NextGen 2011 Workshop Stephen Hope DOCOBO


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NextGen 2011 Workshop Stephen Hope DOCOBO

  1. 1. NextGen  Telehealth   Improving  Outcomes  for  Pa4ents  in   the  Community   Stephen  Hope   Business  Development  Manager   Docobo  Ltd    16/11/2011   1  
  2. 2. Docobo  Company   •  UK  company  formed  in  2001   –  To  commercialise  output  from  an  EU  R&D  project   –  Designed  and  developed  by  us  –  not  a  distributor  (we  control  the  IP)     –  Customised  to  specific  needs  (e.g.  Philips)   –  High  level  of  local,  technical  and  customer  support     –  Focused  on  eHealth  technologies  to  enable  Care  in  the  Community     •  Regulatory  Status  -­‐  A  medical  device  and  solu4ons  company  (accredited  to   EN13485)   –  doc@HOME  Telehealth  System  is  a  Class  I  medical  device,  HealthHUB  and   CarePortal  are  Class  IIa   –  TGA  approval  for  use  in  Australia  and  NZ     –  Docobo  is  NHS  N3  (Intranet)  approved  –  as  such  meet  s  Informa4on  Governance   requirements  to  hold  pa4ent  data   •  NHS  Procurement  –  Buying  Solu4ons  Framework   •  40+  UK  PCT’s  using  doc@HOME     •  Interna4onal  –  Portugal  (original  pilot),  Australia,  New  Zealand,  others  early   stage  (Brazil,  India,  China,  Mauri4us,  Bahamas)    16/11/2011                                                                  Copyright  ©  Docobo  Limited                        Not  to  be  reproduced  without  permission   2  
  3. 3. Enabling  Technologies  suppor4ng  care  in   the  Community   •  Telehealth  –  Managing  pa4ents  –  doc@HOME®   –  Self  management   –  Professional  care  assisted  by  technology   •  Assisted  Living  –  Managing  the  elderly  and  vulnerable  -­‐  CarePortal®   –  Social  isola4on,  fragmented  families,  digital  divide   –  Alpha  Daughter/son  responsibili4es   –  Access  to  support  and  wider  world   •  Care  delivery  logis4cs  –  Managing  Staff  -­‐  ComCare   –  Staff  self  management   –  Make  every  interven4on  count   –  Performance  management  16/11/2011                                                                  Copyright  ©  Docobo  Limited                        Not  to  be  reproduced  without  permission   3  
  4. 4. TELEHEALTH  16/11/2011   4  
  5. 5. Telehealth   •  Remotely  monitoring  vital  signs  and  lifestyle   of  pa4ents  on  a  regular  basis  and  as   frequently  as  the  pa4ent’s  condi4on  requires   •  Passing  and  sharing  this  informa4on  to   appropriate  clinicians  to  allow  early   interven4on;  on  going  management  of   pa4ents   •  Improving  outcomes    16/11/2011                                                                  Copyright  ©  Docobo  Limited                        Not  to  be  reproduced  without  permission   5
  6. 6. doc@HOME®  Telehealth  System  Overview  16/11/2011                                                                  Copyright  ©  Docobo  Limited                        Not  to  be  reproduced  without  permission   6  
  7. 7. 16/11/2011                                                                  Copyright  ©  Docobo  Limited                        Not  to  be  reproduced  without  permission   7  
  8. 8. Ques4ons  on  doc@HOME   •  Ques4on  4mings  (programmable)   –  Ques4ons  can  be  asked  in  fixed  4me  periods,  e.g:   •  morning  ques4ons,  say  06.00  –  12.00   •  alernoon/evening  ques4ons,  say  16.00  –  22.00   •  carer  ques4ons,  say  22.30  –  23.30   Carer   –  Ques4ons  can  be  asked  “Any4me”   Morning   Evening   •  To  capture  events   •  Ques4ons  are  fully  programmable   –  Default  ques4ons   00:00                                        6.00                  12.00              16:00            22:00        23:50   •  Docobo  will  work  with  SAHS  to  define   –  Ques4ons  selected  for  individual  pa4ents   •  Enabling  management  of  whole  person   •  Ques4ons  can  be  added  and  customised   –  Mul4ple  ques4ons  types  (not  just  YES/NO)   •  Mul4ple  choice   •  Numeric  entry   •  Nested   •  Numeric  scale   •  Test  Scale   •  Prompt   –  Fixed  ques4on  types   •  BP,  Sp02,  Peak  flow,  ECG,  etc  16/11/2011                                                                  Copyright  ©  Docobo  Limited                        Not  to  be  reproduced  without  permission   8
