From Neurorehabilitation…

…to Active and Healthy Aging.

Boosting service innovation through ICT solutions.

Josep M Tormos, MD, PhD Research Director investigacio@guttmann.com // www.guttmn.com // www.guttmanninnova.com

From NeuroRehab to AHA Boosting service innovation through ICT solutions

An aging scenario

• Living expectancy in Europe ≈ 80 years

• Dementia and AD, Stroke and Car Accidents (TBI) within top ten etiologies related to global burden of disease:

– cognitive decline induce disability

– worsen copying strategies towards physical disabilities

• Actual model of care provision is no longer sustainable

• ICT can provide innovative solutions to promote more efficient approaches

• In spite of Dot-Com bubble ICT has induced the most revolutionary business models in the last fifteen years.

• E-Health concept

– has been object of multiple calls at all king of levels

– has capture the interest of the most important tech-companies

– has generated hundred of pilots

– but it has still limited impact in care delivery programs

Boosting service innovation through ICT solutions Quantitative and Qualitative Changes

An aging environment

• Actual model of care provision is no longer sustainable NEITHER we have an experience facing aging

• Pyramidal model of care delivery: • Most severe condition affect lower % of population • Intensity of care decay in time

- Acute vs Chronic care • Intensity of care tend to be inverse of the quantitative demand

- Changes of this trend are considered as epidemic - Problems overwhelm solutions - Innovation is needed

• Aging is a growing demand • Demand is extended and increased along time • Problem expand beyond medical care • Problem exceed social support networks

- In number - In complexity

seve

rity

population

Boosting service innovation through ICT solutions Quantitative and Qualitative Changes

An aging enviroment

• Actual model of care provision is no longer sustainable NEITHER we have an experience facing aging

• Pyramidal model of care delivery: • Most severe condition affect lower % of population • Intensity of care decay in time

- Acute vs Chronic care • Intensity of care tend to be inverse of the quantitative demand

- Changes of this trend are considered as epidemic - Problems overwhelm solutions - Innovation is needed

• Aging is a growing demand • Demand is extended and increased along time • Problem expand beyond medical care • Problem exceed social support networks

- In number - In complexity

seve

rity

population

POPULATION

From NeuroRehab to AHA Boosting service innovation through ICT solutions

An illustrative history about…

Quantitative and Qualitative changes…

• No longer than 50 years ago…

– people die just because of an spinal cord injuries

– Brain injury programs were just no necessary

– Disabilities are different condition of an small % of population

– DALY: long-lasting consequences

Problems Inspired Innovation

From NeuroRehab to AHA Boosting service innovation through ICT solutions

Can ICT offer more efficient care solutions to aging problems and make proposals for an Active and Healthy Aging?

From NeuroRehab to AHA Boosting service innovation through ICT solutions

Sustainability

From 2005

• 2.000 cognitive training

programs

– Intensive

– Personalized

– Supervised

– Fun

• > 45.000 sessions

– Monitored and evaluated

• > 350.000 exercises

– 350.000 verified therapeutic

hypothesis

Macromanagement

Models of Care Delivery

• 1.100 Institut Guttmann

• 300 Home

• 600 Hospitals, day centers, etc

Valorization Método y sistema para guiar de forma segura unas intervenciones en procedimientos cuyo substrato es la plasticidad neuronal (PCT/ES2008/000677)

Knowledge – Decision making assistance – Clinical evidence – Personalized medicine

Mesomanagement

72% of patients completing treatment improve in at least one cognitive domain

Communication technologies Collaborative environments Asynchronous interaction Interoperability

Information technologies KDD Data Mining Metha heuristics

Micromanagement

ICT based Cognitive Training Platform

From NeuroRehab to AHA Boosting service innovation through ICT solutions

Can ICT offer more efficient care solutions to aging problems and make proposals for an Active and Healthy Aging?

From NeuroRehab to AHA Boosting service innovation through ICT solutions

I would say…

- We have the experience of many hundred of successful projects (national and international)

- All the most important tech companies have identified an e-health division and have defined e-health strategies (including tele-assistance)

- Also big operators in telecommunication have done it

- There is an increasing number of .apps pushing even the question about how to regulate them

- How many patients have been assigned a care delivery program based on those pilots or those .Apps?

- How many health o care professionals are working behind those technological solutions?

From NeuroRehab to AHA Boosting service innovation through ICT solutions

Innovation… Business model…

• Med-Tech business model:

- Care-provider buys the technology

- Professional use it

- User benefit from it

• Pharmaceutical business model:

- Care-provider recognize the solution

- Professional prescribe (use) it

- User pay for and benefit from it

- Does ICT need an specific Business Model???

seve

rity

population

From NeuroRehab to AHA Boosting service innovation through ICT solutions

Innovation… Business model…

• Med-Tech business model:

- Care-provider buys the technology

- Professional use it

- User benefit from it

• Pharmaceutical business model:

- Care-provider recognize the solution

- Professional prescribe (use) it

- User pay for and benefit from it

- Does ICT need an specific Business Model???

POPULATION

seve

rity

population

From NeuroRehab to AHA Boosting service innovation through ICT solutions

What about Open Service Innovation

POPULATION

• Based on the Open Innovation model • People do not perceive the value of a technology in it self but

on the service that they take or receive from

seve

rity

population

From NeuroRehab to AHA Boosting service innovation through ICT solutions

What about Open Service Innovation

POPULATION

• Based on the Open Innovation model • People do not perceive the value of a technology in it self but

on the service that they take or receive from

•Med-Tech business model: -Care-provider buys the technology -Professional use it -User benefit from it

•Pharmaceutical business model: -Care-provider recognize the solution -Professional prescribe (use) it -User pay for and benefit from it

seve

rity

population

From NeuroRehab to AHA Boosting service innovation through ICT solutions

What about Open Service Innovation

POPULATION

• Based on the Open Innovation model • People do not perceive the value of a technology in it self but

on the service that they take or receive from • Care delivery at AHA is an immature (already existing?) market • This is a new problem, disabling and expensive • Let’s go boost innovation

Care professional Citizen

seve

rity

population

From NeuroRehab to AHA Boosting service innovation through ICT solutions

What about Open Service Innovation

POPULATION

• Based on the Open Innovation model • People do not perceive the value of a technology in it self but

on the service that they take or receive from • Care delivery at AHA is an immature (already existing?) market • This is a new problem, disabling and expensive • Let’s go boost innovation

Care professional Citizen

• Differentiate from competitors • Efficiency • Knowledge

• Co-create • Services • Contents • New technologies

Thank you very much!!!

Josep M Tormos, MD, PhD Research Director investigacio@guttmann.com // www.guttmn.com // www.guttmanninnova.com // www.gnpt.es