Extended National ICT Research Directors Forum meeting on European Large Scale Actions (ELSA) ICT for Health Dr Dipak Kalra Dr Dipak Kalra University College London University College London email@example.com firstname.lastname@example.org behalf of an panel of experts convened to consideron behalf of an panel of experts convened to considerELSA priorities for ICT solutions for sustainable healthELSA priorities for ICT solutions for sustainable health
European health systems:priorities and challenges • Growing expectations for equity of access, quality and efficiency, patient empowerment and engagement • Rising incidence of chronic diseases and increased complexity of their treatment • age related: dementia, cancer • lifestyle related: diabetes, asthma, obesity, ischaemic heart disease • Growing expectations and concerns about patient safety • Need for better integration across wellness, health care, public health, occupational health and social care • Demographic change • ageing population is driving up demand for health services • adverse health worker to patient ratio • Societal pressure for demonstrable protection of privacy
Priorities for reliable state-of-the-arthealthcare to all • focus on prevention and support of patient self-care and life style management • foster translation and utilisation of research results into clinical practice • improve chronic disease management: knowledge driven, longitudinal, across care boundaries, patient involving • focus on (close to) home and ambulatory health services • achieve better integration with between healthcare services, social care and wellness services • improve skills shortage: case based and population based e-learning, advanced simulations and modelling
A pan-European Health Infostructure Wellness Social care Fitness Citizen in the Occupational health Complementary community School health health rapid bench to bed translation real-time knowledge directed care Point of care delivery Teaching explicit consent Research Clinical trials Continuing care (within the institution) Education Public health Research de-identified implied consent Health care Epidemiology +/- consent management Data mining Clinical audit Long-term shared care (regional national, global)
Implications and opportunities forICT in health • Manage increasingly complex clinical care • Connect multiple locations of care delivery • Support team-based care • Deliver evidence-based health care • Improve safety • reduce errors and inequalities • reduce duplication and delay • Improve cost effectiveness of health services • Enrich population health management and prevention • Empower and involve citizens • Protect patient privacy • Better inform and exploit bio-science research
Electronic Health Record - EHR 2.0 Clinical trials, Decision support, functional genomics, EHR repositories knowledge management public health databases and analysis components Integrating information Date: 1.7.94 Whittington Hospital Centring services Healthcare Record on citizens John SmithPersonnel registers, DoB 12.5.46 : Creating and security services using knowledge Mobile devices Clinical Clinical devices, applications instruments Social computing: forums, wikis and blogs
Examples of Health ICT researchenabled by the Framework Programme • Comprehensive electronic records (EHR) • requirements, information architectures, clinical data standards, terminology systems, security - now published as international standards • BUT now needing to be validated against large scale challenges • standardised clinical meaning across diverse communities of practice • cross-border confidentiality protection and de-identification • pan-European quality assured and certified eHealth interoperability solutions • Virtual Physiological Human (VPH) • sophisticated modelling of how body systems and organs behave in health and in disease, to help optimise treatment decisions • BUT now needing to be refined through • linkage with real electronic health records, and real-world clinical data quality • safety testing for real clinical decisions in varied care settings • Personal Health Systems (PHS) • wearable and implanted and near patient monitors, communicating with a central repository: integrating and alerting whenever needed • BUT now needing to • integrate with holistic EHR data • safely advise on patients with multiple diseases and using multi-vendor PHS products
Principles for a successful approach • To focus on a very concrete societal need which can be addressed by user and experience driven R&D, innovation and large scale demonstrators leading to wide deployment • Special effort to engage payers, clinicians and patients at every stage in addition to the other (more committed) stakeholders. • Major milestone: European infostructure on top of national eHealth infrastructures (not their duplication!) • Focus on few applications demonstrating the benefits of such infostructure and open the way for regional/national/international developments • Provision of visible and useful milestones, at regular intervals
Examples of objectives of an ELSAon eHealth • Improve the quality and effectiveness of clinical shared care and facilitate cross border care • Provide “the right information, in the right place, at the right time” to health providers and patients while securing the citizens right to privacy • Bring into the equation other data relevant to our health beyond medical information (lifestyle, environment) • Improve the way clinical research is performed and facilitate faster translation into clinical practice
Emphasising translation • The EU Health Telematics Framework Programmes have inspired some of the best health informatics research on the planet • But, it has proved difficult for some of the research to be refined and validated at the scale needed for national or European adoption • potential impact has not been realised yet • market potential is as yet under-recognised • societal gains and cost savings remain a missed opportunity • It is now vital to capitalise on proof of concept and SME level Health ICT research • ELSA’s have the potential to provide large scale validation, evidence of what works well, and how to turn research results into products and daily experience
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