Health & Social Care Event in Scotland bringing world-leading digital health experts and technologists from Scotland, Estonia and Finland as they gather for FutureScot's Health & Social Care 2017 - a one-day conference focusing on how advances in digital technology can help deliver better outcomes for adults and children as we chart our own course towards health and social care integration in Scotland. Join the conversation: #HSCSCOT
Predictive Medicine & Personal Engaging Healthcare, Health & Wellbeing Data Analytics Environment, Biodesign Finland - Innovating Medical Technologies in Interdisciplinary Teams
Remote Rehabilitation: A Solution to Overloaded & Scarce Health Care Systems_...CrimsonpublishersTTEH
Remote Rehabilitation: A Solution to Overloaded & Scarce Health Care Systems by Karla Muñoz Esquivel in Trends in Telemedicine & E-health
The population across Northern Europe is aging. Coupled with socio-economic challenges, health care systems are at risk of overloading and incurring unsustainable high costs. Rehabilitation services are used disproportionately by older people. One solution pertinent to rural areas is to change the model of rehabilitation to incorporate new technologies. This has the potential to free resources and reduce costs. However, implementation is challenging. In the Northern Periphery and Artic Programme (NPA), the Smart sensor Devices for rehabilitation and Connected health (SENDoc) project.
For more Open access journals in Crimson Publishers Please click on: https://crimsonpublishers.com/
For more articles in Open access journal of Innovation in urgical Open Access Journal
Please click on: https://crimsonpublishers.com/tteh/index.php
The study on social impact of free health service in Sri LankaRavi Kumudesh
Study on social impact of free health service in Sri Lanka
Ravi Kumudesh(kumudeshr@gmail.com)
Statistical data and the sense of community show a gap of total health expenditure and public health expenditure. This gap shows the problem of sustainability of free health and has created several problems on patients who visit the government hospital for their healthcare needs and health development in community.
This study is focused to clear out the disparity of the health policy by identifying the obstacles to obtain free healthcare facilities from state sector healthcare institutions, and to clarify evidently the circulation of additional amount of money in health service other than public health expenditure creating problems of free health service.
Questioner was the instrument used in primary data collection. Responses were analyzed with income levels. Availability of hospital facilities, mode of spending, utility of private and government health facilities, aptitude on current health trends and prevention healthcare were surveyed. Secondary data analysis also carried out based on WHO reports, reports of Ministry of Health and other international reports.
Primary data indicated inadequate facilities in state hospitals. Out of admitted patients 72% were requested some drugs and laboratory tests from outside. Every respondent spends some amount of money monthly for their health needs, even among low income levels. Only 21% was alert on preventive health care. Out of the respondents who utilize the private health care services 78% pay their expenditure from out of pocket. It includes both people with high income levels as well as low income levels. Secondary data analysis could justify the present situation of the country health. Public health expenditure share of total health expenditure is always less than 50%.
The research realized that all income levels utilize private sector for their health care needs. Most of people who utilize the private sector pay their bills out of pocket. These evidences show the disparity of free health policy and the nature of persisting health care service. Complete understand on this complicated underlying reality of health should be concerned in provision of sustainable health care service.
Occupational health and primary health care in ThailandHealth and Labour
Presentation by dr. Siriruttanapruk from the ministry of public health of Thailand at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012
Predictive Medicine & Personal Engaging Healthcare, Health & Wellbeing Data Analytics Environment, Biodesign Finland - Innovating Medical Technologies in Interdisciplinary Teams
Remote Rehabilitation: A Solution to Overloaded & Scarce Health Care Systems_...CrimsonpublishersTTEH
Remote Rehabilitation: A Solution to Overloaded & Scarce Health Care Systems by Karla Muñoz Esquivel in Trends in Telemedicine & E-health
The population across Northern Europe is aging. Coupled with socio-economic challenges, health care systems are at risk of overloading and incurring unsustainable high costs. Rehabilitation services are used disproportionately by older people. One solution pertinent to rural areas is to change the model of rehabilitation to incorporate new technologies. This has the potential to free resources and reduce costs. However, implementation is challenging. In the Northern Periphery and Artic Programme (NPA), the Smart sensor Devices for rehabilitation and Connected health (SENDoc) project.
For more Open access journals in Crimson Publishers Please click on: https://crimsonpublishers.com/
For more articles in Open access journal of Innovation in urgical Open Access Journal
Please click on: https://crimsonpublishers.com/tteh/index.php
The study on social impact of free health service in Sri LankaRavi Kumudesh
Study on social impact of free health service in Sri Lanka
Ravi Kumudesh(kumudeshr@gmail.com)
Statistical data and the sense of community show a gap of total health expenditure and public health expenditure. This gap shows the problem of sustainability of free health and has created several problems on patients who visit the government hospital for their healthcare needs and health development in community.
This study is focused to clear out the disparity of the health policy by identifying the obstacles to obtain free healthcare facilities from state sector healthcare institutions, and to clarify evidently the circulation of additional amount of money in health service other than public health expenditure creating problems of free health service.
Questioner was the instrument used in primary data collection. Responses were analyzed with income levels. Availability of hospital facilities, mode of spending, utility of private and government health facilities, aptitude on current health trends and prevention healthcare were surveyed. Secondary data analysis also carried out based on WHO reports, reports of Ministry of Health and other international reports.
