Presented by:
Dr Liz Mear Chief Executive
House keeping
• In case of emergency
• Mobile phones
• Twitter #NWCEcosystem
• Wifi: Wifi Name: AintreeGuest
Wifi Passcode: Welcome2032
Programme 10:00 Openings & Welcome - Dr Liz Mear, Chief Executive, NWC AHSN
10:15 International Network of Connected Health Ecosystems
Why an Ecosystem?? - Brian O’Connor, European Connected Health Alliance
10:30 International Case Study Examples from Health and Business
Ecosystems in Action! - Professor George Crooks, NHS 24
Collaboration as a Design Principle - Chris Roche, Aridhia
11:00 Questions to the Panel
11:15 Coffee & Networking
11:45 Introduction to the North West Coast Ecosystem
ILINKS Informatics Transformation Programme - Kate Warriner & Dr Craig Gradden Healthier Lancashire Digital Health Work Stream - Declan Hadley
Digital Health – The Mi Programme - Dave Horsfield, Mi Programme
12:45 Questions to the Panel
13:00 Lunch, Networking & Exhibition
14:00 Eat More Chips! - Don Cowling, Proteus Digital Health UK Ltd
Alere - Sumit Nagpal, Alere Accountable Care Solutions
15:00 Breakout Sessions
16:00 Next Steps - Dr Liz Mear, Chief Executive, North West Coast Academic Health Science Network
16:15 Close, Networking & Coffee
Innovation and Health Connected
Presented by:
Dr Liz Mear
Chief Executive
Aims and objectives of AHSNs Innovation, Health and Wealth • To spread innovation at pace and scale across NHS
• To promote and integrate the strengths of higher education, the NHS, industry, third sector
• To improve health of individuals and communities • To focus on the needs of patients and local populations • To speed up adoption of innovation into healthcare • To build a culture of partnership and collaboration • To create wealth
AHSNs, AHSCs and the research and innovation landscape
INVENTION EVALUATION ADOPTION DIFFUSION
Research Councils – set the agenda
CLAHRCs
AHSCs AHSNs
NHS Patient Care
NHS Patient Care
CLRNs
Funding bodies and research centres
Current thinking “We’re never going to be the country that pays the highest prices, or that adopts new treatments regardless of how well they work – just so we can say we’re ‘innovative’. We’ll happily leave that accolade to others. But what we should be is rigorously pro-science, pro-research, and pro-the rapid spread of useful improvement. That’s where AHSCs and AHSNs have such an important role. If we get our act together, what the NHS potentially has to offer – that many other health systems don’t – is a unique combination of biomedical research, population-orientated primary and specialist care serving diverse patient groups, longitudinal data (to allow matching of phenotypes
with genotypes), an aligned financing system,
and a rigorous focus on value creation.”
Simon Stevens, CEO, NHS England
Definition of Innovation
• Service improvement
• Incremental change
• Teaching and training
• Area wide strategy implementation
• Applying existing service developments into a new area
The introduction of new ideas, devices, or methods, accomplished through more effective products, processes, services, technologies or ideas
Campaign example 1 Medicines optimisation/ digital health
• Evaluations in primary care • RIF bid with specialist Trust • Engaged with patient group to
gain insights into problems with medication specific to the group to inform future trials
• Identification of partners for assessment of potential applications
Campaign example 2 Reducing health inequalities – focus on stroke due to Atrial Fibrillation in 2014/15 and NICE compliance
• Working in partnership
• Community testing for AF using POC devices from SME
• Personalisation of medication
• Evaluation/ comparative study
• Expert advice on prescribing and treatment
• Roll out of learning
• Improvement of patient outcomes
• National launch event with European Brain Council
Campaign example 3 Intelligent Data
• Working in partnership – iLinks and Lancs Digital
• Co-ordination of projects to suit local needs
• Development of a Patient Health Record
• ‘Interoperability’ of systems across the region
• Data ‘footprint’
• Prediction of future needs and treatments
• Improvement of patient outcomes
Know your customer Will it deliver cost benefits to the NHS?
– Reduce LOS / reduce admissions
– Redesign current pathways
Will it increase patient safety and prevent disease?
Will it deliver improved diagnosis, treatment and / or care?
Will it improve the patient experience and quality of life?
Will it increase life expectancy?
Why is it better than the current solution?