  9. 9. Viewing  the  clinical  database  16/11/2011                                                                  Copyright  ©  Docobo  Limited                        Not  to  be  reproduced  without  permission   9  
  10. 10. Viewing  pa9ent  specific  data  16/11/2011                                                                  Copyright  ©  Docobo  Limited                        Not  to  be  reproduced  without  permission   10  
  11. 11. Self  Management  -­‐  4  week  feedback  display  16/11/2011                                                                  Copyright  ©  Docobo  Limited                        Not  to  be  reproduced  without  permission   11
  12. 12. NHS  Direct  study  -­‐  South  East  Essex   •  999  calls  –  the  average  number  of  999  calls  made  per   month  by  the  pa4ents  whist  using  the  Telehealth   service  reduced  by  72%.       •  GP  visits  –  the  average  number  of  visits  made  by  the   pa4ents  per  month  to  their  GP  whilst  using  the   Telehealth  service  reduced  by  56%.     •  A&E  visits  –  the  average  number  of  visits  made  per   month  to  A&E  by  the  pa4ents  whilst  using  Telehealth   reduced  by  75%   •  Hospital  admissions  –  the  average  number  of  hospital   admission  per  month  for  the  pa9ents  reduced  by  83%  16/11/2011   12  
  14. 14. Addressing  all  Levels  of  LTC  Triangle  for  Maximum  Impact   Level 3: Highly complex patients As people develop more than one chronic condition (co-morbidities), their care becomes disproportionately more complex and difficult for them, or the health and social care system, to manage. This calls for case management – with a key worker (often a nurse) actively managing and joining up care for these Level 2: High risk patients Disease/care management, in which multidisciplinary teams provide high quality evidence based care to patients, is appropriate for the majority of people at this level. This means proactive management of care, following agreed protocols and pathways for managing specific diseases. It is underpinned by good information systems – patient registries, care planning, shared electronic health records. Level 1:70-80% of CDM Population With the right support many people can learn to be active participants in their own care, living with and managing their conditions. This can help them to prevent complications, slow down deterioration, and avoid getting further conditions. The majority of people with chronic conditions fall into this category – so even small improvements can have a huge impact.16/11/2011   14  
  15. 15. Enhanced  doc@HOME®  Infrastructure  Overview   3rd  Party   • Case Co-ordinators Analy4cs   • Clinical Teams Browser   doc@HOME® Web  Services   3rd  Party   Web   • Call Centres eHealth   • Clinical Teams Applica4on   vendors   Clinical   Scheduling   Database   Engine   • Tailored to Prompts  and   needs of patient. ques4ons  etc   • Self Management Telehealth  Service  Provisioning   • Medication management GPRS,  3G   GPRS,  3G   Broadband   Broadband   GPRS,  POTS   Email  /  SMS   CarePortal®   Tablet  Apps   with  URL   HealthHUB®   • IT  Literate  • Elderly   • Mild  LTC’s  • Poorly   Case Management Pa4ent  &  Care  Giver   Wellness Ø Diabetes  II  • Symptoma4c   Ø Asthma  16/11/2011                                                                  Copyright  ©  Docobo  Limited                        Not  to  be  reproduced  without  permission   15  