Primary data indicated inadequate facilities in state hospitals. Out of admitted patients 72% were requested some drugs and laboratory tests from outside. Every respondent spends some amount of money monthly for their health needs, even among low income levels. Only 21% was alert on preventive health care. Out of the respondents who utilize the private health care services 78% pay their expenditure from out of pocket. It includes both people with high income levels as well as low income levels. Secondary data analysis could justify the present situation of the country health. Public health expenditure share of total health expenditure is always less than 50%.
The research realized that all income levels utilize private sector for their health care needs. Most of people who utilize the private sector pay their bills out of pocket. These evidences show the disparity of free health policy and the nature of persisting health care service. Complete understand on this complicated underlying reality of health should be concerned in provision of sustainable health care service.
Occupational health and primary health care in ThailandHealth and Labour
Presentation by dr. Siriruttanapruk from the ministry of public health of Thailand at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012
The Solomon Islands HiT determines that the country’s health system has significant weaknesses but also considerable strengths. Despite the range and difficulty of issues facing policy-makers in the Solomon Islands, there have been significant achievements in health, including considerable progress in advancing population health status. The performance of the health system is positive, achieving high coverage, high satisfaction levels, and steady progress on health outcomes. Nonetheless, the country faces important health challenges that could undermine development gains made to date
This is an assignment for ITTP Special Topic in IT Engineering. Within this presentation, I try to propose e-health as term project.
E-health is important for Indonesia.
The People’s Republic of China has made great achievements in improving health status over the past six decades, mainly due to the government’s commitment to health, provision of cost effective public health programmes, growing coverage of health financial protection mechanisms and investments in an extensive health-care delivery network.
This is primarily based on a chapter from our most recent publication.
I want to acknowledge the authors of the chapter:
Melisa Tan, Victoria Haldane, Sue-Anne Toh & Helena Legido-Quigley from NUS
Martin McKee from LSHTM
Summary of the current 4 main NCDs situation in Asia including risk factors
Examples of health system response
Challenges
The Republic of Korea HiT notes that economic development and universal health coverage through national health insurance has led to a rapid improvement in health outcomes. Overall, the health status of the Korean population is better than that of many other Asian countries. Reducing inequality in health coverage outcomes, strengthening primary health care and improving coordination between hospitals and long-term care facilities to meet the needs of the aged population are the challenges facing the Government.
This second edition of the health system review of Philippines shows the major changes that have occurred over the 7 years since the last review. Channelling of funds from sin tax to Health has shown unprecedented levels of finances are now available for UHC. PhilHealth has dramatically increased coverage of people as well as service providers that it works with from both government and non-government sectors. However major challenges remain; regional and socioeconomic disparities in the availability and accessibility of resources are prominent and there is a need to improve regulation of service providers. Philippines HiT reports on the current health system reforms undertaken including challenges of incorporating primary health care as in the overall health architecture of the country.
Health access for all Thailand’s.The Thai citizens gain universal access to essential health services at zero cost, and reap significant benefits as babies get healthier, workers increase productivity, and households reduce financial risk.
The Republic of Korea reported its first COVID-19 case on the 20th of January 2020. Since then, the country has reported 34,201 confirmed cases of COVID-19 and 526 deaths. The Republic of Korea’s COVID-19 response is characterized by its swift and broad 3Ts (test – trace – treat) strategy. Measures taken by the country demonstrate a collaborative effort between ministries, across levels of governance, with a focus on the implementation of essential public health measures to prevent and manage COVID-19 cases in the country. Systematic public health measures such as maintaining physical distance, with limited restrictions on mobility, strong health communication, rigorous implementation of isolation and quarantine measures, as well as monitoring and surveillance were key to containing the outbreak in the country.
The report presents the various policies and steps that were put in place from the beginning of the outbreak to control COVID-19 transmission in the country.
These slides present details from the more comprehensive COVID-19 HSRM on the Republic of Korea
Japan was one of the first countries to be hit by COVID-19 and declared a state of emergency by April 2020. Japan’s response to COVID-19 included the imposition of context-specific measures and restrictions based on local need to contain the spread of the disease. Containment measures were enacted under the Act on Special Measures for Pandemic Influenza and New Infectious Diseases Preparedness and Response. Citizens were requested to abide by containment measures that focused on avoiding the 3C’s: Closed spaces with poor ventilation; Crowded places; Close‐contact settings. Health infrastructure, workforce, and supply chain were strengthened, alongside social security interventions including financial support for citizens. Primary health centers were strengthened and were at the forefront of Japan’s COVID-19 response at the local level.
This publication presents the various measures that were put in place from the beginning of the outbreak until December 2020 to control COVID-19 transmission in the country. We aim to update this document as new policies and interventions are operationalized to respond to the outbreak.
The Thailand HiT reports that sustained political commitment to the health of the population since the 1970s has resulted in significant investment in health infrastructure, in particular primary health care, district and provincial referral hospitals, and strengthened the overall functioning of the Thai health system. After Thailand achieved universal health coverage in 2002, public expenditure on health significantly increased from 63% to 77% and out-of-pocket expense was reduced from 27.2% to 12.4% of the total health spending in 2011.
