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Connected Health & Wellbeing – Collaborating with Healthcare for Innovative Service Development

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  • Integrating pharmacogenomics into therapy is an agency-wide initiative. “ For the first time physicians will have a chance to treat patients as “ individuals ” not as members of a “ population ” We will be able to treat patients based on the biology of disease rather than the symptoms of disease ” (Janet Woodcock MD, FDA). FDA Regulations relating to labelling: “ If evidence is available to support the safety & effectiveness of a drug in a selected subpopulation with a disease, the labelling shall describe the evidence and the specific tests needed for selecting and monitoring the patients who need the drug ” (21 CFR 201.57)
  • Integrating pharmacogenomics into therapy is an agency-wide initiative. “ For the first time physicians will have a chance to treat patients as “ individuals ” not as members of a “ population ” We will be able to treat patients based on the biology of disease rather than the symptoms of disease ” (Janet Woodcock MD, FDA). FDA Regulations relating to labelling: “ If evidence is available to support the safety & effectiveness of a drug in a selected subpopulation with a disease, the labelling shall describe the evidence and the specific tests needed for selecting and monitoring the patients who need the drug ” (21 CFR 201.57)
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    • 1. Connected Health & Wellbeing –Collaborating with Healthcare for InnovativeService DevelopmentProf. Jonathan WallaceProfessor of InnovationDirector of Knowledge & Technology Transfer,Faculty of Computing & Engineering, University of Ulster, Northern IrelandFaculty ofComputing &Engineering
    • 2. Faculty ofComputing &EngineeringOutline• Track Record• From Connected Health To Connected Wellbeing• Pervasive Technologies• Effective Evaluation of Connected Health Service Solutions• Healthcare Service Innovation Collaborative Case Studies:– utell– SaSSI– Motivation & Behavioural Change– NOCTURNAL– ACTION
    • 3. Faculty ofComputing &EngineeringProf. Jonathan Wallace – Track Record• Established track record in Telemedicine, Telecare,Telehealth, Connected Health over 20 years.• Sit on Connected Health & Technology Advisory Boardsof number of Health Trusts.• One of the 5 judges for the UK National annual CrystalAwards for Excellence Telehealth & Telecare.• Board Member BioBusiness.• Founder Member BCS Health NI.
    • 4. Faculty ofComputing &Engineering Current Connected Health research interests:– User-Centred Design for Connected Health Service Solutions;– Connected Wellbeing - individualised prediction, prevention and earlydetection as well as education, motivation and behavioural change;– Mobile Service Solutions – exemplars u-tell & SaSSI– u-tell: intelligent spoken dialogue and web portal service solutionwith clinical decision support track and trend remote monitoring.– Successful track record over 7 years monitoring diabeticpatients in South Eastern Health & Social Care Trust.– Mid-way through RCT for new INR module.– New service being developed for obesity and pre-diabetics.Prof. Jonathan Wallace – Track Record
    • 5. Faculty ofComputing &EngineeringWhat Exactly Is Connected Health ?• Not one specific technology or service solution!• Spans every echelon of health care from firstresponse/emergency medical systems throughtertiary medical speciality consultations to thesupport of informal care in the home includingmotivation and behavioural change, educationand information dissemination.• It has to be user-centred, multidisciplinary,standards-based e.g. HL-7 and ensureinteroperability.
    • 6. Faculty ofComputing &Engineering“The Wellness Paradigm”• The “Wellness Paradigm” – shift of responsibilityfor health and well-being into patients’ hands• “Home-centred capability is expected to becomea catalyst for a huge health paradigm shift fromlast-minute heroic intervention to consumer-driven individualised prediction, prevention,early detection and maintenance”(Herman, 2001)
    • 7. Faculty ofComputing &EngineeringLevel 0: Population Wide PreventionLevel 1: Self Care / Supported Self Management(70-80% of chronic disease patients)Level 2: Disease Management(High Risk)Level 3: CaseManagement(Complex Risk)Kaiser Triangle Model
    • 8. Faculty ofComputing &Engineering
    • 9. Faculty ofComputing &EngineeringInnovationSupportOn YourDoorstep
    • 10. Faculty ofComputing &EngineeringInnovationSupportOn YourDoorstep
    • 11. Faculty ofComputing &Engineering
    • 12. Faculty ofComputing &EngineeringEffective Evaluation ofConnected Health Service SolutionsRCTServiceEvaluationEvaluation ContinuumInterrupted Time Series
    • 13. Patient Enters InformationAt Home Or On The Move• Weight• Blood Sugar• Blood Pressureu-tell: DIABETES Architecture SchematicPSTNVoiceXMLInterpreterPrimary / SecondaryCare Provider Intranet• Patient Details• Clinical Targets• ProtocolsElectronic CareRecord (ECR)Database• Data Management• Visualisation• Trend Analysis• Decision Support• Evidence Based MedicineClinical ProfessionalAccess ThroughClinical Workstation,Tablet orSmart Phone Browseru-tell:DIABETESClinical Decision Support PortalRegular Health ReportPrint-Outs Sent To PatientSecureWeb PortalGatewayAdditional Option For PatientsTo Submit & Review Their OwnReadings Via Secure Web Portal
    • 14. The Problem• Patient assessments at bedside still mostly paper-based.• 20+ paper-based assessments per patient andgrowing due to new mandatory requirements.• ~15% of staff time spent on unnecessarypaperwork.• Additional time and cost for Audit /Compliance.• Poor accountability, non-completion, inconsistency,duplication issues.• NHS currently failing to meet mandatory patientsafety assessments.• Existing ECR and EDM systems NOT solvingthis problem.
    • 15. Royal Cornwall Hospitals NHS TrustExemplar2010 - 2011• 119,364 Admissions• 600,000 patient records across 3 sites• 100,000 records in circulation at any given time• 2 Health Records Libraries• 3 Clinic Preparation Departments• 1 Disclosure Office• Typical month:• 47 staff send & file ~92,000 sets of notes• 110 tonnes paper moved in & out ofdepartments
    • 16. • SaSSi - Innovative web-based integrated servicesolution.• Allows clinicians to use tablets, smartphones,laptops or desktops to access clinical informationat the Client/Professional Interface (CPI) both atthe patient bedside and on the move within thehospital.• Designed to enable information capture at the pointof care, place key decision-making data in thehands of clinical staff, and allow real-timemonitoring and auditing of clinical activities.• Most importantly all leading to improved in-patientcare /outcomes.• Current modules - VTE, MUST & MEWS• Next Priority – Nursing AssessmentThe Solution
    • 17. Faculty ofComputing &EngineeringACTION(Assisting Carers using TelematicsInterventions to meet Olderpersons Needs)
    • 18. Faculty ofComputing &EngineeringThank YouQuestions ?jg.wallace@ulster.ac.uk21