Dr. Hubert Curran


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Dr. Hubert Curran

  1. 1. Connected Health in the NI Community A personal view Dr Hubert Curran Clinical Lead ECCH
  2. 2. Northern Ireland
  3. 3. Why LTC focus? <ul><li>In NI over 500,000 have a Long Term Condition </li></ul><ul><li>224,000 Hypertension </li></ul><ul><li>105,000 Asthma </li></ul><ul><li>72,500 CHD </li></ul><ul><li>67,000 Diabetes </li></ul><ul><li>55,000 CKD </li></ul><ul><li>31,000 Stroke/TIA </li></ul><ul><li>29,000 COPD </li></ul><ul><li>23,000 Cancer </li></ul><ul><li>20,000 Heart Failure </li></ul><ul><li>14,400 Severe MH problems </li></ul><ul><li>13,700 Epilepsy </li></ul><ul><li>Others:Dementia, MS, Parkinsons, PVD </li></ul><ul><li>(Raw prevalence data DHSSPS March 2010) </li></ul>
  4. 4. Scale of problem <ul><li>30% of overall population </li></ul><ul><li>60% of patients over 65 have at least 1 LTC </li></ul><ul><li>Of these up to 50% could potentially benefit from Assistive Technology </li></ul><ul><li>The >65 pop is set to rise by 50% by 2028 </li></ul><ul><li>The >85 pop is set to rise by 100% by 2028 </li></ul><ul><li>“ Support Ratio” (those under 65 vs those over 65) will fall from 12:1 to 2:1 in the period 1950-2050 </li></ul>
  5. 5. Demographics
  6. 6. LTC usage of NHS services <ul><li>Those with an LTC </li></ul><ul><li>52% of all GP appointments </li></ul><ul><li>65% of all OP appointments </li></ul><ul><li>72% of all I/P bed days </li></ul><ul><li>Twice as likely to have used SSD within last 6 months </li></ul><ul><li>Three times as likely to have used Community Nurses within last 6 months </li></ul><ul><li>Probably >70% of all current healthcare expenditure </li></ul>
  7. 8. A little recent history of Connected Health: <ul><li>Dec 2006 £1m for pilots to promote telehealth and telemedicine initiatives </li></ul><ul><li>15 pilots, on Telecare (vulnerable patients), COPD, Diabetes, Vascular Disease, Dementia, ICD monitoring, Ambulatory ECG monitoring, Stroke support, Bruxism, Paediatric Congenital Heart Disease. </li></ul><ul><li>8 pilots evaluated on behalf of ECCH </li></ul>
  8. 9. BDO Stoy Hayward evaluation <ul><li>Patients love it </li></ul><ul><li>Clinicians grow to like it </li></ul><ul><li>It appears to reduce anxiety and offer reassurance (mainly to patients!) </li></ul><ul><li>It appears to facilitate appropriate staff deployment </li></ul><ul><li>It may increase workload initially </li></ul><ul><li>Parameter setting (or not) is absolutely crucial </li></ul>
  9. 10. Aims of RTNI <ul><li>Improve the quality of care of patients with longterm conditions [LTC] by making services more responsive and accessible </li></ul><ul><li>Empower patients to become actively involved in the management of their condition </li></ul><ul><li>Provide healthcare professionals with timely patient information to enable them to look after vulnerable people in the most appropriate way, providing for early intervention and averting avoidable exacerbation of the disease. </li></ul>
  10. 11. Other aims <ul><li>Support carers </li></ul><ul><li>Use staff efficiently </li></ul><ul><li>Decrease hospital and nursing home admissions </li></ul><ul><li>Meet increased public expectation </li></ul><ul><li>Exploit developing technology </li></ul><ul><li>Mitigate the effects of the demographic timebomb! </li></ul>
  11. 12. Partners <ul><li>Public </li></ul><ul><li>Professionals </li></ul><ul><li>Policy Makers </li></ul><ul><li>Industry Providers </li></ul><ul><li>Academic and Research Community </li></ul><ul><li>ICT Community </li></ul>
  12. 13. Barriers <ul><li>Organisational or Individual </li></ul><ul><li>Disagreement over the need to change </li></ul><ul><li>Poorly defined policy </li></ul><ul><li>Resource deficiencies </li></ul><ul><li>Low tolerance of change </li></ul><ul><li>Misunderstanding (poor communication) </li></ul>
  13. 15. More barriers <ul><li>Professional preciousness </li></ul><ul><li>Poor leadership </li></ul><ul><li>Tradition and self-interest </li></ul><ul><li>Inertia </li></ul><ul><li>Previous negative experience </li></ul><ul><li>Poor industry preparedness/flexibility </li></ul><ul><li>“One-size-fits-all”! </li></ul>
  14. 16. Personalised Connected Health <ul><li>3 dimensions: </li></ul><ul><li>The severity of chronic illness </li></ul><ul><li>Individual engagement </li></ul><ul><li>Technology readiness </li></ul><ul><li>Joe Kvedar </li></ul>
  15. 18. Key messages <ul><li>Information </li></ul><ul><li>Education </li></ul><ul><li>Developing opinion formers </li></ul><ul><li>Seeking participation </li></ul><ul><li>Negotiation </li></ul><ul><li>Simplification </li></ul><ul><li>Adaption and flexibility </li></ul><ul><li>Evaluation and modification </li></ul>