Japan has made numerous achievements in health most notably the world’s highest life-expectancy in the past two decades, since its founding Universal Health Insurance System in 1961. However, ageing population with low-fertility rates, stagnating economy, increasing burden of NCDs and growing use of expensive technologies pose the critical challenges in service delivery and financial stability in health. Japan HiT reports current health system reforms undertaken and also recent discussion on paradigm shift to the new system as proposed in Japan Vision: Health Care 2035.
The Digital Health Society (by Julien Venne) @ICT2018 Vienna 6th Dec 2018Julien VENNE
The Digital Health Society is a movement involving all stakeholders innovating for a better health and wellbeing of citizens. Presentation done by Julien Venne at the ICT2018 organised by the European Commission in Vienna in December 2018. Learn about and join the movement on www.thedigitalhealthsociety.com
The Solomon Islands HiT determines that the country’s health system has significant weaknesses but also considerable strengths. Despite the range and difficulty of issues facing policy-makers in the Solomon Islands, there have been significant achievements in health, including considerable progress in advancing population health status. The performance of the health system is positive, achieving high coverage, high satisfaction levels, and steady progress on health outcomes. Nonetheless, the country faces important health challenges that could undermine development gains made to date
This is an assignment for ITTP Special Topic in IT Engineering. Within this presentation, I try to propose e-health as term project.
E-health is important for Indonesia.
The People’s Republic of China has made great achievements in improving health status over the past six decades, mainly due to the government’s commitment to health, provision of cost effective public health programmes, growing coverage of health financial protection mechanisms and investments in an extensive health-care delivery network.
This is primarily based on a chapter from our most recent publication.
I want to acknowledge the authors of the chapter:
Melisa Tan, Victoria Haldane, Sue-Anne Toh & Helena Legido-Quigley from NUS
Martin McKee from LSHTM
Summary of the current 4 main NCDs situation in Asia including risk factors
Examples of health system response
Challenges
The Republic of Korea HiT notes that economic development and universal health coverage through national health insurance has led to a rapid improvement in health outcomes. Overall, the health status of the Korean population is better than that of many other Asian countries. Reducing inequality in health coverage outcomes, strengthening primary health care and improving coordination between hospitals and long-term care facilities to meet the needs of the aged population are the challenges facing the Government.
This second edition of the health system review of Philippines shows the major changes that have occurred over the 7 years since the last review. Channelling of funds from sin tax to Health has shown unprecedented levels of finances are now available for UHC. PhilHealth has dramatically increased coverage of people as well as service providers that it works with from both government and non-government sectors. However major challenges remain; regional and socioeconomic disparities in the availability and accessibility of resources are prominent and there is a need to improve regulation of service providers. Philippines HiT reports on the current health system reforms undertaken including challenges of incorporating primary health care as in the overall health architecture of the country.
Health access for all Thailand’s.The Thai citizens gain universal access to essential health services at zero cost, and reap significant benefits as babies get healthier, workers increase productivity, and households reduce financial risk.
The Republic of Korea reported its first COVID-19 case on the 20th of January 2020. Since then, the country has reported 34,201 confirmed cases of COVID-19 and 526 deaths. The Republic of Korea’s COVID-19 response is characterized by its swift and broad 3Ts (test – trace – treat) strategy. Measures taken by the country demonstrate a collaborative effort between ministries, across levels of governance, with a focus on the implementation of essential public health measures to prevent and manage COVID-19 cases in the country. Systematic public health measures such as maintaining physical distance, with limited restrictions on mobility, strong health communication, rigorous implementation of isolation and quarantine measures, as well as monitoring and surveillance were key to containing the outbreak in the country.
The report presents the various policies and steps that were put in place from the beginning of the outbreak to control COVID-19 transmission in the country.
These slides present details from the more comprehensive COVID-19 HSRM on the Republic of Korea
Japan was one of the first countries to be hit by COVID-19 and declared a state of emergency by April 2020. Japan’s response to COVID-19 included the imposition of context-specific measures and restrictions based on local need to contain the spread of the disease. Containment measures were enacted under the Act on Special Measures for Pandemic Influenza and New Infectious Diseases Preparedness and Response. Citizens were requested to abide by containment measures that focused on avoiding the 3C’s: Closed spaces with poor ventilation; Crowded places; Close‐contact settings. Health infrastructure, workforce, and supply chain were strengthened, alongside social security interventions including financial support for citizens. Primary health centers were strengthened and were at the forefront of Japan’s COVID-19 response at the local level.
This publication presents the various measures that were put in place from the beginning of the outbreak until December 2020 to control COVID-19 transmission in the country. We aim to update this document as new policies and interventions are operationalized to respond to the outbreak.
The Thailand HiT reports that sustained political commitment to the health of the population since the 1970s has resulted in significant investment in health infrastructure, in particular primary health care, district and provincial referral hospitals, and strengthened the overall functioning of the Thai health system. After Thailand achieved universal health coverage in 2002, public expenditure on health significantly increased from 63% to 77% and out-of-pocket expense was reduced from 27.2% to 12.4% of the total health spending in 2011.
Japan has made numerous achievements in health most notably the world’s highest life-expectancy in the past two decades, since its founding Universal Health Insurance System in 1961. However, ageing population with low-fertility rates, stagnating economy, increasing burden of NCDs and growing use of expensive technologies pose the critical challenges in service delivery and financial stability in health. Japan HiT reports current health system reforms undertaken and also recent discussion on paradigm shift to the new system as proposed in Japan Vision: Health Care 2035.
