0
FP7-ICT-2009.5.1 – Support Action
Directions for ICT Research in Disease Prevention
This project is partially funded under...
www.preve-eu.org
Client Centred Approach
Patient Centred Medicine
Ambient Assisted Living
Health Service Delivery
Maturity...
www.preve-eu.org
“Biological age” (“years”)
0
100 %
Patient
0
100
(100%
Citizen)
AAL
Tele
med
Preven-
tion
Demand side
Sup...
www.preve-eu.org
0
100 %
Patient
0
100
(100%
Citizen)
Tele-
medicine
D
D
Chronic
Disease
Management
“Biological age” (“yea...
www.preve-eu.org
Personal Guidance Services (PGS)
Conceptual Aims of “the Citizen as
Co-producer of Health Model"
• Inform...
www.preve-eu.org
Hospital
Pharmacy
Specialist-
centre
General
Practice
Home
Restaurant
Super-
market
Museum
Sports centre
...
www.preve-eu.org
Diabetic
Personal
device
Exercise
Health providers
Commodity service providers
Data
Information
Knowledge...
www.preve-eu.org
Data
Information
Knowledge access
The Machine-room of the “Citizen as Co-
producer of Health”
the ECO-sys...
www.preve-eu.org
Decision support (information flows)
EHR
Quality
Assurance
HMO/
Region
Clinical
encounter
Healthcare
Co-p...
www.preve-eu.org
Decision Support
Present service model
• Contemporary service model (provider push) of
prevention:
• Non-...
www.preve-eu.org
Prevention in the Co-Producer Model
context
• From the citizen and co-production of health point of view
...
www.preve-eu.org
Evidence Based Associations between Risk
Factors and Conditions
Type 2-diabetes
Preventable cancer
Cardio...
www.preve-eu.org
Reduction i CVD
disease risk (%)
(95% CI)
Reference
Wine
(150 ml/day)
32 ( 23-41) Circulation 2002;105:28...
www.preve-eu.org
Citizen Modifiable Risk Factors
Co-production of Disease Prevention
Connections between Risk Factors and ...
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The citizen as coproducer of health

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Transcript of "The citizen as coproducer of health"

  1. 1. FP7-ICT-2009.5.1 – Support Action Directions for ICT Research in Disease Prevention This project is partially funded under the 7th Framework Programme by the European Commission The Citizen as Co-producer of Health & Conceptual Framework for Chronic Disease Management Niels Boye University of Aarhus, Denmark
  2. 2. www.preve-eu.org Client Centred Approach Patient Centred Medicine Ambient Assisted Living Health Service Delivery Maturity of ICT Citizen as object User as Operator Expert Systems Corporate Centred User as User Layman Systems Individual Centred Citizen as co-Producer of Health Contemporary State of the Art in ICT and Empowerment Model & Concepts Citizen as proactive subject Disease prevention Disease compensation (Disease cure) Assisted living The Citizen as Co-producer of Health – enabled by ICT
  3. 3. www.preve-eu.org “Biological age” (“years”) 0 100 % Patient 0 100 (100% Citizen) AAL Tele med Preven- tion Demand side Supply side The Present
  4. 4. www.preve-eu.org 0 100 % Patient 0 100 (100% Citizen) Tele- medicine D D Chronic Disease Management “Biological age” (“years”) D AAL D Preven- tion and Lifestyle Society Hospital The Future
  5. 5. www.preve-eu.org Personal Guidance Services (PGS) Conceptual Aims of “the Citizen as Co-producer of Health Model" • Information and patients as resources • Nature, Nurture, and collaboration with institutionalized health care • Personalized management of prevention (and care of chronic diseases) – in a citizen context • Multilevel ICT-modeling of health and disease encapsulated in to personal devices – From: “Background document for the Consultation meeting on potential European Large scale Action (ELSA) on eHealth” European Commission “ICT for Health Unit, H1, 28.08.2009
  6. 6. www.preve-eu.org Hospital Pharmacy Specialist- centre General Practice Home Restaurant Super- market Museum Sports centre Farm Work Car The PGS Service Architecture diabetes as example
  7. 7. www.preve-eu.org Diabetic Personal device Exercise Health providers Commodity service providers Data Information Knowledge The Personal Guidance Systems Service model diabetes as example
  8. 8. www.preve-eu.org Data Information Knowledge access The Machine-room of the “Citizen as Co- producer of Health” the ECO-system building blocks Choice architectures Co- producers HealthGPS (digital avatar) Political, social, economic Platform services (security, ID) PHR
  9. 9. www.preve-eu.org Decision support (information flows) EHR Quality Assurance HMO/ Region Clinical encounter Healthcare Co-production Health-PGS PHR and digital avatar Research Patient-NGO Research/ Pharmaceutical Co Hospital Data- and Information flow
  10. 10. www.preve-eu.org Decision Support Present service model • Contemporary service model (provider push) of prevention: • Non-specific lifestyle modifications • Primary prevention (e.g. immunisations) • Secondary prevention – (e.g. screening programs) • Tertiary prevention of complications to disease
  11. 11. www.preve-eu.org Prevention in the Co-Producer Model context • From the citizen and co-production of health point of view there is no distinction between primary, secondary and tertiary prevention • It is behaviour planning and execution on the basis of personal-context, evidence-, and knowledge-driven ICT- augmented decisions
  12. 12. www.preve-eu.org Evidence Based Associations between Risk Factors and Conditions Type 2-diabetes Preventable cancer Cardiovascular disease Osteoporosis Musculoskeletal disorders Hypersensitivity disorders Mental disorders Chronic obstructive pulmonary disease Tobacco smoking Alcohol consumption Diet Physical activity Obesity Accidents Working environment Environmental factors Diseases and Disorders Risk Factors
  13. 13. www.preve-eu.org Reduction i CVD disease risk (%) (95% CI) Reference Wine (150 ml/day) 32 ( 23-41) Circulation 2002;105:2836-44 Fish (114 gr 4x/week) 14 (8-19) Am J Cardiol 2004;93:1119-23 Dark chocolate (100g/day) 21 (14-27) JAMA 2003;290:1029-30 Fruit and vegetables (400 g/day) 21 (14-27) Lancet 2002;359:1969-74 Garlic (2.7 g/day) 25 (21-27) Arch Intern Med 2001;161:813-24 Almonds (68 g/day) 13 (11-14) Circulation 2002;106:1327-32 Am J Clin Nutr 2003;77:1379-84 Combined effect 76 (63-84) Franco OH et al. BMJ 2004;329:1447-50. CVD=Cardiovascular Disease, CI = Confidence interval A “polymeal” of the above would cost 21.60 Great British Pounds per week (2004) and give an average increase in life expectancy of 6.6 years for men and 4.8 years for women And give men 9.0 years more life without heart disease for women (8.1 years). Decision support – in prevention Example: Evidence of food having impact in Cardio Vascular Disease
  14. 14. www.preve-eu.org Citizen Modifiable Risk Factors Co-production of Disease Prevention Connections between Risk Factors and Conditions Type 2-diabetes Preventable cancer Cardiovascular disease Osteoporosis Musculoskeletal disorders Hypersensitivity disorders Mental disorders Chronic obstructive pulmonary disease ConditionsTobacco smoking Alcohol consumption Diet Physical inactivity Obesity Accidents Working environment Environmental factors Citizen Modifiable Risk Factors Non-Modifiable Risk Factors Family history and gender
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