Transcript Slide 1

www.healthsysconsult.co.uk
Med-e-Tel
Luxembourg
18th April 2008
Professor Ricky J Richardson
Life President
Chairman
Vice President
Founding Director
Group Clinical Director
Visiting Professor – eHealth
Co-Chairman
UK eHealth Association
eHealth Working Group - EHTEL
European Commission - 1999 – 2003
International Society for Telemedicine
& eHealth
European eHealth Forum
HealthSystems Group of companies
Imperial College, London
Commonwealth eHealth Initiative
Consultant Paediatrician – practicing at:-
Great Ormond Street Hospital for Children, London
The Portland Hospital for Women & Children, London
The Child and Family Practice, 57A Wimpole Street
Princess Margaret Hospital (BMI), Windsor
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Take Home Messages
Mobile eHealth applications
Location Neutral
- Transborder Transactions
Infrastructure - Radical Revision
Personalised Healthcare Delivery
Groups of countries sharing healthcare
resources, medical knowledge and skills
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eHealth-Health System Transformation
C19th Chemistry
Pharmaceuticals
C20th Physics
Imaging
C21st ICT
Knowledge based
Healthcare
Prof Yunkap Kwankam WHO 2007
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eHealth-Health System Transformation
1990 – 2000 Telemedicine and eHealth Pilot
Projects plus Malaysia (national
programme)
2000 – 2005 The First National eHealth
Programmes – NHS Connecting for Health
2005 to 2015
Regional eHealth Networks
The Commonwealth
ePortugese Network
Many others…………..
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The Biological Continuum
Population
Whole Body
Systems
Organs
Tissue
Cells
Proteins
Genes
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The Care Continuum
Home Care
Primary
Care
Secondary
Care
Tertiary
Care
Population
The T Model of
Healthcare after
Atun and Kitney © 2008
Systems
Organs
Tissue
Cells
Proteins
Genes
The Biological Continuum
Whole Body
Telecare
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eHealth-Health System Transformation
In Future - the only
Healthcare Plan will be
YOURS!!!!
Prof Richard Kitney -2005
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Health Transition Demographic transition
THE TIME BOMB !!
Epidemiological transition
Fertility
declines
Infectious
Disease
Mortality
declines
Population
ages
Chronic and non
Communicable
Diseases
emerge
Copyright Professor Rifat Atun – Imperial College
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Population ageing and health
The next 50 years ! 1995 to 2045
More developed countries
160
140
1
4
0
Less developed countries
600
500
120
400
100
80
300
60
200
40
100
20
0
0
1995
2005
2015
2025
2035
2045
1995
2005
2015
2025
2035
2045
80
1
4
0
Least developed countries
70
60
Under 65s
65s and over
50
40
30
Estimated future numbers
of dependent people by age
20
10
0
1995
2005
2015
2025
2035
2045
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Demographics
Ageing population - Implications
Increased Dependency ratio
Increased cost of long term care
Who will support the health and
welfare system in the Future?
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Pakistan at a glance
Country Profile:
Population: 156 million
GDP Real Growth rate: 6.6% (2005)
But
GDP per capita: approx $2225
Population living below the national poverty line (2004/05): 32%
Total health expenditure as % of GDP: 2.4
Maternal Mortality Rate: 320 / 100,000
Infant Mortality Rate: 80 / 1,000
(almost one in ten children die before their first birthday)
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Pakistan – a potential exemplar?
•
Pakistan is a transitional economy country that has made major
strides in its development, there are however…
- Alarming health indicators such as high infant and maternal
mortality rates
- This has been compounded by social welfare indicators such as
low GDP per capita
•
With the new political dispensation there is an opportunity to
transform Pakistan’s Health System.
•
Some health problems can be classed as ‘wicked’– that is their
resolution may in practice involve a trade off between potentially
conflicting public expectations of government’s role i.e.
• Government as a guardian of cultural and religious traditions vs.
• Reproductive health policy
• Women in the workforce
• In certain situations, non government organisations may have more
freedom to act
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Specific healthcare priorities for
Pakistan
1.
Improving Health Services
2.
Managing Chronic Disease
3.
Managing Infectious disease
4.
Reaching vulnerable groups
5.
Reforming Health policy
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Punjab: Proposed 100 Day Health
Actions
1.
Emergency services
2.
Autonomous Hospital
3.
Recruitment and promotion for Doctors / Paramedics
4.
Drug Supply
5.
Non availability of female doctors
6.
Quality of medical education
7.
Private Sector Mainstreaming
8.
Minimum service delivery standards
9.
Renal dialysis
10.
Control of Infectious Hepatitis
11.
Drug Act 2007
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eHealth …….is:the instrument for productivity
gains in the context of existing
healthcare systems but also provides
the backbone for the future citizen
centred healthcare environment
Jean-Claude Healy
World Health Organisation
September 2004
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Healthsystems Transformation
eHealth
Public Health Improvement - Epidemiology
Patient Learning – use of media channels
Care Provider eLearning
Clinical Applications
Health Informatics - Medical Devices
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Who needs eHealth?
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She does !!!
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He does.
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He does
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They do!!!!
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In Rural India - THEY DO !
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In rural and
urban
Pakistan
- they do
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What will they all have in
common?