The Digital Health Society (by Julien Venne) @ICT2018 Vienna 6th Dec 2018Julien VENNE
The Digital Health Society is a movement involving all stakeholders innovating for a better health and wellbeing of citizens. Presentation done by Julien Venne at the ICT2018 organised by the European Commission in Vienna in December 2018. Learn about and join the movement on www.thedigitalhealthsociety.com
Digital Health in Context - Insights from Denmark, USA, China, South Korea an...Till Winkler
Slides from the workshops on Digital Health in Context at Copenhagen Business School (CBS) June 28, and the Hamburg Center of Health Economics (CHE) July 4, 2018.
Usability Lessons From National Healthcare AppsCyber-Duck
From our webinar, The Good, The Bad & The Ugly - Usability Lessons From National Healthcare Apps.
Discover our presentation for World Usability Day, as we shine a light on the impact of digitalisation on public health services, specifically through the lens of delivering great user experiences and better patient care with healthcare apps.
eHealth Summit: "Delivering Services that are Fit for the Future: From Strate...3GDR
Slides from National eHealth Summit, 30 Sept 2015 at Carton House, Kildare: Prof George Crooks OBE, Medical Director NHS 24 and Director, Scottish Centre for Telehealth and Telecare
#eHealthSummit15
http://www.ehealthsummit.ie
http://mhealthinsight.com/2015/09/25/mhealth-insights-from-the-ehealth-summit/
eHealth Practice in Europe: where do we stand?chronaki
eHealth as the use of Information and communication technologies in the practice of health care comprises Electronic health records, Healthcare information exchange cross-jurisdictions, Personal health records, Telehealth, telemedicine and remote monitoring.
There are several efforts to reflect and measure the practice of eHealth including efforts by the OECD and WHO, but in general there is little reported sharing of health data particularly with patients. Specific barriers frequently mentioned are supporting policies and coherent widely implemented standards.
The presentation discusses relevant efforts and programs supported by the European Commission such as the eHealth DSI, eStandards, ASSESS CT, and openMedicine aiming at large scale eHealth adoption It calls for engagement of European Society, its national societies, and its members.
Current regulations regarding eHealth in Europe by Frank Lievens, Executive Secretariat ISfTeH Director, Managing Director Lievens-Lanckman bvba, Belgium
The PPT describes about the healthcare issues in Europe and how eHealth is becoming a solution for those issues. Also the policy for eHealth in Europe. For more information visit: http://www.transformhealth-it.org/
apidays LIVE India - The digitisation of healthcare by Dr S.S. Lal, Global Fo...apidays
apidays LIVE India 2021 - Connecting 1.3 billion digital innovators
May 20, 2021
The digitisation of healthcare
Dr S.S. Lal, President of Global Foundation for Health and Hygiene
National Kanta Services Support Clinical Work in FinlandTHL
National Kanta Services Support Clinical Work in Finland. Vesa Jormanainen, Finnish Institute for Health and Welfare Webinar on Kanta Services
30 October 2019
eHealth Summit: "EU Address: The EU eHealth Strategy: Connecting Member State...3GDR
Slides from National eHealth Summit, 30 Sept 2015 at Carton House, Kildare: Dr Tapani Phia, Head of Unit, eHealth & Health Technology Assessment, European Commission.
#eHealthSummit15
http://www.ehealthsummit.ie
http://mhealthinsight.com/2015/09/25/mhealth-insights-from-the-ehealth-summit/
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Trauma Outpatient Center is a comprehensive facility dedicated to addressing mental health challenges and providing medication-assisted treatment. We offer a diverse range of services aimed at assisting individuals in overcoming addiction, mental health disorders, and related obstacles. Our team consists of seasoned professionals who are both experienced and compassionate, committed to delivering the highest standard of care to our clients. By utilizing evidence-based treatment methods, we strive to help our clients achieve their goals and lead healthier, more fulfilling lives.
Our mission is to provide a safe and supportive environment where our clients can receive the highest quality of care. We are dedicated to assisting our clients in reaching their objectives and improving their overall well-being. We prioritize our clients' needs and individualize treatment plans to ensure they receive tailored care. Our approach is rooted in evidence-based practices proven effective in treating addiction and mental health disorders.
The global radiation oncology market size reached US$ 8.1 Billion in 2023. Looking forward, IMARC Group expects the market to reach US$ 14.5 Billion by 2032, exhibiting a growth rate (CAGR) of 6.5% during 2024-2032.
More Info:- https://www.imarcgroup.com/radiation-oncology-market
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
- Primary pleural tumors and pleural metastases.
- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
COVID-19 PCR tests remain a critical component of safe and responsible travel in 2024. They ensure compliance with international travel regulations, help detect and control the spread of new variants, protect vulnerable populations, and provide peace of mind. As we continue to navigate the complexities of global travel during the pandemic, PCR testing stands as a key measure to keep everyone safe and healthy. Whether you are planning a business trip, a family vacation, or an international adventure, incorporating PCR testing into your travel plans is a prudent and necessary step. Visit us at https://www.globaltravelclinics.com/
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Nursing Care of Client With Acute And Chronic Renal Failure.ppt
Health Social Care Scotland 2017
1.
2. Digital Innovation and Partnership working across health, social
care, housing, third and independent sector organisations.