  16. 16. Clinicians  View  16/11/2011                                                                  Copyright  ©  Docobo  Limited                        Not  to  be  reproduced  without  permission   16  
  17. 17. CAREPORTAL®  –  Solu4on  for  Assisted  Living   •  CAREPORTAL®  is  a  solu4on  consis4ng   of  bespoke  Docobo  designed   hardware  and  an  open  source   solware  platorm   •  Designed  to  be  able  to  give  an  older  or   less  technically  capable  user  access  to   social  networks  and  services   •  The  product  is  likely  to  be  purchased  /   rented  by  a  carer  for  the  user.     •  The  purchaser  will  typically  be  child,   rela4ve  or  partner  who  wants  to   opens  access  to  a  virtual  world   •  Sold  through  mobile  retail  outlets  and   other  community  organisa4ons   CAREPORTAL®  is  a  Class  IIa  Medical  Device  Platorm  16/11/2011                                                                  Copyright  ©  Docobo  Limited                        Not  to  be  reproduced  without  permission   17  
  18. 18. Docobo  Independence  Infrastructure  Overview   Assistance   Services   Family  Web   Delivered   Telehealth   access   concierge@HOME™   Meals   Other   Community  groups:       Services   •     Diary   •     Photos   •     3rd  sector   •     Local  volunteer   Web   Other   Peer  to   •     Private  providers   Browser   Health  IT   Peer   Systems   groups   doc@HOME®   Social   3rd  Party   Community   BeTogether™   Contact   Services   Assist   Web   Browser   Community   Clinical     access   Teams   eNABLE™  SService  Provisioning   Telehealth  ervice   Provisioning   Loca4on   CarePortal®   Services   GPRS,  3G   GPRS,  3G   Broadband   GPRS,  POTS   Broadband  Environmental   HealthHUB®   Tablet  Apps   Email  /  SMS   Controls   Interface   with  URL   • IT  Literate  • Elderly   • Mild  LTC’s  • Poorly   Case  Management   ClientPa4ent  &  Care  Giver   Wellness   Ø Diabetes  II  • Symptoma4c   Ø Asthma  16/11/2011                                                                  Copyright  ©  Docobo  Limited                        Not  to  be  reproduced  without  permission   18  
  19. 19. Interoperable  Solu4ons  for  Assisted  Living   ADL  Alerts   Tynetec   Ac4vity   Trend   Analysis   IP  based   connec4vity   Docobo,  Tynetec  and   JonTek  bring  you:   • Interoperability   • Use  of  legacy  kit   • UK  innova4on   • New  business  models  16/11/2011                                                                  Copyright  ©  Docobo  Limited                        Not  to  be  reproduced  without  permission   19  
  20. 20. NEXT  GENERATION   COMMUNICATIONS  16/11/2011   20  
  21. 21. Future  Connected  Care   Records  Telehealth   Cholesterol   monitor   •  NHS   Care   care   Blood-­‐   •  Social  Care   profs   professionals   pressure  cuff   •  Housing   Glucose   meter   •  Personal  Health  Record  Telecare   NHS   Medica4on   Direct   tracking   Sensor   Service   networks   Care  Portal    Hub   Home  automa9on   Elderly  living   Tele-­‐carer   Pedometer   independently   Lights   Doors  /   Windows   Care  response   Mo4on  /   Ac4vity   service   Bed     Kitchen   Bathroom   Friends  and   Emergency   family   services   16/11/2011   21  
  22. 22. CRITICAL  COMMUNICATION   REQUIREMENTS  16/11/2011   22  
