Realisering av et økosystem : Diabetes og psykisk helsevern som case

Transkript

1 Realisering av et økosystem : Diabetes og psykisk helsevern som case

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3 The Chronic Care Model Forebygging En aktiv og informert pasient Proaktive helse team Pasientløp der egenmestrings løsninger er integrated

4 Økosystem

5 Teknologi for helsepersonell Neste gebearasjon EPJ systemer er integrert med egenmestringssystemer: Ehelse/telemedisin løsninger + EPJ = Framtiden

6 Patients / needs Methods / research Support / innovation Behavior Change Theories Diabetes organizations Hospitals Games/ motivation Algorithms/ statistics ICs/communication Sensors SBGM, sweat, noninvasive EHR-system GPs/specialists Diabetes registers Innovation Medical industry

7 Utfordingen til pasienter me Næring Helseindikatorer Medisinering Fysisk aktivitet

8 Brukermedvirkning I alle faser Fra ide til evaluering Evaluering / Forskning Hva er foretrukket? Hva virker? Hva er bærekraftig?

9 Designing a Diabetes Diary 12 Type 2 diabetes persons engaged over a period of 3 years In an easy way provide the users a better overview of disease-specific elements in a unit that is «always» with them

10 Type 1 versjon Studie 30 T1D Klinikere vil ha det for utvalgte pasienter! Tjenesteinnovasjon

11 Pasient Main menu of the advanced version of the Diabetes Diary Similar situations Food table Blood glucose trends Insulin recording Blood glucose periodicity

12 Spesialist - mottak June 2013, Berlin Plenary meeting 12

13 Spesialist informasjon - hovedbilde Food and insulin dosage. Blood glucose measurements before and after.

14 Målsetning: online og live kommunikasjon mellom helsetjenesten og pasienten basert på data pasienten har valgt å dele. Sikkert mht: Lover og reguleringer Pasientrettigheter og personvern Datasikkerhet Ingen datalagring Integrert sensordata Spesialistløsninger som er godt integrert med daglig arbeid og prosesser.

15 Diabetes Community Public cloud environment Diabetes patient Diabetes patient Biometric sensing devices: Setting up an intermediate session FitBit 2in1 Glucometer Lifescan Glucometer Medical personnel DeSA app DDD app Application and gateway PATIENT S EHEALTH ENVIRONMENT Diabetes Share Live solution - DSL INTERMEDIATE SESSION Patient - specialist Hospital PC / tablet HEALTHCARE ENVIRONMENT (UNN hospital)

16 Diabetes Diary functionality Main screen Registrations Food and medic. Glucose values

17 Tradisjonell konsultasjon

18 Fjernkonsultasjon Shared data Medical clinic, UNN: Ragnar Joakimsen, chief physician of endochrinology Diabetes nurses Mona Torsteinsen and Solrunn Coucheron

19 Gaming learning Test on children with Type 1 diabetes Integration with the Diabetes Diary

20 12 years of mdiabetes R&D BG Bluetooth adapter Smart step counter T1D, Photo Diary, Children Diabetes Diary Android version Diabetes Diary iphone version (Friday) BG Bluetooth prototype T2D app ver.1 Pebble T1D, SMS Children parents T2D app ver.2 T2D, RCT TTL: 2006

21 Diabetes Research Team Internal competence: Technology System development Doctors Risk management Nurses Statistics Researchers PhD students Lawyer

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23 Mastermind EU 9 countries, 13 regions, 23 partners in Europe patients Depression Computer based cognitive therapy Video based care 23

24 Mastermind, Norway. Basic concept The funnel Integration of and video in a comprehensive stepped care system Self help without support General practitioner (GP) follow up plus self help Acute cases GP assisted by specialist Specialist patient policlinic or admittance Self help GP and patien t GP Specialist and patient (video) Specialist patient Admittance Policlinic, video

25 Hvorfor gjør vi dette? VK erfaring: VK internt I foretaket innen akuttpsykiatri (DeVaVi) VK mellom pasient hjemme og BUP (E-BUP) VK mellom fastlege og samarbeidspartnere Andre relevante erfaringer: Akkutteam assisterer fastleger innen behandling av akutt syke pasienter innen psykisk helsevern Psykolog/psykiater besøker fastlegekontorer innen elektiv behandling Elektronisk meldingsutveksling (FUNNKe) Standardiserte elektroniske meldinger (ELSK) Administrattive forhold: Fastleger får godt betalt for VK 25

26 Self help GP + patient GP+pt.+spec. Pt.+specalist Pt. in clinic Internal communication Not interested Home page Not depressed Suicidal take contact Acutely ill Screening GP+ GP no Flow chart of the Norwegian plan for the CIP MASTERMIND project 26

27 Self help GP + patient GP+pt.+spec. Pt.+specalist Pt. in clinic Internal communication Not interested Home page Not depressed Suicidal take contact Better or attrition Acutely ill Admittance Screening Depressed GP+ GP no Waiting list Policlinic Policlinic treatmen treatment t Admittance Better/attrition Better/attrition Better/attrition Flow chart of the Norwegian plan for the CIP MASTERMIND project 27

28 Self help GP + patient GP+pt.+spec. Pt.+specalist Pt. in clinic Internal communication Not interested Home page Not depressed Suicidal take contact Better or attrition Acutely ill Pt. home Admittance Screening Depressed GP+ GP no Video pt. + GP + spec. Waiting list Video + spec. Policlinic treatment Specialist on video with GP and patient Admittance Better/attrition Better/attrition Better/attrition Flow chart of the Norwegian plan for the CIP MASTERMIND project 28

29 Self help GP + patient GP+pt.+spec. Pt.+specalist Pt. in clinic Internal communication Not interested Home page Not depressed Suicidal take contact Better or attrition Acutely ill Pt. home Admittance Video District clinic and central hospital Screening Depressed GP+ GP no Video pt. + GP + spec. Waiting list Video + spec. Policlinic treatment Specialist on video with GP and patient Admittance Video District clinic and central hospital Better/attrition Better/attrition Better/attrition No follow up Follow up by GP Follow up by GP and video Video and spesialist Discharge Flow chart of the Norwegian plan for the CIP MASTERMIND project 29

30 Self help GP + patient GP+pt.+spec. Pt.+specalist Pt. in clinic Internal communication Not interested Home page Not depressed Screening Depressed Suicidal take contact Better or attrition GP+ GP no Diagnose Acutely ill Video pt. + GP + spec. Waiting list Pt. home Video + spec. Policlinic treatment Admittance Diagnostic screening by specialist Specialist on video with GP and patient Admittance Video District clinic and central hospital Video District clinic and central hospital Better/attrition Better/attrition Better/attrition No follow up Follow up by GP Follow up by GP and video Video and spesialist Discharge Flow chart of the Norwegian plan for the CIP MASTERMIND project 30

31 Basic concept The funnel Integration of and video in a comprehensive stepped care system Self help without support General practitioner (GP) follow up plus self help Acute cases GP assisted by specialist Specialist patient policlinic or admittance Self help GP and patien t GP Specialist and patient (video) Special ist patient Admittance Policlinic, video

32 Takk for oppmerksomheten 32