Diana Hekerem
Head of Strategic Commissioning Support
Christine Owen
Improvement Advisor
3. National Improvement Programmes
Care Delivery
• Living Well in Communities
• Primary Care
• Mental Health
• Acute
• Dementia
• Place, Home and Housing
• Medicines (SPSP)
• Maternity and Children’s
System Enablers
• Strategic Planning
• Outcomes-based commissioning
• Strategic Commisioning Design
• Third and Independent Sector Engagement
• Board and Partnerships QI Development
• Evidence, Evaluation and Knowledge Exchange
• Person Centred Health and Care
Tailored
and Responsive
Improvement Support
Grants and Allocations
Blending technical QI methodology, design methods and relational change management techniques
Supporting health and social care services to
redesign and continuously improve
4.
5.
6. …to share new models of care and
generate ideas around alternatives to
overnight support while maintaining safe
and quality support for people who need
it…
10. The Need for Change
Prof George Crooks OBE
CEO Digital Health & Care Institute
11. …everyone is able to live longer healthier lives at home, or in a homely
setting. We will have a healthcare system where we have integrated
health and social care, a focus on prevention, anticipation and
supported self management. When hospital treatment is required, and
cannot be provided in a community setting, day case treatment will be
the norm. Whatever the setting, care will be provided to the highest
standards of quality and safety, with the person at the centre of all
decisions. There will be a focus on ensuring that people get back into
their home or community environment as soon as appropriate, with
minimal risk of re-admission.
Our vision is that by 2020…
28. • Increase Inpatient mortality by 20%
• Increase Inpatient Length of Stay by 1-3 days
• Increase likelihood of errors
• Increase complaints and litigation
Which environment will do the following?
31. • a 15% reduction in A&E visits
• a 20% reduction in emergency admissions
• a 14% reduction in elective admissions
• a 14% reduction in bed days
• an 8% reduction in tariff costs
• a 45% reduction in mortality rates
Which environment produces:
34. Increasing;
• Choice
• Control
• Connectedness
• Collaborations
• Contributions
• Communities
Health, care and wellbeing – person focussed
wider world
locality
home
wider world
locality
home
35. The EC has funded a number of telehealth projects,
among the largest:
United 4 Health
36. Gender and age group
Age group (years)
60%
40%
Μale
Female
0%
10%
20%
30%
40%
50%
<65 65-75 >75
51%
29%
20%
DM COPD CHF
Mean age
(years)
56 ±
17
71 ±
10
73 ± 12
37. Are they familiar with the use of technology?
47%
53%
PC use
YES NO
88%
12%
Mobile Phone use
49. MADIS TIIK MD, PHD
HOW DIGITALIZATION CHANGES HEALTHCARE
&
E-HEALTH IN ESTONIA
50. Tartu University, Medical Doctor, 1996
Tartu University, Family Doctor, 2000
Nordic School of Public Health (Sweden) -
Diploma in Public Health, 2003
Estonian Business School, ICT Management,
2001-2003
Tallinn University of Technology, PhD
(Healthcare Engineering) 2012
Scripps Translational Science Institute (San
Diego, USA), Digital Medicine intern, 2014-
2015
EDUCATION
51. Family doctor 1998-
Estonian Society of Family Doctors, Chairman 2001-2008.
Estonian eHealth Foundation (EEHF), Board member, 2005-2007
Terviseagentuur Ltd. CEO, Owner, 2006-…
Estonian eHealth Foundation, CEO, 2007-2011
Scientific adviser of the President of the Estonia. Preparing report for EU
Commission, how to improve ehealth after 2020. 2011-2012
Tallinn University of Technology (TUT), eHealth Lab, lecturer 2014-
Sitra (Finnish innovation fund), Senior Adviser, 2012-
CAREER
55. INFORMATION SOCIETY STRATEGY (2002)
By 2013
All public services are digitaly available
Public infrastruture is service oriented (x road)
Digital authorisation of users, based on the ID card,
is the best available in the world
Data is stored were it is collected and exchange of
the data is available thous who need it
56.
57. CURRENT SITUATION IN ESTONIA
X-Road launched in Estonia in 2002
More than 170 databases are offering services via X-
Road (producer certificates)
More than 3000 services are available
More than 900 organisations are using X-Road daily
(consumer certificates)
More than 70% of citizens are using X-Road via
Citizen portal
Most of companies (~160 000) are used X-Road via
Entrepreneur portal
58. INFORMATION SOCIETY INDICATORS
100% of schools and government organisations have broadband
connection
75% of homes have broadband connection
99% of bank transfers are performed electronically
95% of income tax declarations made via the e-Tax Board
E-census (2012) 815,467 persons completed the questionnaire -62%
26% of votes were cast over the internet on 2015 (Parlament elections)
99% of prescriptions are digital
100% citizens has a digital medical record
ALL PUBLIC SERVICES ARE DIGITAL (2013)
60. HEALTH INFORMATION EXCHANGE PLATFORM
Operational since 01.01.2009
Implementation strategy (2009-2013)
step by step implementation
User groups in different timeframe
Documents in different timeframe
Only standardized medical documents accepted (HL7v3)
No previous history (before 2009)
Only agreed amount of medical information
Opt out approach for citizens and equal access for all
medical professionals
61. E-HEALTH SERVICES IN ESTONIA
Nation-wide health information system
Available documents
Time critical data (allergy, chronic diseases)
General practitioners and hospital visits
Summary of ambulatory and stationary case
Link to medical images
Referral letter
ePrescription
Digital images - available all over the county (for physicians only)
eReferral
eAmbulance
eSchool
eConsultation
Patient Portal
62.
