and the Quality of Care The Netherlands Hans C Ossebaard 2 National Health Care Institute Health Care Quality Institute > Health Care coverage Basic insured package of care Regulations for the uninsured Risk adjustments > Innovation of health education and training > Quality in Care Facilitating good health care Quality assessment Making quality transparant Multi-year agenda 3 4 Dept. Health, Psychology & Technology Faculty Behavioural, Management & Social Sciences Center for & Wellbeing Research Persuasive Health technology Lab & Persuasive Health technology Lab - Understand and measure the impact of persuasive technology on creating affective relationships - Use monitoring-data (logdata from self-tracking and medical tracking systems) to design personalized interventions - Design implementation strategies for tech in health care 5 6 13 October 2015 1
? Information Revolution cheap ubiquitous participative many-to-many real time is the use of new information and communication technologies (mobile, internet) to support or improve health and health care mhealth, tele-health, telemedicine, consumer health informatics, tele-care, Health 2.0, Medicine 2.0 &c. health, healthcare and biomedical research a way of thinking about new ways of health care delivery, the transition from care to precare and the role of technology 7 8 urgencies D D D P P P P Sys *Time/ place independent Elderly people Chronic diseases/co-morbidity Demand for care Healthcare professionals Health care expenditure Healthcare associated inf. + AMR 9 10 potential barriers Affordability Accessibility Effectiveness Efficiency Safety & Quality Self-management Reimbursement / Investment issues Poor standardization Low awareness (public and professionals) No central direction fragmented, small-scale, low adherence 11 12 13 October 2015 2
policy objectives (2014) policy objectives Within 5yrs: 75% of the chronically ill and the elderly is enabled to carry out self-measurements and receive feed-back (tele-monitoring) on these; Within 5yrs: everyone receiving home care is enabled to communicate on-screen with a health care professional 24h/day; Within 5yrs: 80% of chronically ill people (40% of others) has online/mobile access to medical data (medication, clinical-chemical test results &.). Standardization (inc. authentication, interoperability) Scaling-up succesful initiatives (governance) Integrated and personalized care Mix of policy instruments Awareness campaign (public / professionals) Week 2016 13 14 eh development is a participative process eh development involves continuous evaluation eh development intertwined with implementation eh development changes organization of health care eh development involves persuasive design eh development needs advanced methods to assess impact 15 16 17 18 13 October 2015 3
POSITIVE EVIDENCE (23%) PROMISING EVIDENCE (42%) - home telemonitoring (e.g. heart failure) - telemonitoring hypertension - web-based/mobile education diabetes I/II (150 studies) - web-based support pain management (acute/chronic) - in-home telerehabilitation (stroke / cardiac arrest) - tech assisted support / training brain injury - web-based education / patient empowerment - home telemonitoring chronic diseases (223 studies) 19 20 emental Health and Public Health catching up Quality - Treatment of depression, anxiety and substance dependence - Health education and disease prevention - Cutting edge: - Digital epidemiology (big data) - One Health informatics - Spatial data and geo-information for public health - safety - effectiveness - patient-centeredness, - timeliness - efficacy - equity -VALUE 21 22 Implementation Improvement science Implementation - Bright spots: = Healthcare = changing organization culture see, feel, change. in quality standards - Positive deviance Theory <> Practice - Patient engagement Doing what works - Home environment 23 24 13 October 2015 4
Transition to Value-based health care accelarated by technology hossebaard@zinl.nl 25 26 www.getupgetbetter.com 27 13 October 2015 5