On telemedicine …. Dr Hans C. Ossebaard Pre-conference Symposium ‘The Tele-Health Revolution’ 43rd KMA Annual Scientific Conference Eldoret, Kenya; 23rd-26th

on telemedicine ….

Dr Hans C. Ossebaard

Pre-conference Symposium ‘The Tele-Health Revolution’

43rd KMA Annual Scientific Conference

Eldoret, Kenya; 23rd-26th April, 2015

Klik op het pictogram als u een afbeelding wilt toevoegen

2

222 30 november 2012

The Netherlands


3


Dutch Health Care Institute

Health Care Quality Institute (Diemen/Amsterdam)

1.To promote the development of quality standards, like guidelines;

2.To stimulate the implementation of these quality standards;

3.To collect and publish information on quality of care.

1.To promote the development of quality

standards, like guidelines;

2.To stimulate the implementation of these quality

standards;

3.To collect and publish information on quality of

care.


4


Center for eHealth Research and Disease management

eHealth Research

5

Does it work?-usage-usability and persuasiveness-adherence

Does it help?-health outcomes

Does it pay?-cost-effectiveness

Three issues

www.utwente.nl/igs/ehealth/

Information and communication revolution

cheap ubiquitous

participative many-to-many

real time

6


&c.

health, healthcare and biomedical research

What is eHealth?


7


“eHealth is the use of new information and communicationtechnologies (mobile, internet) to support or improve health and health care”

mHealth, tele-health, telemedicine, consumer health informatics, tele-care, Health 2.0, Medicine 2.0 &c.

What is Telemedicine?


*Time/place independant

8

DD

DP

PP

PSys

What is Telemedicine?


Telemedicine: the professional side of eHealth

Main issues:

- faster- better- cheaper

9


https://www.google.nl/imgres?imgurl&imgrefurl=http://www.saea.uottawa.ca/cpu/resultats/index.php?lang=en&h=0&w=0&tbnid=08yZZ-6VO7mehM&zoom=1&tbnh=232&tbnw=217&docid=10jeJkTx2smWVM&tbm=isch&ei=HQGfU6n4JIO6OLycgbgH&ved=0CAgQsCUoAg


10

101010 30 november 2012

eHealth potential

• Affordability

• Accessibility

• Effectiveness

• Efficiency

• Safety & Quality

• Self-management


11

111111 30 november 2012

↑ Elderly people↑ Chronic diseases/co-morbidity↑ Demand for care↓ Healthcare professionals↓ Budget ↑ Healthcare associated inf. + AMR

eHealth urgencies

Does it work?

12

121212 30 november 2012

source: Elbert NJ, van Os-Medendorp H, van Renselaar W, Ekeland AG, Hakkaart-van Roijen L, Raat H, Nijsten TEC, Pasmans SG Effectiveness and Cost-Effectiveness of eHealth Interventions in Somatic Diseases: A Systematic Review of Systematic Reviews and Meta-Analyses J Med Internet Res 2014;16(4):e110

Positive evidence (23%)


13

131313 30 november 2012

(150 studies)

- home telemonitoring heart failure

- telemonitoring hypertension

- web-based/mobile education diabetes I/II


Promising (42%)


(ca. 223 studies)

- web-based support pain management (acute / chronic)

- in-home telerehabilitation (stroke / cardiac arrest)

- tech assisted support / training brain injury

- web-based education / patient empowerment

- home telemonitoring chronic diseases

14

141414 30 november 2012


eMental Health and ePublic Health follow

- Treatment of depression, anxiety and substance dependence

- Health education and disease prevention

15

151515 30 november 2012

Make it work …


> Electronic Medical Record system> ePublic Health

16

161616 30 november 2012

Monitoring

Prevention and education

Self-management

Electronic Medical Record system (EMR/HMIS)

“The electronic record of health-related information

of an individual that is created, gathered, managed,

and consulted by licensed clinicians and staff from

a single organization / practice who are involved in

the individual’s health and care.”

- - Easier identification of patients due for check-ups

- - Monitoring patient data over a long period of time,

on required parameters

- - Keep a track of overall quality of care within the

healthcare organization, and make

improvements if necessary17

171717 30 november 2012

Electronic Health Record system (EHR)

“An electronic health record is a digital collection of patient health information compiled at one or more meetings in any care-delivery setting”

18

181818 30 november 2012

“An electronic health record is a digital collection of patient health information compiled at one or more meetings in any care-delivery setting”


Personal Health Record system (PHR)


19

191919 30 november 2012

Essential tech for health care

Klik op het pictogram als u een afbeelding wilt toevoegen- Longitudinal Patient records- Exchange with others- Analysis