Wealth Creation Working in partnership – LEPs, NHSA, AHSNs, fund managers
• Attract an investment fund to the region for health technologies
• Job creation
• Spin out companies
• Companies moving into the region
• Grants, local, regional and European funding
• Promoting our region through UKTI and Healthcare UK
Working with industry • Focus on SMEs within region and those with solutions to key
priority areas
• Some bigger company partnerships
• Strong focus on med tech due to longevity of AHSNs
• Forming a Northern Industry Group with NHSA and 3 other NHSAs
• Working through a range of partners to develop a culture of innovation and evidence based practice within the NHS
Working with industry • Evaluation of technologies
• Introductions to clinical specialists
• Facilitation of trials
• Collaborative bids
• Procurement of innovative technologies
• Some bigger company collaborations
• Strong focus on med tech due to longevity of AHSNs
• Forming a Northern Industry Group to align agendas to drive growth across the north
Connected Health Ecosystems ECHAlliance Connected Health Permanent Ecosystem
Patients must be at the centre of the Ecosystem as the users of connected health
services. Patients will help to drive the design and innovation in connected health services and in so doing take more control over their conditions for better health and quality of life.
Why an Ecosystem?? Brian O’Connor
Chair
European Connected Health Alliance
Why Ecosystems?
Brian O’Connor, Chair, European Connected Health Alliance
Who are we?
• Europe’s largest Connected Health membership organisation
• Not for profit, community interest company
• Connected Health is an umbrella term for eHealth, mHealth, digital health, telehealth etc
What do we do and why?
• Deliver leadership for Connected Health
• Help develop Connected Health markets
• To transform health, wellness and social care delivery
• Create economic growth
The Challenge
The opportunity
BUT ECHAlliance Network of Connected
Health Ecosystems is breaking down silos within regions and between
regions
ECHAlliance Connected Health Ecosystem
Another network or cluster?
• Brings all the stakeholders together across connected health spectrum – eHealth, mHealth, Digital Health, telehealth, telecare
• Breaks down the silos
• Specific focus on connected health
• Permanent
• Political buy-in
• Part of an international network
An international network Current Ecosystems exist in :
Northern Ireland, Oulu – Finland, Catalonia – Spain, New York, Manchester – England, North West Coast - England, Scotland, Athens – Greece
Additional ecosystems under development in: France, Spain, Republic of Ireland, Estonia, Sweden, Italy… and beyond Europe
• Countries and regions share similar challenges and are often seeking to address the same problems
• Learn from each other, share challenges and identify common solutions
• We don’t have to reinvent the wheel
Examples of priority areas
• Medicines management
• Development of eHealth strategies
• New business models: innovative procurement, risk sharing, pre-commercial procurement
• Horizon 2020
• Electronic care records
European Commission welcomes Irish EU Presidency declaration on
development of ecosystems May 2013
Neelie Kroes, Vice President of the European Commission, Digital Strategy
"eHealth ecosystems could be the answer to the strain our social security systems are undergoing. If we work together and we use the enormous potential technology has to offer us, we can ensure top healthcare for all in Europe”
Principles of Working Together in an International Network of Connected Health Ecosystems (2013)
This paper provides guidance for Ecosystems in the international network on how they should work together and includes governance, communications and stakeholders.
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ECHAlliance Methodology: Creating a Connected Health Ecosystem (2013) The ECHAlliance International Network of Permanent Connected Health Ecosystems is expanding very quickly due to the high demand from those wishing to break the silos and develop lasting collaborations to create better patient care, at lower costs and creating economic growth. Recognising the challenges that establishing an Ecosystem can pose, we have responded by developing an ECHAlliance methodology for creating a Connected Health Ecosystem.
Almost 1000 people participating in ECHAlliance Ecosystem meetings across Europe in June:
• 11 June: Oulu
• 19 June: Manchester, England
• 20 June: Northern Ireland
• 23 June: Scotland
• 26 June: North West Coast, England
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June 2014 is a busy month for the International Network
There’s never been a better time to be part of an ECHAlliance Connected Health Ecosystem
Brian O’Connor, Chair
European Connected Health Alliance
[email protected] www.echcalliance.com
34
www.echalliance.com
@ECHAlliance
-
ECHAlliance
Ecosystems in Action!
VIDEO
Professor George Crooks
OBE Medical Director
NHS 24
Collaboration as a Design Principle
Chris Roche
Chief Commercial Officer
Aridhia
Questions to the Panel
Refreshment Break
ILINKS Informatics Transformation Programme Kate Warriner
Deputy Director, Informatics Merseyside
Dr Craig Gradden
Medical Director, Liverpool Health
Craig Gradden, Medical Director, Liverpool Community Health NHS Trust and
Chair, Clinical Informatics Advisory Group
Kate Warriner, Deputy Director, Informatics Merseyside
Background
Across the North Mersey local health and social care economy there is a driving ambition to deliver, at scale, shared information and to move to a culture where ‘we share’, questioning ‘how do we?’ rather than ‘why can’t we?’ by default.
