Tools for regions managing digital transformation · 2017-09-11 · Tools for regions managing digital transformation: examples and illustrations Marc Lange, Secretary General @ehtel_ehealth

1

@ehtel_ehealth EHTEL Summer 2017

Tools for regions managing

digital transformation: examples and illustrations

Marc Lange, Secretary General

@ehtel_ehealth@ehtel_ehealth

EHTEL Summer 2017 2

Authorities and Payers

UsersIndustry

2


People with a different viewpoints

50+ corporate members

• with 300+ staff

• from 20+ countries

4 000+ followers

75% of members involved

in EU-funded projects

10+ EU events every year

EHTEL Summer 2017 3


WHAT’S WRONG WITH THE

IMPLEMENTATION OF

DIGITAL HEALTH?

EHTEL Summer 2017 4

3


The challenge of

telehealth and telecare implementation

75% of projects

fail during the operational stage

5

Chen, S., Cheng, A., & Mehta, K. (2013). A review of telemedicine business models.

Telemedicine and e-Health, 19(4), 287-297.

EHTEL Summer 2017

The challenge: NT+OS=NOS

New Technology + Old System =

New Old System

EHTEL Summer 20176

4

EHTEL Summer 2017

Scaling-up?From pilot to routine care …

7

Telemedicine

service

Run

Plan

People

Context

IT & eHealth

infrastructure

16Legal & sec.

guidelines

13

Legal & sec.

conditions

11

Legal & sec.

experts

14

Market

procurement

18

Service

monitoring

17

Change

management

10

Cultural

readiness

1

Leadership

3

Compelling

need

2

User

friendliness

6

Potential

to scale-up

12

Primary

client

8

Business

plan

9

Privacy

awareness

15Patient

centeredness

5

Stakeholder

involvement

4

Resource

aggregation

7

Strategy and management

Organisation and management

Legal and security

Technology and market

Enabling service deployment:

18 Critical success factors

EHTEL Summer 2017 8

5

EHTEL Summer 2017

With TREAT (Telemedicine REadiness Assessment Tool)

Doers working on a deployment plan

for a particular telehealth service

Will use these 18 Critical Success Factors to assess

their plan – collectively – against a set of indicators

CSF 1. Assure that there is cultural readiness for the telemedicine service

In my organisation/region, • doctors and other healthcare professionals are ready to share clinical

information with each other and with the patient• financial and other incentives are aligned with the service to be deployed• an underpinning culture embraces technology• an underpinning culture welcomes and even promotes change

9

Use cases

EHTEL Summer 201710

www.ehtelconnect.eu

http://en.wikipedia.org/wiki/Vest-Agder_County_Municipality

http://www.sshf.no/

http://en.wikipedia.org/wiki/Scotland

http://www.jitscotland.org.uk/resource/assessment-of-the-csf-for-mainstream-adoption-of-tec/

http://www.ehtelconnect.eu/

6

JIT

EHTEL Summer 201711

25

15

1 1

0

In Scotland, there is a compelling case for the use of technology-enabled care across our health and social care services.

Strongly Agree (59.5%)

Agree (35.7%)

Don't Know (2.4%)

Disagree (2.4%)

Strongly Disagree (0.0%)

Self-assessment of the Critical

Success Factors for

Mainstream Adoption of

« Technology Enabled Care »

Strong points

Cultural readiness to change

Consensus on the advantage

of telemedicine in meeting

compelling need(s)

Leadership

Resources availability for

scaling-up

12

16

2

9

3

There are financial resources available for development and embedding of technology-enabled care.


Agree (38.1%)

Don't Know (4.8%)

Disagree (21.4%)


JIT

EHTEL Summer 201712

0

7

7

27

1

Citizens who will benefit from technology-enabled care are sufficiently involved in developing services.


Agree (16.7%)

Don't Know (16.7%)

Disagree (64.3%)


2

7

720

4

There is a level of trust such that medical professionals (including doctors), and other healthcare professionals, are ready to share clinical

information with each other and with their patients.


Agree (17.5%)

Don't Know (17.5%)

Disagree (50.0%)


Challenges (1)

Capacities, skills and

engagement of

Citizens

Health professionals

Senior managers



7

JIT

EHTEL Summer 201713

0

13

13

12

2

There is appropriate alignment between the large-scale deployment of technology-enabled care and financial (and other) incentives.


Agree (32.5%)

Don't Know (32.5%)

Disagree (30.0%)


0

11

11

15

3

Time and capacity to achieve implementation at scale is factored into action planning.


Agree (27.5%)

Don't Know (27.5%)

Disagree (37.5%)


Challenges (2)

Change management

Commitment of managers

to lead change

Alignment between

incentives and

objectives

Management of the change

process

Interoperability

JIT

EHTEL Summer 201714

2

13

15

8

2

Transparent frameworks are in place for arrangements (e.g. contracts and Service Level Agreements) setting out expectations, rights and

responsibilities between providers and commissioners.


