Power to patients: How telehealth promotes equal partnership in health services

Transcription

1 Power to patients: How telehealth promotes equal partnership in health services ehelseuka2014 Bjørn Engum, NST/UNN June 2nd, 2014

2 Message from Minister of Health at national health conference: My speech deals with today s most important issue: Move power to the patient ( ) It is not only his body, but also his medical record, and it should definitely be accessible.

3 What NST can do for the Minister This presentation will cover: o NST - our role and competences o The Chronic Care Model o Examples of patient centred technology o Many solutions but few services o Being better together

4 NST and the University Hospital of North Norway (UNN) NST takes part in developing and implementing solutions for e-health and clinical systems in UNN (through FIKS - Implementation of Clinical ICT systems and piloting of DIPS Arena) NST is the department for coordinated care at UNN

5 National Advisory Unit on Telemedicine National board established 2011 NST strategy concentrates on o Clinical patient s pathways and models for coordinated care o Preventive care and self-management o Implementation and innovation Research activities reached all time high in 2013 Advisory activities undergoing revision in 2014 to adapt to stakeholder s needs WHO collaborating centre Telemedicine and e-health

6 About NST Results scientific publications 31 researchers (22 PhD) 8 public defences of dissertation Tromsø Telemedicine Laboratory (Centre for research based innovation) 11 EU projects 99 national projects Centre in the University Hospital of North- Norway since 1993 National advisory unit on telemedicine since WHO collaboration centre since Master of telemedicine at UiT since 2005 National board established 2011 NST strategy concentrates on o Clinical patient s pathways and models for coordinated care o Preventive care o Implementation and innovation

7 NST s competences NST is through it s patient centred research a central partner in the development of the health service. Experienced in large scale implementation. Strong interdisciplinary competence on PhD level. Telemedicine, e-health and welfare technology are important tools for a good coordination of care. Participation in national and international networks gives us today s issues and helps sharing of knowledge. WHO collaborating centre Telemedicine and e-health

8 Chronic Care Model (CCM) Model for Health Region North Adopted by the Faculty of Medicine And also by the municipalities Wagner Journal of Nursing Care Quality 2002;16(2):67-80.

9 Patients Access to Electronic Health Record A joint project: Norwegian Directorate of Health (Hdir) Northern Norway Regional Health Authority (HN), NST and DIPS Proof of concept developed by Tromsø Telemedicine Laboratory ( ) o Technical demonstrator developed. Recommendations on how patients and citizens can receive secure access to their health record via the national health portal. First HN-patient will retrieve EHR documents via HelseNorge.no in September 2014 o Design interface: Norwegian Directorate of Health in collaboration with usergroups in HN o Pilot-phase 5-30 patients (UNN) o -> 500 patients (October-December 2014) o Large-scale service in the region by March 2015 o o Content: EHR, access log, appointments, patient communication. Some types of documents (lab) by late 2015 due to technical requirements. People with chronic diseases and cancer will be involved in the development of the service The service will be developed for scaling nationally (Hdir to define system architecture)

10 Patients requirements 1 76% would like to receive their journal in electronic format 87 % planned to share it with others Most patients requested their journal as they would like to learn more about their diagnosis and treatment. Some patients are in a (potential) conflict with the health facility, hence needed a complete, dated and signed copy of their journal Patients would like to check who had accessed their journal 1 Pre-study Sørensen, Kummervold: Access to EHR: outreach, use and sharing. NST-report 03/2012 (Norwegian)

11 Who needs access to EHR today?

12 Shared Decicion Making (SDM)

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14 mdiabetes Research Project Portfolio User-Involved Design Motivational groups / social media Integration w/hospital Statistical modeling (of users own data) Available as app Integration w/gp New functionalities, s.a.: gaming, watches, sensors

15 Virtual team (VT) interdisciplinary teams centering online around the patient not linked to diagnosis as other similar tools can be has generic functions that is deployable to all complex and chronic patient pathways Diagnosis-specific tools as plugins

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17 VT provides interdisciplinary teams with: Overview, history and status in the pathway Team communication Cooperation, planning and coordination Information and transfer of competences Self-management and prevention

18 En innbygger en journal Access to health information both for patients and professionals Change/adaptation of regulations Health information online Helsenorge.no Stronger national governance Continue implementing of solutions with positive effects

19 Barriers Many pilots few services Tele-/e-health are complex changing processes o Need for organizational changes o Have to be synchronized in different areas/levels Costs and benefits are different o Incentives o Easy to get funding for pilots Culture gap o Hospitals o Municipalities o GPs o Patient Telemedisinbarometer

20 Summary En innbygger en journal is an important goal or milestone This goal will be achieved by systematic research and development of competence National governance but local competence development and implementation Cooperation across borders also regionals example from health service research