2002 The MobiHealth consortium. Prescription Nobody Cares traditional marketing, me-too products

Transcription

1 Dimitri Konstantas Val Jones Richard Bults Rainer Herzog MobiHealth IST University of Twente (NL) CTIT APS Ericsson Consulting Germany Health care today Problems and issues Life expectancy increases We have more chronic disease patients (diabetes, cardiovascular, asthma etc) Patients and non-patients seek medical advice more often People becoming health conscious Hospitals face worsening resource problems (time, space, resources, costs..) 1 2 Scenarios for the future development of the health care sector: how to meet the challenges Dissolving the boundaries of traditional point of care PATIENTS ROLE Patients Rule! Active Empowered Managed Care convenience, quality individualized, interactive of life, DTC health & patient management managed costs Monitoring of of patient s status status // progression Patient s Home Doctor s Office Managing patient s compliance Observe Manage PAYERS ROLE Diagnosis Consulting Prescription Nobody Cares traditional marketing, me-too products Passive Payers Rule! pharmacoeconomics, only cost matter Quick Quick handling of of emergency situations Adaptation of of treatment 3 4 Wouldn t it be nice... It can be done today... To have the same level of health care while continuing a normal active life, instead of being stranded at the hospital? To have your health status monitored without having to go to health center? Available technology Mobile medical sensors Widely available public wireless network Acceptance of new services GSM telephone based services Internet 5 6 1

2 The Dream... Mobile patient management: Individualized dialog in real time GPRS Patient Reminders, questions Treatments Information Push GPRS SMS WAP Content Management Data warehouse Doctor Hospital Sensor readings Data Pull Analysis Health Broker 7 8 Disease prevalences (Germany) and acceptance rate of mobile patient management Disease Prevalence Acceptance* 10% 20% Diabetes Stroke Asthma Hypertension CAD Patient management leads to significant savings for insurers EXAMPLE 1: Percentage of yearly treatment costs per patient for Asthma, (100= 5,000) Cost Basis for Insurers Savings in Treatment Costs New claims due to PM Costs of PM Program Total Costs Net Savings for Insurers EXAMPLE 2: Overview of disease related costs of Diabetes in Germany 5% of all Germans suffer from Diabetes Type I diabetics 4-5 mill Type II diabetics Disease related costs per patient and year: well monitored diabetics: badly monitored diabetics: 8.500? Costs caused by diabetes related late stage diseases: Diabetic Foot: 1 Bil. Renal diseases and dialysis: 1,5 Bil. Total potential users * Estimated acceptance rates for mobile disease management programs 9 Source: BKK, Preussen Elektra, Efficient patient management can save approx. 20% of yearly treatment costs and Hannover between 50-60% of costs due to late stage diseases. McKinsey 10 Personal mobile health care Vital signal information to the health broker over public network Personalized measurements Personalized follow-up and advice Health record Requirements Flexibility and personalization Different persons have different needs Reliability Comparable to clinical measurments Privacy and security Non-intrusive freedom of movement

3 Wireless medical telemetry Patients wear sensors which measure biosignals and transmit them in real time over wireless communications link eg. EMG, ECG, respiration, BP.. NB cardiac and respiratory monitoring can already be done using an ordinary mobile phone. Application Areas Home care In home and out of home health monitoring Post treatment follow up Pharma research Sports and recreation Chronic disease research Trauma care Virtual Trauma Team emergencies, accidents, disaster sites theatre ER Mobile devices plus wireless comms to allow emergency staff to communicate with hospitals/specialists to facilitate: - remote assessment of patient - early intervention - preparation (eg. of theatre) Paramedic/patient BAN (bluetooth, GPRS..) Virtual Home care Mobile Health Body Area Network The patient is equiped with a personalized set of sensors/actuators and is connected (via /GPRS) to a health center. Intensive care at home Sports and recreation Medical follow up Medical research 17 Blood pres/pulse Glucowatch headset services EEG ECG 18 3

4 Mobile Health Operational Overview Public Operator Call center General practitioner Wireless data services Hospital Health broker 19 Issues for Mobile Health BAN Quality of service Security, privacy, performance, network segmentation Social acceptance Health risks, economic issues Legal issues Accreditation of the devices and applications Legal restrictions for health care Hospital responsibilities for patient treatment 20 Why? Bandwidth Need more than 9 kbps 13 kbps Data transmission delays No connection delay Cost per KB instead per minute Why - bandwidth as the basis for mobile applications photo web movie 3G wireless Enhanced wireless (adding GPRS ) Enhanced wireline (ISDN) HSCSD Basic wireline (analog ) DATA QUANTITY 100 KB 30 KB 3000 KB GSM HSCSD GPRS TRANSMISSION SPEEDS 10 Kbps 58 Kbps 115 Kbps EDGE 384 Kbps 2 Mbps Web Photo Video clip 2G wireless (GSM) TRANSFER TIME sec 1 min 10 min 1 hour 22 Why - more convincing advantages The successor of present day mobile standards Main advantages: better utilisation of the frequencies high data transmission rates of up to 2 Mbs always connected, always on-line charging of data volume, not connection time Enables the simultaneous transmission of pictures/videos, speech and data in multimedia applications The MobiHealth Project IST Overall objective The development and trial of new services and applications in the area of mobile health, promoting the use and deployment of GPRS and. creates new distribution channels as well as new competitive advantages for innovative companies

5 MobiHealth targets MobiHealth BAN Development of new m- health services and methodologies for their evaluation Integration of a generic m- health Body Area Network (BAN) Validation of GPRS and networks for m- health services via large scale trials Validation of the accuracy of measurements and data capture Validation of medical, social/ ethical and economic advantages of the new m- health applications n sensor MBU internal communication links external communication link actuator 0...m 26 MobiHealth architecture \ Hospital patient management system Trauma care Home care Home Pharma Testing BAN Operating System Sports Communications Management IP Interface MobiHealth Trials 4 trial sites The Netherlands, Enschede Spain, Barcelona Sweden, Lulea Germany Trials will start in late spring 2003 Multiple scenaria will be trialed 2.5G 3G 4G Trial Scenaria MobiHealth organization Examples of potential trial scenaria (to be finalized end of June 2002, the list is not complete) Home care and follow up for chronic patients Virtual trauma team High risk pregnacies Monitoring of respiratory insufficiency Project start : May 1 st 2002 Project Duration : 18 months Project Budget : 8.2 MEU EU contribution 4.9 MEU 6 partners 8 members

6 The MobiHealth Consortium Ericcson Consulting GmbH (DE) Gsout Telia (SE) University of Lulea University of Twente (NL) MST, TMSI, Compaq, Yucat Telefonica moviles (ES) Consorti Sanitari Clinic, University Pompeu Fabra Phillips Research (UK) CMG Wireless Data Solutions (NL) 31 Contacts University of Twente Prof. Dr. Dimitri Konstantas Dr. Val Jones Mr. Richard Bults CTIT APS P.O.Box 217 NL-7500 AE Enschede The Netherlands Tel.: / 4018 mailto: dimiti@cs.utwente.nl mailto: jones@cs.utwente.nl mailto: bults@cs.utwente.nl Ericsson Consulting Mr. Rainer Herzog Senior Consultant Maximilianstr. 36 D München Germany Tel.: Mobile.: mailto: rainer.herzog@ ericsson.com 32 Summary 33 6