Our Vision
Over the past 12 months we’ve been busy getting
our ‘ducks in a row’!
Communication
with stakeholders over past 12
months
Many organisations
and individuals involved in shaping
the programme
Unanimous enthusiasm and
support for shared information across
the economy
Strategy Signed Off
Wheelie Bin Syndrome
The Information Exchange…
…is a health and social care record
centred around the whole person …includes the
ability for individuals to
access and contribute to their
own record and person centred
care plans
…to a clinician looks and feels as though it is one
system
…gives a new layer of intelligence
through analysis of data from across
various organisations
…complements partner
organisation systems and
strategies and can be seamlessly
integrated
…delivers combined datasets
delivering an enhanced level of
intelligence for risk stratification and
operational planning
…is entirely customisable and
role based providing different
default views dependent on role
...gives a specific view across health
and social care providing an early warning for child
protection
Strategy Objectives and Outcomes
To create and deliver an information exchange across health and social care
To ensure informatics system-wide coherence and strategic leadership across health and social care
To exploit the benefits and investment of existing and future technologies and processes
Appropriate electronic information made available 24/7 to practitioners
Information is relevant and available at the point of care in real-time
Individual/ client access and contribution to electronic care record
A paper light health and social care economy
Underpinning the delivery of this strategy is…
A set of 12 Guiding Principles:
- Cultural - Leadership - Technical
Digital Maturity Framework
- Using HIMSS model - 8 stages
- Individual and economy assessment of IT usage
and maturity - Incremental approach
Top Priorities
Tackling Information Governance
Identifying what information needs to be shared
Delivering the technical requirements of the information exchange
Governance
££ Investment
decisions, set direction & priorities
Clinical Informatics
Advisory Group
All organisations represented incl. Local
Authority Informatics Reps & CCIO/ Clinical Reps
South Sefton CCG Finance &
Resource Group
Southport & Formby CCG
Finance & Resource Group
Liverpool CCG Healthy Liverpool
Programme Programme
Board Each CCG:
Programme Reports Risks/ Issues
Benefits Decisions
Health & wellbeing
Boards
CCG Governing Body
CCG Governing Body
CCG Governing
Body
ILINKS Transformation Programme Board
The eyes of the individual…
The eyes of the health and social care professional…
Summary
The scale of ambition is big, the potential benefits extremely exciting and the result - delivering a vision, which will make a real difference for our population and our
practitioners.
Healthier Lancashire Digital Health Work Stream
Declan Hadley
Digital Health Lead
NHS England (Lancashire) Local Area Team
Healthier Lancashire
Digital Health Work Stream Presented by Declan Hadley
NHS England (Lancashire) Jun 14
78
The case for change
A Digital Health
Ecosystem
What are we trying to achieve?
Better health outcomes
Improve the experience of care
Improve efficiency
What changes are we proposing?
Increasing digital literacy
Sharing digital records
Building a partnership for
connected health
Who will be involved?
Citizens & Professionals
Commissioners & Providers
Industry & Academia
How will we know we’ve done it?
Digitally empowered Citizens
Digitally engaged workforce
A supportive digital ecosystem
Project Overview
Shared Records Platform (HIE)
Personal (Life-long) Wellbeing Record
Commercial Partnerships
Voluntary Sector
Social Enterprises
CharitiesFamily & Friends
Personal Fitness
Assistive Technology
Mobile Apps
Remote Consultation
Remote Monitoring
Social Services
Hospitals GP Practice Ambulance Research
Tier 1 Sharing – Public Sector, secure, relevant & proportionate
Tier 2 Sharing – Individually owned & shared on request
Share
Empower Enable
Digitally
Pan-Lancashire Development work
Risk profiling
Planning
Predicative Analytics
Population Health
Big Data
Digital Health – The Mi Programme
Dave Horsfield
Mi Programme Manager
Liverpool CCG
Who is ?
• Consortium led by LCCG and funded by Government Technology Strategy Board
What does Mi do?
Community
Smart Economy
Technology
Innovation & Development
Technology – towards self care
• Telehealth
• Telecare
• New technology
• Retail & Advice
• Pathway Development
Community
• Community Champions
• Digital Champions
• Digital Hubs
• Active @ 60
• Livetime Team
• House of Memories
• Federated Membership
Economy
• Liverpool Vision eHealth Cluster
• ERDF Funding
• H2020
• EU Reference Site
• SME Engagement & ‘Hack’ Days
Innovation & Development
• Technology Development & Sensors
• Brainport, Eindhoven
• Person Held Record (PHR)
• Apps – NML/Digital & Social Inclusion
• EPG
• Insight
• Service Design
• ECDL for AL
Mi Activity
Questions to the Panel
Lunch Break (1 hour)
Eat More Chips!!
