NextGen 2011 Workshop Stephen Hope DOCOBO

NextGen Telehealth Improving Outcomes for Pa4ents in

the Community

Stephen Hope Business Development Manager Docobo Ltd [email protected]

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Copyright © Docobo Limited Not to be reproduced without permission

Docobo Company •  UK company formed in 2001

–  To commercialise output from an EU R&D project –  Designed and developed by us – not a distributor (we control the IP) –  Customised to specific needs (e.g. Philips) –  High level of local, technical and customer support –  Focused on eHealth technologies to enable Care in the Community

•  Regulatory Status -‐ A medical device and solu4ons company (accredited to EN13485) –  doc@HOME Telehealth System is a Class I medical device, HealthHUB and

CarePortal are Class IIa –  TGA approval for use in Australia and NZ –  Docobo is NHS N3 (Intranet) approved – as such meet s Informa4on Governance

requirements to hold pa4ent data

•  NHS Procurement – Buying Solu4ons Framework •  40+ UK PCT’s using doc@HOME •  Interna4onal – Portugal (original pilot), Australia, New Zealand, others early

stage (Brazil, India, China, Mauri4us, Bahamas)

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Enabling Technologies suppor4ng care in the Community

•  Telehealth – Managing pa4ents – doc@HOME® –  Self management

–  Professional care assisted by technology

•  Assisted Living – Managing the elderly and vulnerable -‐ CarePortal® –  Social isola4on, fragmented families, digital divide

–  Alpha Daughter/son responsibili4es –  Access to support and wider world

•  Care delivery logis4cs – Managing Staff -‐ ComCare –  Staff self management

–  Make every interven4on count

–  Performance management

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TELEHEALTH

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Telehealth

•  Remotely monitoring vital signs and lifestyle of pa4ents on a regular basis and as frequently as the pa4ent’s condi4on requires

•  Passing and sharing this informa4on to appropriate clinicians to allow early interven4on; on going management of pa4ents

•  Improving outcomes

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doc@HOME® Telehealth System Overview

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Ques4ons on doc@HOME •  Ques4on 4mings (programmable)

–  Ques4ons can be asked in fixed 4me periods, e.g: •  morning ques4ons, say 06.00 – 12.00 •  alernoon/evening ques4ons, say 16.00 – 22.00 •  carer ques4ons, say 22.30 – 23.30

–  Ques4ons can be asked “Any4me” •  To capture events

•  Ques4ons are fully programmable –  Default ques4ons

•  Docobo will work with SAHS to define –  Ques4ons selected for individual pa4ents

•  Enabling management of whole person

•  Ques4ons can be added and customised –  Mul4ple ques4ons types (not just YES/NO)

•  Mul4ple choice •  Numeric entry •  Nested •  Numeric scale •  Test Scale •  Prompt

–  Fixed ques4on types •  BP, Sp02, Peak flow, ECG, etc

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00:00 6.00 12.00 16:00 22:00 23:50

Morning Evening

Carer


Viewing the clinical database

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Viewing pa9ent specific data

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Self Management -‐ 4 week feedback display

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NHS Direct study -‐ South East Essex •  999 calls – the average number of 999 calls made per

month by the pa4ents whist using the Telehealth service reduced by 72%.

•  GP visits – the average number of visits made by the pa4ents per month to their GP whilst using the Telehealth service reduced by 56%.

•  A&E visits – the average number of visits made per month to A&E by the pa4ents whilst using Telehealth reduced by 75%

•  Hospital admissions – the average number of hospital admission per month for the pa9ents reduced by 83%

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NEXT GENERATION TELEHEALTH AND ASSISTED LIVING

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Addressing all Levels of LTC Triangle for Maximum Impact

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Level 3: Highly complex patients As people develop more than one chronic condition (co-morbidities), their care becomes disproportionately more complex and difficult for them, or the health and social care system, to manage. This calls for case management – with a key worker (often a nurse) actively managing and joining up care for these Level 2: High risk patients Disease/care management, in which multidisciplinary teams provide high quality evidence based care to patients, is appropriate for the majority of people at this level. This means proactive management of care, following agreed protocols and pathways for managing specific diseases. It is underpinned by good information systems – patient registries, care planning, shared electronic health records.

Level 1:70-80% of CDM Population With the right support many people can learn to be active participants in their own care, living with and managing their conditions. This can help them to prevent complications, slow down deterioration, and avoid getting further conditions. The majority of people with chronic conditions fall into this category – so even small improvements can have a huge impact.


Enhanced doc@HOME® Infrastructure Overview

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Pa4ent & Care Giver • Elderly • Poorly • Symptoma4c

• IT Literate • Mild LTC’s Ø Diabetes II Ø Asthma

Case Management Wellness

Email / SMS with URL

GPRS, 3G Broadband

CarePortal® HealthHUB®

GPRS, POTS

GPRS, 3G Broadband

Tablet Apps

Web Services

3rd Party Analy4cs

3rd Party eHealth vendors

• Call Centres • Clinical Teams

Web Applica4on

Browser • Case Co-ordinators • Clinical Teams

• Tailored to needs of patient. • Self Management • Medication management

Prompts and ques4ons etc

Scheduling Engine

Clinical Database

doc@HOME®

Telehealth Service Provisioning


Clinicians View

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CAREPORTAL® – Solu4on for Assisted Living •  CAREPORTAL® is a solu4on consis4ng

of bespoke Docobo designed hardware and an open source solware platorm

•  Designed to be able to give an older or less technically capable user access to social networks and services

•  The product is likely to be purchased / rented by a carer for the user.

