Virtuelt hjemmebesøk. Rune Fensli. UiA, ehelse, Førsteamanuensis Senter for ehelse Universitetet i Agder

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1 Hjemme-monitorering av pasienter i en Norsk samhandlings modell. EU-prosjektet United4Health med fokus på KOLS-pasienter Innomed Fagdag 06. november 2013 Virtuelt hjemmebesøk Rune Fensli Førsteamanuensis Senter for ehelse Universitetet i Agder rune.fensli@uia.no UiA, ehelse,

2 Senter for ehelse og omsorgsteknologi Fakultet for helseog idrettsvitenskap Fakultet for teknologi og realfag Fakultet for økonomi og samfunnsvitenskap Et av toppsatsingsområdene for Universitetet i Agder UiA, ehelse,

3 Project model organization VISIONS The Center for ehealth is an arena for teaching, research, development, and testing of new technology for use in the health - and social - sector, with a focus on the user perspective. National and International Research Institutions Active users: Patients, close relatives Externally funded research Network of co-operating partners Research projects Center for Careing Research Industrial partners Municipality health care hospitals UiA, ehelse,

4 450 m 2 ehelse-lab et Mini helse-norge Klinikklaboratorium med: Sykehus Sykehjem Helseklinikk Mobile hjemmetjenester Pasienthjem med sensorer og smarthus teknologi Undervisning Forskning Utvikling Utprøving av ny teknologi Til nytte for brukere UiA, ehelse,

5 Pasienthjem/Smarthus anno 2020 Scenario: Aleneboende mann (Harald), 75 år Demo-rom for fremtidens omsorgsteknologi Flere aktiviteter sammen med industrielle partnere Trådløs overvåkning/monitorering av medisinske data Sensorer i rom og installasjoner Falldetektor Integrasjon av teknologiløsninger Tilgangsstyring og kontroll Deteksjon av endringer i bevegelsesmønstre mv Bruk av videobasert samhandling UiA, ehelse,

6 Usability Lab UiA, ehelse,

7 ehelse Lab et Mini helse-norge Høyteknologisk infrastruktur for samhandling UiA, ehelse,

8 Ongoing projects ehealth Extended Care Coordination RFFA project Municipalities in Agder, Research partners and Business partners Research in cross municipality teams and the lack of access to medical information Develop new ideas of shared access lab implementation ehealth Smart-home SOA-based Architecture for Tele-Home-Care Services and future ehealth solutions and services PhD fellows research iage EU Interreg project New approaches to service delivery and economic development through ICT innovation, areas of decline affected by an ageing population. United4Health EU, CIP-ICT-PSP, Pilot Type A, Objective 3.5, Large scale deployment of telehealth services for chronic conditions Sørlandet Hospital, UiA, Tromsø Telemed, University Hospital North Norway ehealthtest-center Aust-Agder Utviklings- og kompetansefond Establish an independent test-center for evaluation of ehealth/ict (focus on coordination reform and home care solutions) Contribute to increased competence in the Agder region and in national- and international relations UiA, ehelse,

9 United4HealthProject and Norwegian Partners UNIversal solutions in Telemedicine Deployment for European HEALTH care ICT PSP call identifier: CIP-ICT PSP ICT PSP Theme/objective identifier: ICT for Health, Aging well and Inclusion Grant agreement no: UiA, ehelse, 2013

10 Objectives The Project aims to demonstrate that the Personal Health-based solutions for the management of people living with chronic diseases in home settings already validated or under validation in RENEWING HEALTH can be successfully transferred to other regions and deployed at scale. How to implement a new health care service for continuous functionality in patient treatment flows? UiA, ehelse,

11 Scotland (UK) Basque Country (ES) Wales (UK) Southern Norway (NO) Northwest Moravia (CZ) Slovenia (SL) Campania (IT) Sicilia (IT) Nord Pas De Calais (FR) Galicia (ES) Syddanmark North. Norway South Karelia Central Greece Berlin Total Number of Patients Pathology Intervention New pilots funded by ICT PSP New pilots funded from other sources Existing RENEWING HEALTH partners Diabetes COPD CVD Life-long monitoring Short-term follow up after hospital discharge Remote monitoring of Congestive Heart Failure Total UiA, ehelse,

12 Norwegian Challenges Organizational innovative changes based on the patients daily follow-up at point-of-care, according to the Norwegian Coordination reform, Juridical regulations in collaboration of patient treatment and care, with implementation of secured access to shared information recorded and stored within the Norwegian Health Network. Integration into existing health care data services. Patients access to medical information and treatment plans. Standardizations in technological solutions. UiA, ehelse,