63. ACCESS RIGHTS FOR EHR
All healthcare providers must send data to EHR
Regulated by the law
Access only to licensed medical professionals
The attending doctor concept
ID card for authentication and digital signature
Patient has the right to close his/her own data collected to
the central database (opt out)
Citizen can access their own data
Citizen can declare their intentions and preferences
Citizen can monitor visits to their EHR
64.
65. ORGANIZATION AND FINANCING OF E-HEALTH
Estonian eHealth Foundation
Standardization
Development of new services
Maintenance of the HIE system
Financed from the state budget
1/3 of the maintenance cost (HIE) is coming through
healthcare providers
Each price in the Estonian Health Insurance Fond
price list contains a ehealth components
Investment cost for ehealth
Maintenance cost
66. DISTRIBUTION OF COSTS AND BENEFITS OF ESTONIAN
E-HEALTH PLATFORM (DIGIIMPACT STUDY 2010)
Total cost of EHR system development (2005-2010) was
around 10M€ - it is 7.5€ per citizen
67. EU 2.8 M€
EHR 1,599,705
IT SOLUTION 18%
STANDARDIZATION 34%
PUBLIC RELATIONS 15%
ETHICS AND LEGISLATION 12%
PROJECT MANAGEMENT 21%
DIGITAL PRESCRIPTION 218,822
DIGITAL REGISTRATION 188,223
DIGITAL IMAGES 186,479
EDUCATIONAL PROJECT (INCREASING MEDICAL
PROFESSIONALS SKILLS IN COMPUTING)
624,254
68.
69. HEALTHCARE SYSTEM TODAY
Specialist
329 will
meet a
medical
profession
al, e.g.
nurse
1000 citizens
During one
month
800 of
them have
some
medical
concerns
Green, LA. Fryer, GE Jr. Yawn, BP. Lanier, D. Dovey, SM (2001). ‘The ecology of medical
care revisited.’ New England Journal of Medicine, 344(26): 2021–2025
EHR
Laborator
y /other
tests
General
practicion
er
Laboratory
/other tests
73. 25
WORKFLOW WITH VIRTUAL CLINIC
Nurse
Self-care
EHR
PHR
Symptom checker
Data extraction
Data analytics
Decision making
Advice and
recommendation
Health account
1000 citizens
During one
month
800 of
them
have
some
medical
concerns
Genera
l
practitio
ner
Speciali
st
Laborat
ory
640
160
74. AI
Services for
the person
Health
data
PHR
Health and
wellness
DEVICES
SERVICES
Genomic data
MY
HEALTH
Health
Account
IHAN
My
Data
++
EHR
Sickness data
Disease
episode
informatio
n
Medical
services
Open data
VISION OF HEALTH 3.0
75. ARCHITECTURE OF IHAN
Monitoring and
certification
Mobile App
For person
“Bank”
Personal account
IHAN
consortium
User
B
Trust
Services
(CA/RA +
TSA)
Security Server
Adapter
INTERNET
User
C User
D
User
A
User
Y
User
X
“Central bank”
Services
78. E-mail: madis@madistiik.com
CONTACT INFORMATION
GET IN CONTACT FOR FURTHER COOPERATION
Key-note presentations
Company and government consultations
Business proposals
Round tables and discussion groups
GSM: +372 510 91 43 Skype: kiitsidam
“Accelerating innovation saves
healthcare”
Madis Tiik
LinkedIn: madistiik
Web: www.madistiik.com
79. The Need for Change
Prof George Crooks OBE
CEO Digital Health & Care Institute
80. …everyone is able to live longer healthier lives at home, or in a homely
setting. We will have a healthcare system where we have integrated
health and social care, a focus on prevention, anticipation and
supported self management. When hospital treatment is required, and
cannot be provided in a community setting, day case treatment will be
the norm. Whatever the setting, care will be provided to the highest
standards of quality and safety, with the person at the centre of all
decisions. There will be a focus on ensuring that people get back into
their home or community environment as soon as appropriate, with
minimal risk of re-admission.
Our vision is that by 2020…
97. • Increase Inpatient mortality by 20%
• Increase Inpatient Length of Stay by 1-3 days
• Increase likelihood of errors
• Increase complaints and litigation
Which environment will do the following?
100. • a 15% reduction in A&E visits
• a 20% reduction in emergency admissions
• a 14% reduction in elective admissions
• a 14% reduction in bed days
• an 8% reduction in tariff costs
• a 45% reduction in mortality rates
Which environment produces:
103. Increasing;
• Choice
• Control
• Connectedness
• Collaborations
• Contributions
• Communities
Health, care and wellbeing – person focussed
wider world
locality
home
wider world
locality
home
104. The EC has funded a number of telehealth projects,
among the largest:
United 4 Health
105. Gender and age group
Age group (years)
60%
40%
Μale
Female
0%
10%
20%
30%
40%
50%
<65 65-75 >75
51%
29%
20%
DM COPD CHF
Mean age
(years)
56 ±
17
71 ±
10
73 ± 12
106. Are they familiar with the use of technology?
47%
53%
PC use
YES NO
88%
12%
Mobile Phone use
113. Transforming the Acute Care
Pathway
Dr Jane Eddleston
Consultant in ICM and Anaesthesia
Deputy Medical Director, CMFT
114. Conflict of interest:
Assisted in customising Patientrack for UK
Clinical lead for NICE 50
Clinical lead for the Acute Care
Competency Framework
Member of the RCOP working group for
NEWS
115. 12 million patients are admitted to
the NHS annually (38,000 daily)
60% of admissions are emergency
Acute Medicine >Acute Surgical
emergencies
In-patient treatment more complex
and interventional
Acutely ill patients are a core
business for Acute NHS Trusts
116. How effective is our care pathway for
acutely ill patients ?:
Frequently poor recognition of
deteriorating health in our hospitals.
