Joint Digital Healthcare Symposium "Our Digital Health ... is everyone ready?"
Given earlier Alert Levels in Brussels, most of the Joint Digital Healthcare Symposium took finally place on 19-20 January 2016. The STOA workshop "eHealth in Europe: reality and challenges ahead" was held in the European Parliament on 1 December 2015 (the original date of the full symposium) and is accessible as recorded web stream.
Some excerpts of session proceedings (featured "sessions in spotlight" will vary over time) are highlighted here to rehearse the lively debates of eHealth Stakeholders and Policy Makers on using eHealth and mHealth at scale to transform healthcare delivery.
Day 1 - Transforming the patient experience and leveraging of the benefits of eHealth in Europe
[session in spotlight] The first day of the conference started with an exploration of the experiences of United4Health patients on three of the telehealth-using sites.
Facilitated by Donna Henderson, U4H co-ordinator at NHS 24, Scotland, the conference audience heard from by three specialist clinicians - cardiologist Dr Miren Nekane Murga, Dr Sandeep Thekkepat on diabetes and Dr Hugh Brown (right) on COPD.
The United4Health Vision and it's evaluation approach were introduced by Leo Lewis, Projekt Manager, and Dr Panos Stafylas, Medical Co-ordinator, both representing HIM SA, Brussels.
- Dr Panos Stafylas, United4Health Medical Coordinator of HIM SA, laid out the comprehensive work that United4Health - as a study of deployment - has undertaken to explore the implications of telehealth use for patients in each of three areas of chronic conditions. As a consequence, United4Health is able to lay out a seven-step approach to telehealth deployment, ranging from innovating to adopting in real life. More than 10,000 patients have been involved in the United4Health initiative, with some 1.5 million days of follow-up and around 80,000 contacts with physicians. The project has been able to process all the resulting data within a 40-day period. Some of its first indicators are that hospitalisation rates are being reduced; some 90+% of patients are showing substantial satisfaction rates, and, in particular condition areas, there have been reductions in several conditions (e.g., in patients with diabetes, there are reductions in glycated haemoglobin i.e., HbA1c). Most interestingly, it appears that as a result of the United4Health project, many of the project sites are now going to enhance and expand their use of telehealth use in the months and years to come. Hence, scaling-up is working!
- COPD is the third most common cause of death in Wales and the second most common reason for admission to hospital in England, announced Dr Hugh Brown. The Welsh Hywel Dda pilot resulted in beneficial reductions of the numbers of days that patients were hospitalised and overall saved costs. The major lesson learned was about process: not to introduce the telehealth support at the moment of discharge from hospital. In parts of Wales, connectivity is difficult - there is not even a 2G gsm system, and no WiFi noted Claire Hurlin of Hywel Dda, Wales in the corresponding insight (breakout) session. Hence, the authority reverted to using landline phones. The most versatile system on offer for use with its patients was Florence ('Flo'), a simple messaging service which enables reminders to be sent . Using this system "puts the patients back in control of their everyday lives." Overall, the key message is about: "Helping you live your life your way."
- Dr Sandeep Thekkepat - who appears as @doctorinsulin on Twitter - described the upcoming diabetes pandemic: some 642 million people globally are expected to experience the disease by 2040. He outlined the use that is being made in Scotland of the SCI-Diabetes system and MyDiabetesMyWay. Scotland's use of these applications has led to far greater patient control of their own conditions. The positive results could ultimately lead to reduced diabetes complications. Telehealth-supported diabetes care has become firmly part of routine care in the country. As Dr Thekkepat concluded, "We are now able to make important sensible decisions, and frequently."
- The in-depth telehealth initiative on cardiac conditions that has taken place in the Basque Country, enabled the Kronikgune site represented by Dr Nekane Murga, to conclude that it resulted in "an improvement in patient health, in patient satisfaction, and in the health services. In addition, there were also improvements in patient empowerment and adherence, and in anticipatory care." For the Basque Country, this was particularly an area where patient satisfaction was very high.
Day 2: Healthcare Anywhere and the Internet of Everything
[session in spotlight] Concluding the Joint Symposium, this future-proofing session explored the implications of the Internet of Things for the next generation of healthcare.
Chair, Mario Romao of Intel Corporation, painted a picture of many new technologies that can already work in health and care (including public health) and which are now already available in retail stores: sensors, electronic fitness products, wearables etc. The Internet of Things aka the Internet of Everything will become the paradigm for digital health and wellness.
Four speakers looked at the different, new and innovative ways in which healthcare could and should be provided in this "anywhere" sphere.
- Elijah Charles of Intel in the United Kingdom spoke about "riding on the datum", exploring data from integrated systems, communication between systems, and messaging so as to be able to undertake effective planning for patient flows in hospitals and clinics and between primary care and secondary care institutions. His conclusion was that healthcare institutions are not yet making the most of the potentially huge amount of data that is available to them.
- Claus F. Nielsen of DELTA, Denmark - a self-confessed 'gadget boy' - drew from the experiences of his young son who has diabetes type I, a condition that affects 25,000 Danish children. Using equipment to help measure vital signs with regularity can enable a son to measure his health status, and a father to have piece of mind even when miles away from home. Many new forms of equipment are available, including those being supported with the help of pharmaceutical companies. For example, Continua's personal connected health alliance is working to generate greater awareness, availability and access to plug-and-play personal health technologies. Mr Nielsen's tip was to look to Scandinavia because that is where it is happening", and his encouragement to all was to "come and visit us
- Yet diabetes, especially diabetes type II, is a huge problem worldwide, as Dr Petra Wilson of the International Diabetes Federation pointed out. In Europe, perhaps one out of every 11 people have diabetes; in the United Arab Emirates, for example, it is however one out of every four. She particularly criticised health care data silos. Every person with diabetes spends much of his or her time in self-management: up to 8755 hours a year. For this reason, obtaining more data about one's condition can help the individual, but at the same time it can assist healthcare professionals to do a better job and health care systems to manage the coming tidal wave of chronic conditions much more effectively. Some data protection and privacy issues remain to be resolved, however.
- The view from the pharmaceutical sector on data regulation was articulated by Brendan Barnes, who represented the European Federation of Pharmaceutical Industries and associations (EFPIA). EFPIA welcomes the new agreement on General Data Protection Regulation. The pharmaceutical industry is most interested in using de-identified data. Areas to be explored would include a platform for continuing dialogue among the diverse stakeholders in the field, and the construction of a regulatory framework that will both enable further drugs research while still helping to build trust.
See here the recorded webstream of our affiliated eHealth Policy Event chaired by MEP Eva Kaili at the European Parliament in Brussels (Recording). Doers from the field have informed policy makers of what it really means to use eHealth and mHealth at scale to transform healthcare delivery. Access STOA (European Parliament) presentations here
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