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Connected Health Leadership Summit - 2009
Telemedicine/ Telehealth
Engagement
Dr. Sascha Henke, Bosch HCTM
Connected Health Leadership Summit - 2009
1. Situation / 2. Motivation
• Communication of EU Commission on Benefits of
Telemedicine for EU citizens (11/2008)
• Statement Ilias Iakovidis, January 13th, 2009:
“In 2009 our priorities are interoperability and telemedicine”,
“Personal health systems have become a priority area“,
“Current economic crisis could offer a huge opportunity to
invest in e-health to stimulate jobs and economic growth“.
(„Health is wealth“)
E-Health Europe
Connected Health Leadership Summit - 2009
2. Motivation
What can we expect from Telemedicine (benefits) ?
Interactive flexible RPM solutions support individuals with chronic conditions, by telehealth and clinical-intelligence for physicians and nurses to make directed interventions.
Fill a gap in the continuum of care
• Early detection of exacerbations / impairment of health
• Efficient, exception-based, individualized interventions
• Patient empowerment, education, behaviour change, motivation
->
• Reduced Hospitalizations + Improved Quality of Life
Connected Health Leadership Summit - 2009
2. Motivation
What can we expect from Telemedicine Industry ?
Technology `Invented for life`, which means
… reliable technology, designed to last
… technology that accompanies people for a good part of their lives
… intelligent, innovative and beneficial technology to help make peoples lives easier and more enjoyable
Connected Health Leadership Summit - 2009
End-to-End Solution to provide a holistic Model of Care
System technology based on well established Appliance User friendly appliance base station and peripheral biometric devices, Clinical content designed to patient condition(s), Patient management software and secure IT/data infrastructure.
Implementation and management support provided by TM suppliers Organisational support to build, integrate and operate clinical workflows, Management reporting and clinical trials/health economic outcomes.
TM regions: Local services provided by local partners 1st level technical and clinical triage, patient home installation, training and refurbishment.
Patient empowerment
Effective clinical
intervention
Connected Health Leadership Summit - 2009
System View
Connected Health Leadership Summit - 2009
Patient empowerment by helping to understand their Illness and motivate Change in Behaviour
Knowledge
Behaviour
Symptoms
Knowledge
Behaviour
Symptoms
Knowledge
Behaviour
Symptoms
‘The start’: Understand health risk Identify potential problems and address causes
(including co-morbidities and psycho-social factors)
‘The training’: Strengthen behavioural change
Identify change in health status
Connected Health Leadership Summit - 2009
Consistent and unparalleled Results
High Patient
Acceptance
Improved Clinical
Outcomes
Reduced Health Care
Cost
New four-year VA study shows 19% drop in admissions, 25% decrease in bed days with population of >17,000
University of Colorado COPD study with Kaiser shows decreased symptoms, increased exercise tolerance, and decreased smoking rates, and was associated with decreased mortality
Long-term unpublished controlled study shows continuously dropping health care costs:Quarter 10 of study showing 32% drop in costs on intent-to-treat basis
85% of patients in VA are using the Appliance daily 90% recommend use of System
Connected Health Leadership Summit - 2009
Consistent and unparalleled ResultsCondition # of
Patients% Decrease
Utilization
Diabetes 8,954 20.4
Hypertension 7,447 30.3
CHF 4,089 25.9
COPD 1,963 20.7
PTSD(Post Traumatic Stress Disorder) 129 45.1
Depression 337 56.4
Mental Health, other 653 40.9
Single Condition 10,885 24.8
Multiple Conditions 6,140 26.0Dr Darkins et al, 2008
Connected Health Leadership Summit - 2009
Goal: Telehealth Applications all across the Continuum
Fit
& h
ealt
hy
Critica
lly ill
Guided training (depends on fitness level)
Instruction on health- conscious behavior
Motivation and instructionon active, healthy lifestyle
Monitoring of symptoms and self-assessment
Acute state monitoring and emergency interventions
Wellness At RiskChronic
ConditionsHigh-Risk /Complex
Future Today
Health management for individuals at any location, at any time from multiple sources
Connected Health Leadership Summit - 2009
3. Action
Challenges in RPM calling for action:
• Reimbursement
• Recognized IT/ interoperability standards (⇒ scaling)
• Acceptance (physicians and patients; medical content; usability)
• Integrated end2end Solutions (industry cooperation with medical/ political)
Cross EU – regions activities/comittees
Connected Health Leadership Summit - 2009
Project Group Engagement:
Actions to facilitate market growth and CH acceptance and
Ensuring that development informed by feedback from all stakeholders.
• Definition of CH,
• Identification / systematic categorisation of CH applications (use
cases)
• To what extent do European and US markets differ ?
• Does this limit the value of knowledge transfer or other forms of
information/experience exchanges?
• Analysis of benefits/risks from CH by stakeholder groups
(Customers, Payors, Users, Provider and Policy makers).
Connected Health Leadership Summit - 2009
Group Engagement
• Key adoption barriers:
• Identification:
• Scientific and pragmatic evidence of clinical outcomes.
• CHF policy and reimbursement schemes, effective business models
and service models
• Are there potential acceptance roadblocks/issues that will restrict the
growth of CH – and if so what areas and how might these be
overcome?
Connected Health Leadership Summit - 2009
• Key adoption Barriers
• Development of key measures to overcome adoption barriers:
• Which stakeholder groups (e.g. Individuals, communities,
healthcare professionals, policy developers), most require CH
awareness, education.
• Does CH need cohesive and systematic media management ?
• How are products tested and accredited for usability and do we
anticipate that user acceptance will be linked to European,
national and/or local approvals?
• Is sufficient investment being made in human factors research,
• What techniques can be adopted to reduce product design
failures?
Connected Health Leadership Summit - 2009
Group Engagement
• Key adoption Barriers
• Idenfication of accepted benefits and ways to use those to
strenghten
CH use
• To what extent can user/stakeholder demand for CH capabilities
drive public policy development?
• Do we have evidence/examples of good CH dialogue practice,
examples of effective CH ecosystems, and
CH empowered communities?
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