© charles lowe consulting 2010 from it to independent living – how to make telehealth &...

© Charles Lowe Consulting 2010© Charles Lowe Consulting 2010

From IT to independent living – how to make telehealth & telecare catalyse improved care

Charles LoweCharles Lowe Consulting Ltd.charles.lowe@btinternet.com

07860 619424

© Charles Lowe Consulting 2010© Charles Lowe Consulting 2010

DH definitions

Telecare – service user to responder: environmental monitoring

Telehealth – patient to clinician: vital signs monitoring

Telemedicine – clinician to clinician: seeking expert advice

eHealth – all the above

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The differences

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What works best

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Why

X

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What’s the problem?

2000 2010 2020 2030 20400

10

20

30

40

50

60

Age Structure - Western Europe

%

20-60

75+

• Fewer professionals

• More LTCs

• Raised expectations

© Charles Lowe Consulting 2010© Charles Lowe Consulting 2010

Or to look at it another way

2010 2020 2030 2040 2050 20600

10

20

30

40

50

60Dependency ratios

%

All EU

UK

Denmark

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Will remote monitoring work?

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The vision – Mrs Smith, a COPD sufferer in 2018

The home hub collects and aggregates information from the connected

applications such as the spirometer and home sensors

The home sensors detect Mrs Smith’s

movements around the home and send an

alarm to her family if there is not sufficient

movement

The home sensors detect when Mrs Smith is

sitting for too long a period of time. An alarm

is sounded if she sits for too long a period in

winter to encourage her to move around to

keep warm

Mrs Smith provides regular spirometer

readings to her nurse which are sent from her

home hub

If Mrs Smith has an infection, she can provide a sputum sample to be

analysed by her home diagnostics kit. This detects the presence of

bacteria and sends the results to her doctor from her home hub

Mrs Smith’s smart medication dispenser reminds her to

take her medication by sounding an alarm. If Mrs Smith

fails to take her medication, her family are notified

Mrs Smith wears an alarm in case she falls. If she

needs assistance, she can sound the alarm to contact

a member of her family

Mrs Smith accesses her medical records and

interactive health information through her home hub

4

Source: Fathom Partners, Health Technology Futures, Kings Fund event

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Remote monitoring works…BUT:

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…with the result that…

X inappropriate

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Depression

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Dementia prevalence

0

5

10

15

20

25

%

65-69 70-74 75-79 80-84 85+

Age

Source: Alzheimer’s Disease International www.alz.co.uk

“Individuals with high mental stimulation had a 46 percent decreased

risk of dementia” Michael Valenzuela, Univ. New South Wales

http://www.msnbc.msn.com/id/11025839/

© Charles Lowe Consulting 2010© Charles Lowe Consulting 2010

© Charles Lowe Consulting 2010© Charles Lowe Consulting 2010

Before process change

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After

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Time with Clinician in 3 months

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Time when remote monitoring in 3 months

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But there are lots of players involved

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Is this your health service?

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Or this?

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How can technology help...

Release time to careCatch disasters early at home & awayReduce anxietyAnticipate medical exacerbations Improve disease managementPromote self-careEliminate unwanted human contactTurn rush into quality timeHelp people to help each otherInformate

Falls,

seizuresOxygen

sats, help at

hand, GAD7 CHD,

COPD Medication

compliance,

new linkages

Expert

patient, mental

stimulationEsp for

learning

disabilities

Part of

working

completely

differentlyOne way of

providing

human contact

Reduce admin,

POCT, self

service

Resulting in:

1) Improved outcomes

2) Secondary -> primary care

3) Lower costs

4) Discoveries

Discover

new

linkages

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Challenges

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Trials

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Not what you expect?

Mobile phonesCognacTanksARPAnetCarsStereo soundGunpowderRemote monitoring

Continuous vs episodic care

24x7x365

Autonomous

Decision support

Behaviour change

Self-management

Informating

More patients

Less travel

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Council SMG

PCT Board

GP Forum

PEC

CEC

LMC

Adult Services Board

Programme Board

Project Boards

Management

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Leadership

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Thank You

Charles Lowe

Charles Lowe Consulting Ltd.

charles.lowe@btinternet.com

07860 619424