Empowering Patients and Professionals, the Role of ehealth

Transcription

1 Empowering Patients and Professionals, the Role of ehealth Mikko T Nenonen, emba Adjunct Professor & Specialist of General Practice Associate Chief Physician at Pertunmaa Health Centre Senior Executive Consultant, TalentVectia Ltd. Special competence for healthcare information technology & administration

2 About the presentation Introducing myself Health IT since 1979 Many ways to do it The Four Stakeholders The Finnish electronic prescription as an example It is not only ehealth You need a solid theoretical framework, case Chronic Care Model Rethinking the Role of the Patient From compliance to ownership The Three Wise Patients model It can be made simple Talent Vectia 2

3 About myself Talent Vectia 3 First salary from healthcare organization in June 1959 Physician (GP) since 1978 FINSTAR/WATTI-project 1979 Development Manager at STAKES (statistics and registers) Evaluation group of project Macropilot Rheumatism Foundation Hospital ( ) Medical director, administrative physician EFQM recognition 450/1000 points Local politician Municipal, regional and hospital boards etc. Management consultant (2005 -) EHMA board member Finnish Medical Association, ehealth working group Health policy advisor

4 Health IT since 1979 Some observations Talent Vectia 4

5 Many ways to do it Varkaus FINSTAR / WATTI-project Interactive pioneering Mänttä Spa & Jaala Health Centre DOCTOREX Small scale system installed and customized with friends Rheumatism Foundation Hospital ACUTE Searching for a modern HIS with support to process-like organization and new EFQM recognized model Experiences with PEGASOS & EFFICA and testing CERNER & EPIC Conclusion The new system must be a solution to an existing problem or it must fulfill some real needs to be accepted If there is no resistance, the system does not change anything, it is just IT In business new IT is used to prevent the old way of working In healthcare it is often built on old-fashioned processes Fail early, fast and cheap! Talent Vectia 5

6 EMR Generations and Adoption Stages (Gartner & HIMSS) Talent Vectia 6

7 Talent Vectia 7 The Four Stakeholders The Finnish electronic prescription as an example

8 Patients: Ownership of their medication Professionals: Comprehensive and accurate list of current medication ehealth or Change Owner of the service providing organization: Increased productivity, more patients treated Government: Diminish forgery & misuse Talent Vectia 8

9 The interests of Government were selected Patients use eprescriptions like paper-ones, no empowerment Physicians run into problems everyday and only 10 % of medication lists are up-to-date and accurate Owners face decreased productivity, two to four weeks working time lost every year / physician Statistics on misuse and forgery are not yet available The process has lasted 20 years and the old or missing definitions prevent modern way of thinking Professionals were mobilized in implementation phase, not before Patients were seen as targets Owners have the role of paying this all If you select one stakeholder, you often ignore the other three ones Talent Vectia 9

10 Talent Vectia 10

11 Talent Vectia 11 It is not only ehealth You need a solid theoretical framework, case Chronic Care Model

12 STM / STO 07/11/2013 The Chronic Care Model or Health Value Model was chosen as the main development tool and framework in Finland to improve the prevention and care of chronic conditions to clarify the mission of PHC to improve work satisfaction to empower patients

13 Self management support Delivery system design Decision Support Clinical information systems Individual care plan Patient classification according to needs Indentification of key customers Call systems, planned, proactive visits Self management tools Group visits, peer groups Evidence based development work Case manager EBMeDS= Electronic Decision Support Community resources and policies Health care organization Systematic documentation

14 Talent Vectia 14 Rethinking the Role of the Patient From compliance to ownership

15 Most important is a healthy change in the life leading to increased health-value Modified and developed from Routasalo, Airaksinen, Mäntyranta, Pitkälä, DUODECIM, 2009;125: Talent Vectia 15

16 Talent Vectia 16 The Three Wise Patients model It can be made simple

17 To solve a problem, launch change or develop anything Three patients linked with the target (= with the disease, needing the service etc.) One pot of coffee, biscuits and coffee bread (Finns always drink coffee) Discuss the situation together and ask what these patients want and how they would like to be served and by who Test the idea in practice if it does not work, take the next three patients Talent Vectia 17

18 Talent Vectia We are employed by our patients

19 Talent Vectia 19