  23. 23. Next  Genera4on  Telehealth  Communica4on  Requirements   •  Mobility  -­‐  Seamless  to  The  User   –  Seamless  Mobility  vs    Service  Discovery   •  Emergency  Buwon  priority  across  any  network  technology   •  Minimised  delay   –  Real-­‐4me  duplex  communica4on   –  Video  call   •  Loca4on  aware   –  Posi4on  –  seamless  service  mobility  from  outdoor  to  indoor  loca4on  techniques   •  Reliable  Connec4on  across  any  Network  type  to  Assistance  Centre   •  Secure  Data  Connec4on  across  mul4ple  networks   –  Full  data  protec4on  for  Vulnerable  Adults  and  Children   –  NHS  N3  Security  approvals   •  Separa4on  of  Telehealth,  Telecare  and  Public  Domains     •  Security  -­‐  password  and  enrolment  -­‐  encryp4on     •  QoS,  Priority  and  Pre-­‐Emp4on  across  any  Network  type     •  Mul9ple  Cri9cal  Uplink  Services  on  Asymmetric  NG  Technologies   biased  towards  downlink    16/11/2011   23  
  24. 24. THE  FUTURE  ASSISTED  LIVING     BUSINESS  MODEL   Implemen4ng    the  personal  budget/  private  pay    integrated   model    16/11/2011   24
  25. 25. The  Personal  Budget/Private  Pay  Model   •  Statutory  and  Elec4ve  e-­‐Health  Services  combined   •  More  choice  to  the  individual   •  Allows  rela4ves  to  purchase  services     •  BUT  WHO   –  Recommends   –   Monitors   –  Supplies  Equipment  and  Services   –  Supplies  Communica4ons    Packages   –  Bills   •  WHO  PAYS  and  HOW   •  Companies  will  now  need  to  address  the  Personal   Consumer  Domain  as  well  as  the  Enterprise  Domain  16/11/2011   25  
  26. 26. The  Future  Personal  Budget/Private  Pay  Business  Model    Framework   TELECARE   Services   CHUBB  AGEUK   Community   Health  Care     Communica9ons  Providers     SCPCT   Services     Services   DOCOBO   AGEUK,  SCPCT   and  Retail  Outlets   SCPCT  HDLHB     HDLHB  GLENSIDE   GLENSIDE       BT     O2     Telehealth  Service  Roaming   Interac9ve  Content   TELEHEALTH     Services     HealthHUB,     Provider   Wrist  Unit,     DOCOBO     Handsets   PDAs   Content   Terminal   Content   Provider   Supplier   Terminal   Content   Provider   Supplier   Terminal   Provider   Prime  Assisted     Supplier   AGEUK   Living  Service   Provider   DOCOBO  GUIDANCE,   Programmes,  News   DOCOBO   HWC  etc     Games   Shopping   Videos,  Music   Web  Page   People,+   Arrows  represent   Adverts   User   Equipment   Flow  of  Money  16/11/2011                                                                  Copyright  ©  Docobo  Limited                        Not  to  be  reproduced  without  permission   26  
  27. 27. FINALLY  16/11/2011   27  
  28. 28. What  did  Stan  tell  us?   •  Produc4vity  /  Efficiency  /  Burden   reduc4on   –  The  nurse  has  reduced  the  number  of   •  Pa4ent  experience   visits  per  week  by  4  enabling  her  to  visit   other  needy  pa4ents   –  He’s  doing  it  from  his  lounge   –  Stan  is  empowered  –  no  longer  anxious   in  his  usual  chair   –  reduced  calls  on  Health  Service   –  He  has  become  an  expert   •  Climate  /  Environmental   pa4ent;  knowing  when  vital   –  Reduc4on  in  unnecessary  home  /  clinic   visit   signs  are  high   –  He  is  confident  and  able  to   live  in  his  own  home  with   his  wife   –  His  wife’s  quality  of  life  has   improved   –  He’s  no  longer  grumpy!   [Note:  Stan  was  the  subject  of  an  independent  BBC  Video]  16/11/2011   28
  29. 29. Summary   •  Telehealth  can  significantly  improve  the  quality   of  life  of  pa4ents  with  Long  Term  Condi4ons   •  Pa4ent  Selec4on  is  key   •  Next  Genera4on  Communica4ons  will  enable   Next  Genera4on  Assisted  Living  Services   •  But  Who  Pays  for  Them  and  How  is  yet  to  be   determined   •  Above  all  Next  Genera@on  Networks  need  to  be   engineered  to  ensure  that  my  Heart  ADack   alert  is  not  obstructed  by  someone  else   watching  Eastenders  on  HD  IPTV  16/11/2011   29  
  30. 30. Thank  You   Docobo Limited The Old Granary 21 High Street Great Bookham Leatherhead Surrey KT23 4AA Tel: +44 (0)1372 459 866   30