Transcript Document

An eHealth Strategy for Ireland
Bringing improved population wellbeing, health service efficiencies and economic
opportunity through the use of technology enabled solutions.
eHealth : What does it mean?
ICT and eHealth
• eHealth is also known as
• Health IT ( US phrase)
• Also known as
• Connected Health
• mHealth
… not solely about ICT & computerisation
Definitions of eHealth exist
• What is eHealth
"The combined use of electronic communication and
information technology in the health sector“
World Health Organisation
“eHealth means Information and Communication
Technologies tools and services for health. Whether
eHealth tools are used behind the scenes by healthcare
professionals, or directly by patients, they play a
significant role in improving the health of European
citizens”
European Commission
Societal changes from technology
We have seen enormous changes brought about by ICT based
technology in the last 20 years
• Travel …think Ryanair.com, Trivago, AirBNB
• Media … think RTE player, IrishTimes.com …
Twitter .. Facebook ..You Tube
• Education … digital school books.. Distance
learning
• Retail : think Amazon.com, ebay, pigsback,BT
• Registration for nurses doctors is on-line
• Bills, Bookings … think Tolls, Bins, Parking fines,
Banking, Theatre , Revenue pay and file end of the month
– All done over the Internet … still costs the same !!
Where is health care in all this?
Health care is well behind the curve
– Why can’t we readily book appointments for
GP’s, hospitals, clinics…..
– See our test results….
– Keep track of immunisations for our kids….
– Prescriptions…. See on line what we are taking..
what we took 6 months back … or did we take it?
– When we were last at the GP, Specialist etc
What are the barriers to eenablement
• Health Care transactions
– Are complex
– About vulnerable people
– Services delivered by multiple professions, multiple
providers over many locations
– Change processes to bring about change are not
simple
– Legal issues
– Technology issues
– Legacy issues such as PPARS
– Privacy and confidentiality issues
Process Change
• At its simplest eHealth is about
“Access to the right information, in the right place at the right time”
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Information is the lifeblood of modern medicne, and health information is dedicated to
be circulatory systems.
– David Blumenthal New England Journal of Medicine 362 2010
It is fundamentally about process change and reconfiguration
underpinned by ICT
If we are to benefit from technology we must be prepared for change.
Opportunities that eHealth provides
• Impact of eHealth developments on the
healthcare delivery system
• Potential and opportunities to change and
help re-configure healthcare delivery
• New information and systems environment
• Provides a enormous opportunities and
significant challenges
eHealth offers new services
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Personal Health Records
GoogleHealth, HealthVault, Have not got traction yet but are not ‘mainstream’
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Health social networks,
Breast cancer.org PatientsLikeMe, CureTogether, MedHelp very popular widely used
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Consumer personalised medicine
23andMe (Genomics) DirectLabs (Blood & Bio Marker Tests) Genome Sequencing is now nearly a consumer product
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Quantified self-monitoring
Keas, (Personalised Care Plans) Zumelife (Chronic Care)
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Healthcare Social Media
Blogs - DiabetesMine, HealthMatters, WedMD
Microblogs - Livestrong, Stupid Cancer
Social Networking - Organised Wisdom, PatientsLikeMe, DailyStrength
Podcasts - John Hopkins Medical Podcasts, Mayo Clinic
Social Sharing - Flickr, You Tube, ICYou
Forums - Google Health Groups
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Clinician Social Networks
Sermo, Medscape Physician Connect, Asklepios, MEDTING
For patients …..
For clinical resources
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Use of Services
61% - American adults looked online for health information (2009)
84% - physicians engage online as part of their clinical workflow
71% - physicians are interested or already use physician social networks
Sources of information used by American adults for health or medical issues information or
assistance:
86%
68%
57%
54%
- Ask a health professional - such as a doctor
- Ask a friend or family member
- Use the internet
- Use books or printed material
Impact of online Health Information
60% - Affected a decision about how to treat an illness or condition
56% - Changed their overall approach to maintaining their health or the
health of someone they help take care of
53% - Led them to ask a doctor new questions, or to get a second opinion
from another doctor
Potential from Advances in
Technologies
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Location-aware technologies enables increased access
and quantity of information – provides greater safety
Home automation and sensor technologies support
telehealth and mobile health applications
Virtual doctors/health professional visits
Easier user access to information and technologies
through voice, touch screen, eReaders, biometrics, etc.
Focus and investment by large scale companies in
monitoring and telehealth technologies
Broadband and Internet use among seniors increases
Significant developments in portals and tools for
caregivers
Increasing use and development in personal emergency
13response systems
How Smart can technology get?
