Why)are)you)here?) • To)work)with)important)matters?) • To)help)the)humanity?)
DANISH&IDEAS&
in)future)health)care
• To)work)in)great)teams)solving)the)most) important)problems)in)the)world?) Henning&Langberg&
• To)make)money?
Professor) CopenRehab) Institut)for)folkesundhedsvidenskab) www.henninglangberg.dk&
Langberg,)CopenRehab,)KU
The&prevalence&estimates&
of&diabetes&worldwide&–&2003
The&prevalence&estimates&
of&diabetes&worldwide&–&2025
20
Diabetes(Atlas)second)edition,)IDF)2003
Type&2&diabetes,)) Langberg,)CopenRehab,)KU
the)metabolic&syndrome)and)cardiovascular&disease)in)Europe
Langberg,)CopenRehab,)KU
Total&annual&direct&medical&costs&for&patients&with&type&2&diabetes& (CODED2&1998) UK& 2.6&billion&Euros
Sweden& 0.7&billion&Euros
Belgium& 1.1&billion&Euros
Netherlands& 0.4&billion&Euros
France& 4.0&billion&Euros
Germany& 12.4&billion&Euros
Spain& 2.0&billion&Euros
Italy& 5.8&billion&Euros
Can Diabetes be Prevented? Risk of Type 2 Diabetes can be reduced: ◆ Losing weight ◆ Taking regular exercise : walking for 30 mins per day ◆ Eating healthier food: ▪ Less fat (burgers, fries, crisps, sweet foods) ▪ More fibre (fruit and vegetables, wholegrain alternatives for rice, bread) ◆ Cutting down on alcohol consumption
Total&for&these&8&countries&=&29&billion&Euros
Ultimate aim is to reduce the longterm complications
Type&2&diabetes,)) the)metabolic&syndrome)and)cardiovascular&disease)in)Europe
Langberg,)CopenRehab,)KU
Langberg,)CopenRehab,)KU
Challenge
Effect?
8-12 weeks
Langberg,)CopenRehab,)KU
Langberg,)CopenRehab,)KU
Collaboration
Municipality)of)Copenhagen
5 prevention centres for 500.000 citizens 250.000 “Copenhagens” have a health challenging lifestyle 3000 lifestyle related interventions/year
1000 change lifestyle
Only 50% participate in PA
0.4% change lifestyle Langberg,)CopenRehab,)KU
Solution
Langberg,)CopenRehab,)KU
Solution
Technology
Technology
> Outcome Registries > Endpoints
InterWalk&&
Total mortality
Online&database
Cardiovascular mortality
Data-linking using cpr-no. >)Measure)(accelerometer)+)GPS))) ) P)Physical)fitness) )
DD2 cohort
P)Training)intensity)and)duration)
>)Individualise)training)intensity)) >)Individualise)training)/)voice)guide) >)Historical)data)local) >)Automatic)data)upload)) ) )
P)Physical)fitness)) P)all)IWT)data)
>&CPRDno.&mandatory&for&app&use Langberg,)CopenRehab,)KU
Outcome&data&
Surgical procedures Dialysis
> Registry Central Population Register The Danish National Registry of Patients The Danish National Registry of Patients The Danish Registry on Regular Dialysis and Transplantation
Use of medicine
The Danish Prescription Registry
Metabolic regulation
The Danish Diabetes Database for Adults (DDDA) and DAMD
Infections
InterWalk&+&DD2&+&other®istries Social prognosis
Microbiological databases Statistics Denmark Langberg,)CopenRehab,)KU
The&informationDmotivationDbehavioral&skills&model&(IMB)
Motivation
Behavioral)Skills
Behavioral) Change
Information Fischer)&)Fischer)2005
Langberg,)CopenRehab,)KU
Langberg,)CopenRehab,)KU
Langberg,)CopenRehab,)KU
Langberg,)CopenRehab,)KU
Langberg,)CopenRehab,)KU
Langberg,)CopenRehab,)KU
)))))DigiRehab)–)digital)solution)to)guided)hometraining Sy Perlis, 91 years old World record: 85 kg
Paradigm)shift)P)from)a)passive)to)active)rehab)
Langberg,)CopenRehab,)KU
Langberg,)CopenRehab,)KU
Cost&of&Home&visits&and&practical&help&to&citizens& +65
$2B&annually&& 20.000&$&per&treated&elderly
Langberg,)CopenRehab,)KU
Langberg,)CopenRehab,)KU
Is)“At)the)Point)of)Care”)Too)Late? Health care spending
Health Status
Healthy /
Low Risk
At Risk
High Risk
Early
Active Clinical
Disease Early Symptoms Symptoms 20% of people generate 80% of costs
Can&we&exploit&medical&data&to&intervene&earlier?& ))P)Early)detection)of)atPrisk)patients) ))P)Provide)personalized)evidence)to)enable)proPactive)decisions
Langberg,)CopenRehab,)KU
E-mail:
[email protected]
Langberg,)CopenRehab,)KU