Frequently inadequate processes in
place to deliver safe care.
Avoidable admission to critical care
for some patients.
Avoidable death for others.
Differences in case-mix adjusted
outcomes/morbidity across the
country.
117.
118.
119. 7
2007 Acute care beds Per 1 000 population
Source: OECD Health Data 2009
0
1
2
3
4
5
6
7
8
9
Japan
Korea
Austria
Germany
Hungary
CzechRepublic
SlovakRepublic
Poland
Belgium
Greece
OECDaverage
Finland
France
Switzerland
Australia
Italy
Netherlands
Denmark
Norway
Portugal
Ireland
Turkey
Canada
UnitedStates
UnitedKingdom
Spain
Sweden
England
Mexico
2007 Acute care beds Per 1 000 population
120. Trend in Emergency Admissions, Acute bed
provision and length of stay
40%
50%
60%
70%
80%
90%
100%
110%
120%
130%
140%
150%
2000-1 2001-2 2002-3 2003-4 2004-5 2005-6 2006-7 2007-8 2008-9 2009-10 2010-11
Acute beds Emergency admissions Length of stay
Acute general beds reduced by 1/3rd in 25 yrs; emergency admissions
increased by ~40%; >65 yrs utilise 70% bed days
123. Impact:
Acute admissions increased
Complexity of in patient work increased
Bed stock reduced
Turnover increased
National Cardiac arrest rate in hospital
static
Weekend effect: mortality 10% higher, why?
125. Why the weekend effect?
Less specialist/consultant presence
Reduced nurse staffing
Fewer junior doctors
Team care fragmented
Continuity of care impaired
More handovers
Delayed or less skilled investigations
Drive to 7 day services:14 hr review, twice daily ward
rounds in Critical Care, AHP input, Diagnostics.
Pattern of admissions ?
13
127. Pattern of admissions
At weekends, public holidays:
- Less care in community –
fewer nurses in community/care homes
less primary care
- Less sick patients delay seeking help
- Acutely sick call 999 etc
Thus relative shift of severity of illness of admissions
Mortality at weekends complex, multifactorial
15
129. How to cope with increasing acute load?
Improved care in community? – doubtful
More hands to the pump?
-more registrars & consultants from
most specialities on acute rotas
Working Differently: where does IT fit in?
17
130. NPSA Report 2007
- NPSA 2007 report “ Safer
care for the acutely ill
patient: learning from
serious incidents”. 576
deaths that could be
interpreted as potentially
avoidable and relating to
patient safety issues
131. Deterioration: issues
No observations made for a prolonged period
prior to a patients death and changes in vital
signs were not detected (21.8%)
Despite the recording of vital signs, there was no
recognition of clinical deterioration and/or no
actions were undertaken (47%)
Deterioration was recognised and assistance
sought but significant delays occurred in the
patient receiving medical attention ( 11%)
132. Deterioration: actions
Recording of Vital signs: Measurement (technique and
accuracy),and Documentation
Recognition of abnormal values: knowledge of normal
physiological measurements
Interpretation of measurements in context of individual
patients
Intervention appropriate to abnormality
Response being timely and matching skills to patient
needs
Organisational team working
136. EWS v Medical Emergency Teams
UK have preference for EWS
Australia /US mixed preference
Most MET criteria based on extreme values of specific
objective physiological criteria. Response all or nothing
EWS use aggregated scores which have weighted
criteria. Graduated multitiered response.
NEWS of 7 : sensitivity 44.5%, specificity 97.4%
NEWS independently associated with increased
mortality, MET criteria not.
MET systems have lower specificity ( Crit Care Med
2016; Smith et al 2171 -2181) . Workload greater.
137. Competency
Group
Non clinical Staff "Recorder" "Recogniser" "Primary
Responder“
"Secondary
responder"
Critical
Care
Description of
group role
call for help and
recognition of
illness
recorder and
interpretation within
T&T protocol
recognition and
interpretation of
observations
primary response
and intervention
Secondary
response and
intervention
Tertiary
response
and Critical
care
NICE Response
Level
Low Risk Low Risk Low Risk Medium Risk High Risk
Patients themselves
Relatives
Ward Clerks
Ward Domestics
Porters/support staff
Trainee clinical staff
Band 2-4 HCAs
Band 5-6 Ward Nurses
Band 6-8 Ward Nurses
Physiotherapists
FY 1 Doctors
FY 2 Doctors
ST 1-2 Doctors
ST 3 to Consultant Doctors
Critical care outreach
Critical care advanced practitioners
Critical care ST1-2 Doctors
Critical care ST 3 to Consl
Hospital at night team
138. Experience with Patientrack
Large tertiary trust (MRI, ST Mary’s, RMCH, REH) plus
DGH (Trafford).
