• Other Medical Data of the Patient from other sources

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What problem are we trying to solve

Cost of complications / opportunity (NL):

• 1 Feet amputation = € 45.000

• 3.000 amputations = € 135 million

• Possibility for improvement = 50% less complications = € 67 million

Source: Nitel

Source: VU, Hoornse study

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A person will use his browser and the Internet connection to log in to his “Digital Logbook” Security : Username + Password

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A person can have more than one role! He / Can be a patient or not yet a patient. Can also be patient and doctor in the same time. Can be both a Family Doctor and Anticoagulation Specialist ...

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This person uses his “Digital Logbook” for both his Diabetes Treatment and for his preventive Cardio Vascular Risk Management

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Patient can use the the “Digital Logbook” to fill in medical measurements. In COMMODITY12 we want to automate the input BUT ... still need input from the patient.

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Patient can see all the Laboratory Results and the individual Treatment Goals he / she will make with the doctor

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Patient and medical professionals all work in the same Medical Database! They therewith share the same data!

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Here an example of how we will use the HES-SO Artificial Intelligence knowledge to improve decision making!

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The system will calculate the severity and the Risk of this patient to develop a problem with the feet!

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In the overall view of the medical professional the “Treatment Advice” will be shown!

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Patient can see whether he or she has received the

treatment according to the protocol.

Patient is always informed on process!

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How to further improve the treatment

Improve the quality of medical decisions

• By having more information regarding the patient (examinations, profile, laboratory results, Genetic data, body sensor data, ...)

• By applying all medical knowledge available to the individual patient Using Agent technology and Medical Rules Engines

• Will lead to: Improved and more personalized treatment plan for patients. Implementation, use and and evaluation starting in 2013 in Lausanne and Lodz!

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Thank you very much!

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Extra Slides

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GP Centre

Issue: Other Diseases / Treatments

Diabetes Treatment

Risk

Analysis

Lab

Research

Quarterly

Control

Eye

Check

Self

Control

Foot

Control

Diet

Advice


DMS

X Y X Z …

Home

DMS

COPD / Asthma Cardio Vascular

Risk Management DMS DMS ?

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GP Centre

Vision - Individual Care Plan:

Diabetes Treatment

Risk

Analysis

Lab

Research

Quarterly

Control

Eye

Check

Self

Control

Foot

Control

Diet

Advice


DMS

X Y X Z …

Home

EHR

COPD / Asthma Cardio Vascular

Risk Management DMS DMS

Individual

Care Plan EHR

Central Patient Data.

HL7 CCD IHE

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CO

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UN

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N M

anagem

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rd (IH

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Managem

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CARE Management

(Process)

DATA Store Data Warehouse

Treatment Rules

Workflow Authorization

HL7 V3 RIM

ATNA

EUA

BPPC

XDS

PIX

Business Intelligence

eHealth in the Box – ECO System

User Access

Data Management

Snomed CT

XD

S

larg

e

Billing Auditing

Medical Knowledge

Producing Medical

Knowledge

Medical Treatment

Administrative Data

Examination Data

Laboratory Data

Genetics Data

Sensor Data

... ...

RFD

XDW

CT

XUA

Evert Jan Hoijtink, Portavita.nl, pour la journée e-health 2013

Technology

Transcript of Evert Jan Hoijtink, Portavita.nl, pour la journée e-health 2013