Agree (32.5%)

Don't Know (37.5%)

Disagree (20.0%)


1

15

15

9

0

There is clear guidance on any legal, ethical and confidentiality issues relating to the deployment of technology-enabled care.


Agree (37.5%)

Don't Know (37.5%)

Disagree (22.5%)


Challenges (3)

Governance and

infrastructure

Guidance needed on legal

and cyber-security issues

Service Level

Agreements …



8

JIT

Conclusions of the

workshop

Developing an action plan with key priorities and

timelines at both local levels and the national level

Obtaining the necessary skills to develop sound

business models to ensure sustainability

Benchmarking the new Telehealth & Telecare Delivery

Plan – that will take Scotland up to 2020 – through an

international Peer Review process

EHTEL Summer 201715


DO WE HAVE ALL THE

ANSWERS FOR SCALING-UP?

EHTEL Summer 2017 16


9


Service Innovation

≠ Product Innovation

R&D strengths are more important for new product

development than they are for service development

A company's willingness to cannibalize

organizational routines and prior investments is

more important in the case of new service

development than new product development


Edwin J. Nijssen, Bas Hillebrand, V, K (2006). Exploring product and service innovation similarities

and differences.(Elsevier, 241 - 251


Technology versus Service Readiness


•Actual system proven in operational environment

TRL9

•System complete and qualified

TRL8

•System prototype demonstration in operational environment

TRL7

•Technology demonstrated in relevant environment

TRL6

•Technology validated in relevant environment

TRL5

•Technology validated in lab

TRL4

•Experimental proof of concept

TRL3

•Technology concept formulated

TRL2

•Basic principles observed

TRL1

•The service has been rolled out to its target population

SRL8

•The organisation supporting the services has been adapted as appropriate.

SRL7

•Wide-scale adoption: The service (with its technology solution) is adopted by its users and non-users

SRL6

•Evidence of the benefits of the service has been assessed with a statistically significant

SRL5

•Service prototype developed, tested and validated in lab

SRL4

•Technology identified as an enabler for the desired change

SRL3

•User readiness to change a process or create a new one

SRL2

•Capturing drivers and scoping area for change

SRL1

10


Scaling-up: tools and methods


Environmental

conditions

SCIROCCO Maturity Model

Business

Model Canvas

Impact

assessment

MAST, HTA …

MAFEIP Decision Support

ASSIST Cost & Benefit

Scaling-up

management

Service

Readiness

Level model

MOMENTUM Critical Success

Factors

Testing facilities, living labs,

co-production labs, citizen

science …




Environmental

conditions


Business

Model Canvas

Impact

assessment

MAST, HTA …



Scaling-up

management

Service

Readiness

Level model


Factors



science …

11


Early Impact Assessment


Monitoring and Assessment Framework

for the EIP on Active and Healthy Ageing

An on-line analysis tool which

• Provides an early assessment of the likelihood that

interventions will achieve the anticipated impact,

• Helps to identify what drives interventions’ effectiveness or

efficiency

A use case in Cataluña

• Elderly patients, living at home, with a history of heart failure or

stroke and an additional chronic disease.

• MAFEIP showed that the intervention is better (more effective)

than the standard care, but that it is also more expensive!

www.mafeip.eu

Willingness to

Pay?


Data Collection and

Impact Assessment

Model for Assessment of Telemedicine (MAST)

www.united4health.eu/overview/project-evaluation/

Based on the EUnetHTA model, and adjusted to

telemedicine

Objectives

• Guiding research teams in structuring their data collection

• Improving the scientific level of data collection and reporting

Towards a predictive modelling tool


http://www.mafeip.eu/

http://www.united4health.eu/overview/project-evaluation/

12


MAST use cases


© HIM s.a.


ONCE AGAIN, DO WE HAVE

ALL THE APPROPRIATE

ANSWERS FOR SCALING-UP?


13




Environmental

conditions


Business

Model Canvas

Impact

assessment

MAST, HTA …



Scaling-up

management

Service

Readiness

Level model


Factors



science …

@ SCIROCCO_EU

► From pilot to routine care …

◼ Technology

◼ Change Management

Scaling-up Innovative Services

for Integrated Care

EHTEL SUMMER 2017

► But

◼ People need to be ready for change

◼ A structure is needed to finance innovative services and manage their deployment

◼ An eHealth infrastructure is needed to support and ease their deployment

◼ Transition funding is needed to deploy the new model of care and decommission the older one

◼ Plans and means are needed to deal with inhibitors in place

14

@ SCIROCCO_EU

EHTEL SUMMER 2017

Maturity Model for

Integrated Care:

- 12 dimensions

(with an explanatory

narrative)

- each with a rating scale (0-5)

www.scirocco-project.eu

@ SCIROCCO_EU

Self-Assessment Conversations:

an On-Line Tool

EHTEL SUMMER 2017

Yes, but getting thedevices to

interoperate is anightmare!