Some views of the future….
eHealth is about Transformation from Industrial Age
Healthcare
to Information Age Healthcare
Industrial Age Healthcare
Information Age Healthcare
Individual Self-care
Person
Community
Primary
Secondary
Tertiary
Transformation
Through
Cost-Effective Use
of Information &
Communication
Technologies
Friends & Family
Community Networks
Professionals as Facilitators
Professionals as Partners
Professionals as Authorities
Source: Adapted from Malaysian Telemedicine Blueprint
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Changing Role of Patients
Patient
ePatient
Passive Role
Active (engaged role Role
Information given
Seek out information (Internet)
Top down delivery
Partner in delivery
Paternalistic Medicine
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Participatory Medicine
Health systems challenges we all know
them…..
• Increasing Demand due to:
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Ageing Populations
Rise of Chronic Diseases
• Already Stretched Services
• Planned Reform of Health
Services
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Universal Health Insurance
Money Follows the Patient
Formation of Hospital Groups
• Current ICT Issues
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Current Ireland ICT budget 0.85% vs. EU
average 2-3%.
Lack of understanding of benefits
Ireland eHealth Strategy : Methodology
• Extensive Research
• 8 countries, EU and Non-EU
• Benefits/ROI and Lessons Learned
• eHealth week in Dublin in May
• eHealth Brings…
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Patient Centric, Empowerment
Higher Quality
Safer and more Transparent
Easier Access,
Cost Efficiencies
Prevention Focus
Economic (Jobs) Impact
• Analysis of EU and WHO Policy
eHealth Benefits
To Ireland
• Population Wellbeing
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Healthier Citizens
Empowered and Mobile citizens Patient as Consumer
Focus on prevention Healthy Ireland
‘Keep people out of hospital’ Supporting the clinical Programs
• Health Delivery Service Benefits
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Deliver Higher Quality, Lower Cost,
Easier Access, Higher Transparency Supporting UHI , MFTP
Move to Patient-Centric system Chronic Disease Management / Tele health/care
Will enable Planned Reform Program : Supporting Money Follows the Patient
• Economic Development
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Export-driven jobs creation : Some good examples of that in Ireland
eHealth start-ups :
Ireland Ideally placed for new ‘Services’ : industry leader in Pharma, ICT harware and software
and Medical Devices
International Experiences
Summary of Findings...
(Based on 8 countries analysed)
1. Dedicated delivery entity with proper
focus, governance and authority
2. Deploy in phases. Avoid ‘big bang’
approach.
3. Use interoperability standards
4. Strong stakeholder and clinical
engagement from the outset.
5. National Health Identifier is crucial.
6. Strong branding and pubic awareness
7. Skills shortages need to be addressed at
all educational levels
Implementation
• Create ‘eHealth Ireland’
• Fully focussed delivery entity
• Made up of stakeholder organisations
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Health, DJEI, Agencies, Academia etc
• Full Fiscal Oversight
• 4 Key Functions…
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Project Delivery (ePrescribing, Telehealthcare etc)
Ecosystem Creation
Patient Empowerment
Economic Impact Realisation
• Key ‘Enabling Functions’
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Legal and regulatory
Technical interoperability
Health identifier
Branding and Public awareness
eHealth Innovation
Ecosystem
Build a World Class Innovation Ecosystem
• Collaborative Environment
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Focus on Commercialisation
Open-up services to R&D
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E.g. Horizon 2020 Funding
Promote Entrepreneurship
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Academia
Industry
Health Services
Cross Border
International Alliances (e.g. EU/US)
Start-ups support
VC funds, incubators…
Export-led Jobs Creation
eHealth Innovation Ecosystem
Models in Catelonia, Northern Ireland, Manchester, New
York….
Proposed Timelines
Key Actions
1. Create ‘eHealth Ireland’ and source requisite leadership.
2. Develop full Business Plan
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Input (funding and resources) from Govt depts, agencies, academia and others
Set up governance structure including board.
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Strongly branded entity eHealth Ireland
Resource internally where possible.
3. Begin Work on Priority Programs
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ePrescribing, Online Referrals and Scheduling, Telehealthcare and others
4. Begin work on ‘Enabling’ Functions
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Legal, Regulatory, Standards, Branding and others.
5. Coordinate with Govt agencies to drive Economic Benefits program.
6. Health Identifier Bill due by end October
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Work with partners to ensure Identifier is deployed in a timely manner.
Its only beginning……
American Health care is one of the last great industries to
remain largely undisturbed by information technology
revolution of the past few decades
– Vijay Vaitheeswaran, The Economist, November 22, 2010
Medicine has built on a long history of innovation, from the
stethoscope and roentgenorgram, to the MRI. Doctors have
embraced each new technology to advance patients care. But
nothing has changed clinical practice more fundamentally
than one recent innovation: the Internet.
Pamela Hartzband and Jerome Groopman , New England
Journal of Medicine.
•Thank you for your time