Telemedicine Services

Telemedicine Services Innovative Approach to Delivery of Healthcare Dr. Fedor Lehocki Director, NCTS Workshop in Bratislava 11.12.2012 NCTS • Establ...
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Telemedicine Services Innovative Approach to Delivery of Healthcare Dr. Fedor Lehocki Director, NCTS Workshop in Bratislava 11.12.2012

NCTS • Established on 1.12.2011 • based on 15 years of expertise in domain of medical informatics • university centers of excellence and competence center • contract with NCZI

• Slovak University of Technology in Bratislava Co-founders:

• IBM (strategic partner), Slovak Medical Chamber • WHO in Slovakia  Competencies  Creating environment for telemed. Adoption  Evaluation and validation of telemedicine services  Standards in medical informatics

Motivation  Disruptive demographic related to population of middle-aged and older adults (est. 33% of overall EU population by 2025)1  Increasing number of patients with chronic conditions (CVDs, diabetes, cancer, osteoporosis, COPD, asthma, Alzheimer’s dementia, arthritis)  Growing demands on national health care systems in terms of medical staff and funding expenditures (increase from 9% up to 16% of EU GDP by 2020)2  Standard & Poor's warns of likely downgrades related to "a number of highly rated“ countries from 2015 if their governments fail to enact reforms to curb rising healthcare spending and other costs related to ageing populations3 1WHO

global report on Noncomunicable diseases country profiles 2011

2Businessweek,

18.2.2010

3Standards

& Poor’s report, Reuters 31.1.2012

Addressing the Issues  Introduction of new services for healthcare provision improving the consistency of quality level, enabling access to care, and cost containment  Supporting decentralization of care – patient centered medical home  Integrated care model (connected health)  Trends towards prevention  Stopping “brain drain” in SK related to shortages of healthcare professionals in Western EU countries  Using innovative technology

Definition of Telemedicine

“The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities” WHO adoption of telemedicine description

Example – Existing Technology

Complete loop  Sensor devices  mHealth, telecommunication networks  Big Data in healthcare  Retrospective, real time and predictive analytics

Example – Existing Technology

Standardization, technical interoperability  HL7  IHE  Continua  IEEE

Examples of Telemedicine + teleradiology

Non Technical Challenges  Importance of gathering evidence regarding the impact of telemedicine applications  Legal liability, licensing and accreditation, especially when telemedicine services are delivered across jurisdictional boundaries  The unwillingness of many private and public healthcare payers to provide adequate reimbursement for telemedicine services  The requirement for new models of staffing, scheduling and care coordination, especially for telemedicine services that involve remote monitoring  Financial justification and incentives — most healthcare systems do not reward clinicians for keeping patients well (or less sick), only for treating them when they become sick  The limited integration of telemedicine data into electronic health record (EHR) systems  The lack of sufficient bandwidth or Internet connectivity in some areas

Example – Diabetes Telemedicine Services

Additional functionalities  Adding custom notes on general health (symptoms, infections)  Comments on related to diabetic conditions (hypoglycaemia)  GPS position  Emergency button  Insulin information – dose, type, mode (regular, extra correction)  Sugar intake – meal/drink database (type, quantity)  Assynchronous message exchange patient/healthcare provider

Benefits Making specialist services more accessible to patients Enabling closer monitoring of patients' health and enabling more frequent or rapid intervention  Avoiding or delaying hospital admissions, nursing home admissions and physician office visits Using clinicians' time more efficiently  Improving the working lives of clinicians — for example, by enabling them to work from home Reducing travel costs and the time needed for patients and clinicians  Involving patients more closely in taking care of themselves  Helping clinicians to share skills and expertise  Reducing the social inequality caused by the suboptimal geographic distribution of health services, especially between urban and rural areas  Enabling HDOs to increase revenue by offering new medical services or by expanding existing services  Enabling HDOs to improve efficiency by eliminating loss-making medical services and outsourcing them to vendors or to other HDOs

Thank you for your attention.