We are all using HL7 FHIR

as standard for electronic data exchange

This will all be resolvedsoon, as we are joining an

international standardsgroup for devices

http://www.scirocco-project.eu/

15


Sustainability business modelling

To understand and create value for

• The organisation

• The patient

To expand practices in an economically

sustainable way

To increase the probability of success

To compare and contrast experiences

29EHTEL Summer 2017


The Business Model Canvas

https://strategyzer.com/

http://www.businessmodelgeneration.com/canvas/bmc

30EHTEL Summer 2017



16


Business modelling

in health and social care

Business Model for delivering care

• Despite it is an unusual term in the public sector,

all health and social services have an implicit business model.

• Deploying telehealth/telecare creates disruption and requires the

business model to be made explicit and adapted

Resources

• Telehealth/telecare to improve economic effectiveness

• To do more with less or

• More with the same overall budget

Reimbursement

• “Patient – health professional – payer” triangle

31EHTEL Summer 2017


The Business Model Canvas

in health and social care

People

Professionals

Organizations

32EHTEL Summer 2017

17


CASE STUDY

33EHTEL Summer 2017

www.ehtelconnect.eu

www.united4health.euU4H_EC

General Practitioner

CHF telehealth configuration& key interactions: Scotland

STH Florence / Medvivo / SPS Web Portal

Practice nurse

Data Transmission Information Exchange Optional Contact (direct/indirect)Triggered ALERT

Patient Telehealth IT-Infrastructure Care Team

STH Simple Telehealth /Medvivo / SPS Server

Health Coaching Messages:via Tabletand Mobile

Cardiology home-visiting specialist nurse

Florence / Homepod/ SPS Tablet

Family

Connected Devices

Cardiologists at hospital or

local healthdistrict

Please enter

Pulse & Blood Pressure

Cardiology home-visiting specialist nurse



18


FLORENCE

Self-management

Improving health

outcomes

Quality of life

Pre-diagnosis

Care at home

Targeted care

Quality reputation

and compliance of

targets

(accommodating

evolution of

demand)

Cost reduction

Complex COPD

patients

Health

professionals

Hospital

Health system

Respiratory nurse

Referring clinician

GP

Hospital

Florence (IT co)

NHS

Strategic planners

Data governance

Personalization

Supported self-

management

Anticipatory care

Mobile (SMS)

Customer

documentation

Information

booklet

Enrolling

(stratification)

Early discharge

Monitoring

Alert management

Data Protection

Protocol

customization

Pulse-oximeter

SMS system

Smart phones

Investment: kit, smart phones

Recurring: communication cost

(SMS), annual license

Explicit: From TEC fund to

healthcare budget

Implicit: Efficiency gain





Environmental

conditions


Business

Model Canvas

Impact

assessment

MAST, HTA …



Scaling-up

management

Service

Readiness

Level model


Factors



science …


19


A service package which

Brings Europe direct to your desk

Facilitates for you

• A multi-stakeholder understanding of

implementation projects

• A self-assessment of implementation

successes and challenges

Is tailored to your needs

• By using well established methodologies



EHTEL Summer

201738

Päivi Hämäläinen

“Doing a business modelling exercise with EHTEL really

fitted with the Scottish digital health and social care

context. It has really helped us to ‘future-proof’ the

directions we aim to take, and to inform our next step

digital health and social care plans.”

Margaret Whoriskey

“The project group became aware of the Critical Success Factors for

a successful roll out. The results have been presented to the

strategic leader group in the hospital and all the municipalities.

The project plan for 2015 had been revised, addressing two main

tasks: preparing and implementing a business plan and a change

management plan.”

Wenche Tangene

“In Finland, the policy makers needed to have a trusted review of our

eHealth achievements and our chosen strategic approach.

The review gave us the opportunity to reflect on our work to date. It meant

we could be positive about our investments. We could also move forward

with confidence as a country with our eHealth work”

http://www.sshf.no/

20


Sail with the European Union

- ride the wave with EHTEL!


www.ehtelconnect.eu


Contact details

40

Marc Lange

Secretary general

EHTEL Association168, avenue de Tervuren, bte 2

B-1150 Brussels Belgium

Tel: +32 (0)2 230 15 34

Fax: +32 (0)2 230 84 40

Mobile: +32 (0)475 27 71 45

[email protected]

www.ehtel.eu

www.ehtel.eu

www.ehtelconnect.eu

EHTEL Summer 2017


http://www.ehtel.eu/


Documents

Tools for regions managing digital transformation · 2017-09-11 · Tools for regions managing digital transformation: examples and illustrations Marc Lange, Secretary General @ehtel_ehealth