Pilot work 2009/10.
Introduced a tiered response strategy utilising the acute
care competency framework
Trust wide educational strategy
Core adult EWS with paediatric and maternity EWS
Weekly cardiac arrest review
Core business
Weekly reports
Significant reduction in cardiac arrests
Other significant developments eg Diabetes, EOL
139. What does reliability
look like?
Tertiary University
hospital
~1300 adult beds
Specialist services
Weekly Assurance:
-timeliness of
observations
-completeness
- who is undertaking
the observations
- response
- outcomes
142. Impact:
▪ Assurance in quality of care, recognition of
deteriorating health and effective response.
▪ Robust framework to target educational strategy
▪ Educational strategies geared to medical
emergencies and not cardiac arrests
▪ Surgical division 9 cardiac arrest in 12 months
▪ Fears of increased workload for Critical Care
unfounded
▪ Developments of other initiatives linked to
observation assessment eg “comfort”
observations in EOL care; Diabetic regime
143.
144. Digital Health and Care
Embracing the Digital Age
Dr Margaret Whoriskey
Head of Technology Enabled Care and Digital Healthcare
Innovation, Scottish Government
154. Digital technology is key to transforming health and social care
services so that care can become more person-centred.
Health and Social Care Digital Transformation…..
Health and Social Care Delivery Plan
Empowering people to more actively manage their
own health means changing and investing in new
technologies and services. The time is right to
develop a fresh, broad vision of how health and
social care service processes in Scotland should be
further transformed making better use of digital
technology and data.
155. Clear signposts
to local support
services
On-line repeat
prescription
ordering
On-line
appointment
scheduling
Digital
Reminders
Exchange
correspondenc
e digitally
Share
information
with those who
need to know
Consistent &
definitive
sources of
information.
VC and
eConsultation
s
The National
Conversation
156. I have access to the
digital information, tools
and services I need to
help maintain and
improve my health and
wellbeing
I expect my health and
social care information to
be captured electronically,
integrated and shared
securely to assist service
staff and carer that need to
see it.
I expect that digital technology
and data will be used
appropriately and innovatively.
To help plan and improve
services, enable research and
economic development and
ultimately improve outcomes for
everyone.
As a citizen of
Scotland…
157. Plenty to build on
Patient Platforms – e.g. My Diabetes
My Way and Renal Patient View –
over 10,000 users and growing
National ECS and KIS
Growth in Access to cCBT
Patient Management Systems
Additional 35,000 citizens enabled through
Technology Enabled Care Programme –
including over 3,000 people remotely
managing their health
Scotland’s Leading Four Star
Reference Site Status within Europe
Access to Online Information -
NHS Inform, Care Information
Scotland, ALISS etc.
GP Online
Patient Services
Over 160,000 telecare
users – including
more than 20% of all
over 75s
Development of Innovation Centres
Over 120,000 connected end devices to
the SWAN network
National NHS VC
Infrastucture –
Electronic Prescribing in
Primary Care
eWhiteboards
Electronic Referrals
158. Cabinet Secretary
for Health & Sport
Health & Social Care
Management Board
Digital Health &
Care Strategy
Strategic Oversight
Group
Digital Health &
Care Strategy
Working Group(s)
Digital Health &
Care Strategy
External Expert
Panel
COSLA
Stakeholders,
including eHealth
Leads and CCLG
Members
Strategy Development Governance
159. Emerging areas for the strategy
• Digital maturity assessment– The development of an appropriate model and
approach to support and target improvements for digital health and social
care services across Scotland.
• Architecture, Infrastructure, Standards and Interoperability - Defining the
overarching design decisions that should be taken centrally, and supporting a
longer-term view of convergence and rationalisation, including to support
greater integration and sharing of health and care data.
• Information Governance and Data Sharing - Enabling the effective sharing of
data and information to support public service transformation and the
information needs of people, practitioners and organisations.
160. Emerging areas for the strategy
• Cyber Security – Ensuring a high level of confidence in the resilience of service
provision.
• Data and Analytics – Facilitating the availability of integrated health and social
care data from a diverse range of sources to support quality improvement,
research and innovation.
• Person-centred services - Information and application services, enabling
citizens to manage their own health and care related information, and use a
range of digital applications and services to support their health and
wellbeing.
• User-centred design – Setting expectations for and building the capacity in the
system to undertake user-centred design.
161. Common themes identified
• Culture and leadership
• Interoperability of systems
• Data sharing and access to records, including for innovation and research
• Connectivity
• Access to appropriate technology and devices, including to support mobile working
• Resources and funding
• Skills development – both staff and public
• Self-management / digital to empower/enable
162. NextSteps
September – Meet with Panel to discuss their emerging findings.
October – Develop outline draft strategy.
November/December – Engage in stakeholder dialogue on draft strategy.
January/February – Health and Sport Committee publish report on inquiry in to
Technology and Innovation in the NHS.
February/March – Finalise and publish Strategy.
Questions?
164. We need your help - thank you!
Join the conversation:
• Please join in with our dialogue platform to help us
shape our new strategy, all ideas are welcome! See -
www.ideas.gov.scot
• Share with colleagues and relevant groups
• Follow us on Twitter @eHealthScotland
@TECScotland