13 Preceding considerations MethoTelemed Guidance Purpose of the telemedicine application? Relevant alternatives? International, national, regional or local level of assessment? Maturity of the application? Multidisciplinary assessment 1. Health problem and characteristics of the application 2. Safety 3. Clinical effectiveness 4. Patient perspectives 5. Economic aspects 6. Organisational aspects 7. Socio-cultural, ethical and legal aspects UiA, ehelse,

14 «Collaborative Point-of-Care Services Agder» A spin-off project funded by RCN, Norway VERDIKT ( ) Establishing new organization of care teams, with suitable technological solutions Medical indicators should be developed, in order to evaluate the patients actual condition based on a standardized triage, where the need for follow-up and escalations in treatment when needed are defined. Decisions will be decentralized to local health care services, and supervised by the GP and specialist. This is assumed go give cost-effective treatment plans for large groups of chronically ill patients Partners: SSHF, UiA, Devoteam Solution, Applica, DIPS, SINTEF IKT erdikt/hovedsidemal&p= UiA, ehelse,

15 Utvikling av «Forløpsjournal» (Treatment Pathway Health Record) Ref Meld.St.9: Én innbygger én journal UiA, ehelse,

16 Southern Norway and the Coordination Reform In Norway, the new health care reform of 1 st January 2012, the Collaboration reform, has changed the responsibility for patient treatment, rehabilitation and follow-up, with a comprehensive change especially for the municipality healthcare services. Thus there is a demand for improved collaboration and communication between hospitals and the primary care services at the municipalities. As there are many small sized municipalities in Norway, they will struggle to organise healthcare services cross-border in intermunicipality care teams. Within the two Agder counties, the 30 local municipalities are organised in five regions closely collaborating in developing healthcare services for the future. By the end of 2012, it is planned that all the 30 municipalities should be connected to the National Health Net (NHN), and thus be able to exchange patient information using electronic messages with Sorlandet Hospital and with all GPs/local doctors within this region. 16

17 Technical solutions for COPD, Diabetes and Heart Failure by use of Tablets CIGNUS Bloodpressure Meter CIGNUS Glucometer Vitalograph Peakflow Meter Cardguard 1-12 Lead ECG IEM Scale Clever Nonin IR Ear-Thermometer Oxymeter UiA, ehelse,

18 Pasientens hjemme-utstyr Dette er «Behandlingshjelpemidler» Video konferanse høyttaler HD video kamera Spirometri Pulsoksymetri UiA, ehelse,

19 Jabber video konferanse Pasienten vil i en definert periode ha daglig videomøte med KOLSsykepleier KOLS-sykepleier bør benytte en video-konferanse enhet fra Cisco EX90 Kan enkelt koble opp videokonferanse med lege Medisinske måledata og journalnotater er en web-basert løsning på PC Dette er et samhandlings verktøy UiA, ehelse,

20 United4Health and the Norwegian Point-of-Care United4Health Model Norwegian Collaborative Setup Innovation Sub-Project financed by the Research Council of Norway, UiA, ehelse, 2013

21 Patient empowerment Med-deltakelse i avgjørelser Forutsetter kunnskaper om egen helse og sykdom Pasienten benytter Internett for å finne informasjon Vil i fremtiden aktivt måle fysiologiske parametere Pulsoksymetri, spirometri, blodsukker, INR, blodtrykk etc Daglige spørsmål om sykdomstilstand Prestasjoner, forbedringer ved rehabilitering/opptrening Føre en «helse-dagbok» Elektronisk samhandling med helsetjenestene for råd/oppfølging UiA, ehelse,

22 Fra forskningen: Åpen infrastruktur Pasient/pårørende Patient IIP PEHR Collaborative dashboard Hjemmesykepleier publish Fastlege Treatment Pathway Health Record Sykehus/ spesialist Fremtidens pasient oppfølging Koordinering av aksjoner UiA, ehelse,

23 Kommunal kommunikasjonssentral for helse- og omsorgstjenester (Call-senter) Fremtidig behov for å koordinere innsats: Call-senter «Helsevakt» Trygghetsalarmer Legevaktsoppgave Hjemmemonitorering Kommunal Øyeblikkelig Hjelp (KØH) UiA, ehelse,

24 helsenorge.no den offentlige helseportalen Helse- og omsorgsminister Anne-Grete Strøm- Erichsen åpnet onsdag 15. juni den nye nettportalen for helseopplysninger: Helsenorge.no er en veiviser til den helsetjenesten og selvbetjeningsløsninger i helsesektoren. Portalen presenterer også informasjon om forbygging, helse, sunnhet, sykdom, behandling og den enkeltes rettigheter som pasient. meldinger/2011/lanserer-ny-helseportal.html?id= UiA, ehelse,

25 Interoperability and Standardization UiA, ehelse,

26 Virtuelle hjemmebesøk Det kan være krevende å følge opp pasienten over distanse «Varme hender» må understøttes av fornuftig teknologi UiA, ehelse,