Efficiency Quality Self-management Cost-effective

20

202020 30 november 2012

Cost-effective: improved hospital revenues (+30%)

Transparency & Accountability

Planning & process optimalisation

Governance

Integrated health information system (EMR/HMIS/EHR/EPR)

21

www.iicd.org

212121

30 november 2012

Examples

Klik op het pictogram als u een afbeelding wilt toevoegen GP teleconsultation instead of physical referral

75% of patients do not need to be reffered to hospital

Ophthalmologic exam done by paramedic optometrist instead of ophtalmologist 5% of diabetic patients visit ophtalmologist instead of 100%

Teledermatology , telecardiology: home telemonitoring

African examples (teleradiology, teleconsultation, telediagnostics Malaria/HIV, mHealth)

22

222222 30 november 2012

ePublic Health


23

232323 30 november 2012

● Food● Water● Soil ● Air● Blood● Vectors

ePublic Health


24

242424 30 november 2012

● Hard to predict● High reproduction rate● Post-antibiotic era: ↑ antimicrobial resistance● 60% of all human diseases / 75% of all emerging infectious

diseases● $20 billion direct/ $200 billion indirect (2000-2010)

ePublic Health


25

252525 30 november 2012

75% health/economic damage

in 19 countries e.g. 55.000 deaths rabies

(Asia, Africa); 590 million/yr.

rabies prevention/control

(source:

International Livestock Research Institute, 2012;

http://www.who.int/neglected_diseases/zoonoses/en/ )

http://www.who.int/neglected_diseases/zoonoses/en/

http://www.who.int/neglected_diseases/zoonoses/en/

One Health

26

262626 30 november 2012

OneHealth Central and Eastern Africa www.ohcea.orgAfrica

● One Health Initiative ● CDC (Centers for Disease Control and Prevention)● ECDC (European Centre of Disease Prevention and Control)● EFSA (European Food Safety Autority)● FAO (Food and Agriculture Organisation)● GAR(Global Alert and Response)● OIE (World Organisation for Animal Health)● PROMED mail - the Program for Monitoring Emerging Diseases ● PROMED Healthmap WHO Outbreak News WHO rabies● Med-Vet-Net Association ● WHO (World Health Organization)● ADNS (EU Animal Disease Information System)● OHCEA; focal point in NRB

http://www.onehealthinitiative.com/



http://www.cdc.gov/

http://www.ecdc.europa.eu/en/Pages/home.aspx

http://www.efsa.europa.eu/

http://www.fao.org/home/en/

http://www.who.int/csr/en/

http://www.oie.int/

http://www.promedmail.org/

http://healthmap.org/promed/

http://healthmap.org/promed/

http://www.medvetnet.org/



http://www.who.int/en/

http://ec.europa.eu/food/animal/diseases/adns/index_en.htm

One Health

27

272727 30 november 2012

One World - One Medicine - One Health

• Addressing the interconnectedness between human, animal and

environmental health

• Accelerated biomedical research discoveries

• Enhanced public health efficacy

• Expanded scientific knowledge base

• Improved medical education and clinical care

ePublic Health + One Health = One Health informatics


28

282828 30 november 2012

Reach and social impact of public health interventions,

when extended and connected with the opportunities

offered by information and communication technologies, is

considerably enlarged as compared to biomedical

approaches alone to biomedical approaches alone

One Health informatics


29

292929 30 november 2012

biomedical approaches alone Information and communication tech

enlarges reach/impact of public health interventions

- EursafetyHealth-net

- Mobile app Lyme disease

- Big Data



30

303030 30 november 2012

biomedical approaches alone EursafetyHealth-net: Antibiotic Stewardship in action



31

313131 30 november 2012

biomedical approaches alone

Mobile app Lyme disease: prevention of infectious tick bites:

self-management


32

323232 30 november 2012

biomedical approaches alone

Big data: analyzing social media for early warning, prevention and control of zoonoses (digital epidemiology)

African examples in ePublic Health


33

3333

●Family planning (KEMSA/SIC)

●Blended Learning

(AMREF/NCK/Accenture)

●m4RH (FHI360)

33 30 november 2012

… on Telemedicine

Promising Potential

Focus on what works

Think big Start small

EMR/HIMS/EHR/PHR … ePublic Health / On(e)Health

34

343434 30 november 2012


[email protected]

353535 30 november 2012

[email protected]

mailto:[email protected]



www.getupgetbetter.com

36

363636 30 november 2012

[email protected]





http://vimeo.com/90739743

Documents

On telemedicine …. Dr Hans C. Ossebaard Pre-conference Symposium ‘The Tele-Health Revolution’ 43rd KMA Annual Scientific Conference Eldoret, Kenya; 23rd-26th