•  The purchaser will typically be child, rela4ve or partner who wants to opens access to a virtual world

•  Sold through mobile retail outlets and other community organisa4ons

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CAREPORTAL® is a Class IIa Medical Device Platorm


Telehealth Services

doc@HOME®

Other Health IT Systems

Web Browser Clinical

Teams eNABLE™ Service Provisioning Telehealth Service Provisioning

ClientPa4ent & Care Giver • Elderly • Poorly • Symptoma4c

• IT Literate • Mild LTC’s Ø Diabetes II Ø Asthma

Case Management Wellness

Docobo Independence Infrastructure Overview

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3rd Party Services

Delivered Meals Other

GPRS, 3G Broadband

Tablet Apps Email / SMS with URL

HealthHUB®

GPRS, POTS

Social Contact

Peer to Peer groups

Family Web access •  Diary •  Photos

BeTogether™

Community access

Assistance Services

Community groups: •  3rd sector •  Local volunteer •  Private providers

Community Assist

Web Browser

concierge@HOME™

Environmental Controls Interface

GPRS, 3G Broadband

Loca4on Services

CarePortal®


Interoperable Solu4ons for Assisted Living

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Tynetec Ac4vity Trend Analysis

IP based connec4vity

ADL Alerts

Docobo, Tynetec and JonTek bring you: • Interoperability • Use of legacy kit • UK innova4on • New business models

NEXT GENERATION COMMUNICATIONS

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Future Connected Care

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care profs

Friends and family

Tele-‐carer

Care response service

Emergency services

NHS Direct

Care professionals

Care Portal

Elderly living independently

Records

•  NHS

•  Social Care

•  Housing

•  Personal Health Record

Telehe

alth

Telecare

Home au

toma9

on

Cholesterol monitor

Blood-‐ pressure cuff

Pedometer

Glucose meter

Sensor networks

Medica4on tracking

Lights Doors / Windows Mo4on / Ac4vity Bed Kitchen Bathroom

Service Hub

CRITICAL COMMUNICATION REQUIREMENTS

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Next Genera4on Telehealth Communica4on Requirements •  Mobility -‐ Seamless to The User

–  Seamless Mobility vs Service Discovery

•  Emergency Buwon priority across any network technology •  Minimised delay

–  Real-‐4me duplex communica4on –  Video call

•  Loca4on aware –  Posi4on – seamless service mobility from outdoor to indoor loca4on techniques

•  Reliable Connec4on across any Network type to Assistance Centre •  Secure Data Connec4on across mul4ple networks

–  Full data protec4on for Vulnerable Adults and Children –  NHS N3 Security approvals

•  Separa4on of Telehealth, Telecare and Public Domains •  Security -‐ password and enrolment -‐ encryp4on •  QoS, Priority and Pre-‐Emp4on across any Network type •  Mul9ple Cri9cal Uplink Services on Asymmetric NG Technologies

biased towards downlink

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THE FUTURE ASSISTED LIVING BUSINESS MODEL

Implemen4ng the personal budget/ private pay integrated model

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The Personal Budget/Private Pay Model •  Statutory and Elec4ve e-‐Health Services combined •  More choice to the individual •  Allows rela4ves to purchase services •  BUT WHO

–  Recommends –  Monitors –  Supplies Equipment and Services –  Supplies Communica4ons Packages –  Bills

•  WHO PAYS and HOW •  Companies will now need to address the Personal Consumer Domain as well as the Enterprise Domain

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TELECARE Services CHUBB AGEUK SCPCT DOCOBO

Community Services AGEUK, SCPCT

HDLHB GLENSIDE

The Future Personal Budget/Private Pay Business Model Framework

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BT O2

TELEHEALTH Services DOCOBO

Content Provider Content Provider Content Provider

AGEUK

Terminal Supplier Terminal

Supplier Terminal Supplier

User

Programmes, News Games Shopping Videos, Music Web Page Adverts

HealthHUB, Wrist Unit, Handsets

PDAs

People,+ Equipment

Health Care Services

SCPCT HDLHB GLENSIDE

Telehealth Service Roaming

Prime Assisted Living Service Provider DOCOBO

Arrows represent Flow of Money

Communica9ons Providers and Retail Outlets

Interac9ve Content Provider

DOCOBO GUIDANCE, HWC etc

FINALLY

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What did Stan tell us? •  Produc4vity / Efficiency / Burden

reduc4on –  The nurse has reduced the number of

visits per week by 4 enabling her to visit other needy pa4ents

–  Stan is empowered – no longer anxious – reduced calls on Health Service

•  Climate / Environmental –  Reduc4on in unnecessary home / clinic

visit

•  Pa4ent experience –  He’s doing it from his lounge

in his usual chair –  He has become an expert

pa4ent; knowing when vital signs are high

–  He is confident and able to live in his own home with his wife

–  His wife’s quality of life has improved

–  He’s no longer grumpy!

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[Note: Stan was the subject of an independent BBC Video]

Summary •  Telehealth can significantly improve the quality of life of pa4ents with Long Term Condi4ons

•  Pa4ent Selec4on is key •  Next Genera4on Communica4ons will enable Next Genera4on Assisted Living Services

•  But Who Pays for Them and How is yet to be determined

•  Above all Next Genera@on Networks need to be engineered to ensure that my Heart ADack alert is not obstructed by someone else watching Eastenders on HD IPTV

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Thank You

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Docobo Limited The Old Granary 21 High Street Great Bookham Leatherhead Surrey KT23 4AA

Tel: +44 (0)1372 459 866 [email protected]

NextGen 2011 Workshop Stephen Hope DOCOBO

Health & Medicine

Transcript of NextGen 2011 Workshop Stephen Hope DOCOBO