A mobile
phone
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Potential of eHealth to support
some policy objectives in Punjab
Issue
eHealth solution
Emergency services
Mobile / Telephone / internet based
advice to extend service beyond major
cities
Autonomous Hospital
Extend reach of tertiary services via ‘pro
poor’ telemedicine clinics delivered from
centres of excellence
Recruitment
and promotion for
Doctors / Paramedics
Implement ‘professional networking sites’
supported by Government to improve
communications / raise morale
Drug Supply
On-line ordering and monitoring of drug
supplies at remote sites
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Mobile Telecare
Based on a Primary Care Centre built inside a standard 44 Tonne Container
Mobile Primary
Care Centre
Satellite
Footprint
150 Km
Medical Centre/Medical
Information Centre
(EPR, PACS etc)
Remote
Villages
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Some eHealth initiatives to
consider for Punjab
Mobile / Telephone / internet based emergency medical advice service
‘Pro poor’ telemedicine clinics delivered from centres of excellence
‘Professional networking sites’ and promotion for recruitment
On-line ordering and monitoring service for drug supplies at remote sites
Telemedicine consultations by lady doctors based centrally
On-line educational tools and access to on line courses for medical students ,
with associated participation in international regulatory / standardisation
Standards based inter-operable eHealth architecture to ensure that private
providers can operate seamlessly with public sector
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Where does Web-based
Medicine take the Punjab?
• Access to the remote expert
• Borderless Medicine
• Direct access to the international medical
market
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Access to the Remote Expert
• Integrated medicine across the country
– Health Care professionals in more remote areas
can have instant access to top specialists
without either party leaving their office
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Borderless Medicine
• Direct access to international experts
– Health Care professionals in Pakistan can have
direct access to leading specialists in other
countries at minimum cost
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Old Method for Teleradiology
Glasgow
Transfer of images between the
two sites for reading
Lahore
Images can be lost or
incorrectly catalogued
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Web-based Teleradiology
No transfer of images between
sites –images are viewed and
read anywhere. Images stored on
a central server
Images cannot be lost or
incorrectly catalogued
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This is what
we have now!!
Historical focus of
ICT has been on
automation not
transformation
Paper Kills !!!!!
Richard Granger - Director General
NHS CfH
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EU / WHO / Commonwealth initiatives :Countries are forming groups to share scarce health
resources, skills and knowledge where they share a
common language, culture or heritage.
World Health Organisation – Global eHealth Strategy
(193 countries)
European Community (25 countries)
ASEM eHealth Working Group (43 countries)
Commonwealth eHealth Programme (53 countries – 1.8 billion citizens)
Launch date – 19th May 2008 by Archbishop Desmond Tutu
at Commonwealth Ministers of Health Conference – World Health
Assembly
ePortuguese eHealth Network (9 countries – 250 million citizens)
eHealth has become a core pre-occupation of governments worldwide
Public Private Partnerships are essential to achieve eHealth goals
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Traditional Healthcare Delivery Model
Teaching Hospitals
3°
HealthCare
Regional Hospitals
2°
HealthCare
District General
Hospitals
1°
HealthCare
General
Practitioners
The Patient Community - Bottom of the pile!!
Unchanged for 6000 years - circa 3000 BC!
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Future Health System Transformation
The Informed Wired up Citizen Community
The wellness paradigm
C-Health
WWW
Freestanding
Diagnostic
Centres
IDTV
Home
Care
IDTV
Direct Access to specialists
Health
Kiosks
DayCare
Surgery
Community
Hospitals
(Non-acute)
WWW
Community Acute
Hospitals Trauma
Maternity
(Acute)
Allied HealthCare Professionals
Primary HealthCare
The ‘Super’ Primary Care Physician
PRIMARY TELERADIOLOGY
AND TELEPATHOLOGY
?
Clusters of Specialists
global spread &
universal access
?
eHealth &
Telemedicine
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We are at the dawn
of the age of citizen
centric Healthcare
Systems
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Emerging trends for telehealth solutions
Personalised and home based services:
•
•
•
•
•
Self care
home care
sensors
mobile
on line advice – phone / internet
Education:
• citizen education – HIV in Africa
• eLearning
Integrated imaging
• Integrated dimensions: molecular to whole body
• Nationally networked medical equipment
• Decision support and quality algorithms
Genomics
Clinical hot spots (borne out by recent SCT survey in Scotland):
• Unscheduled care
• Diabetes and long term conditions
• Paediatrics
• Oncology
• Cardiology
• Psychiatry
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The Future
Biogenetically engineered stem cell mice!
Gene targeting
Nobel Prize Winners for Medicine 2007
Sir Martin Evans, Mario Capecchi, Oliver
Smithies
Lord Ara Darzi’s Vision for London
•Walk In Treatment Centres
•Diagnostics in the High Street
•Improved outcomes for Stroke Patients
Patients
Partners in the healthcare process
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Where are the challenges??
Not the technology ------------------- The People
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HealthSystem Transformation
The reasonable man adapts himself to the world;
The unreasonable one persists in trying to adapt the world
to himself.
Therefore, all progress depends on the unreasonable man !!!
George Bernard Shaw
(1856– 1950)
Via Prof Jean Claude Healy
World Health Organization
September 2005
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Philosophical Thought
Are we the Culpable
Generation ?
Take Action Now!
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eHealth
UK eHealth Association
www.ukeha.org.uk
International Society for Telemedicine and
eHealth
www.ISfT.net
THANK YOU!!!!
Professor Ricky J Richardson
[email protected]
Mobile +44 7785 231 762
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