Julian Bradwell
General Manager
Proteus Digital Health UK Ltd
Every Thing is Going Digital… Things on The Internet
2000 The Internet on Things
Now The Internet is The Thing
2010
Familiar Business Models Fundamentally Changed
Will Health Care Be Any Different?
THE WORLD’S FIRST INGESTIBLE SENSOR
CE Marked and Available to Use Without Restriction on Age or Medical
Condition
Digital NDA Ingestible Sensor approved as medical device - Unlimited use by patients ingesting up to 30 sensors per day Approval pathway agreed by agency leadership for adding sensor to existing drugs - No additional safety or efficacy data required - No bioequivalence data required for similar formulation - Approval standard: manufacturing data package (e.g., stability) - Opportunity to shorten timeline for future products Pathway confirmed in meetings with agency review staff on specific digital medicines Initial indications favorable for similar path in China and Japan
Developing Use Cases In Three Care Settings
Hospital
Home & Community
GP Surgery
GP Surgery • Enable physician data gathering • Monitor adherence, activity • Make correct prescribing decision • Slow progression of disease • 2 week use case
HOSPITAL • Quality: enable daily panel triage • Check on adherence, lifestyle • Prevent re-admission in 30 days • 45 day use case
HOME • Enable family collaboration and teamwork approach • Monitor adherence, activity • Slow progression of disease / therapy • 90 day plus use case
54% of Previously Uncontrolled Hypertensive Patients Controlled
Within Two Weeks
All patients with a history of uncontrolled hypertension 2 week system use-case with integrated blood pressure measurement on Day 14 Data from 164 patients
Need Further Testing 10% (N=17) Missing BP measurements or less than 6 days of use
Controlled with Therapy 54% (N=88) Controlled Hypertensive Systolic BP <140 mmHg Diastolic BP <90 mmHg Adherence>=70%
Need Adherence Support 13% (N=21) Adherence<70%
Need New Therapy 23% (N=38) Uncontrolled Hypertensive Systolic BP >=140 mmHg or Diastolic BP >=90 mmHg Adherence>=70%
Powerful New Metrics, Unprecedented Insight
Circadian Pattern Based on Posture Medication Taking Behavior
Supine Sitting Standing Patch not worn
Circadian Pattern
Time of Day
Da
ys
0 2 4 6 8 10 12 14 16 18 20 22 24
10
20
30
40
50
60
Pill Taking Behavior
Time of DayD
ays
0 4 8 12 16 20 24
10
20
30
40
50
60
0 1 2Pills Taken in Day
Da
ys
Taking Adherence
0 2 4 6 8 10 12 14 16 18 20 22 24
0
20
40
60
80
Time of Day
De
gre
es
Average Circadian Pattern (+-std)
0 4 8 12 16 20 240
5
10
15
20
Time of Day
# P
ills
Timing Adherence
*
*
*
Dose Taken
Patch not worn excluded session from %
Data for 84-Year Old with Mild Dementia Reveals His Stable Activity and Medication Pattern Son Now Knows This and Checks In Only When Needed
Circadian Pattern
Time of Day
Da
ys
0 2 4 6 8 10 12 14 16 18 20 22 24
5
10
15
20
25
30
35
Pill Taking Behavior
Time of Day
Da
ys
0 4 8 12 16 20 24
5
10
15
20
25
30
35
0 5Pills Taken in Day
Da
ys
Taking Adherence
0 2 4 6 8 10 12 14 16 18 20 22 24
0
20
40
60
80
Time of Day
De
gre
es
Average Circadian Pattern (+-std)
0 4 8 12 16 20 240
2
4
6
8
Time of Day
# P
ills
Timing Adherence
Data for 90-Year Old with Mild Dementia Reveals Unstable Activity and Medication Patterns Son Follows Up Frequently to Make Sure His Dad is Doing Okay
Circadian Pattern Based on Posture Medication Taking Behavior
*
Dose Taken
Patch not worn excluded session from %
*
*
Supine Sitting Standing Patch not worn
Enables Interventions Driven By Real World Data
Proteus Provides Opportunity for Benefit In Numerous Areas
Medicine optimisation
Realise value from prescribed medications
Goals Reached with fewer drugs = Reduced cost
Reduced overprescribing and inappropriate poly pharmacy
Less Meds Wastage
Reduced unnecessary escalation to more expensive drugs
Optimisation of primary care service use
Reduced Appointments with Health Care Professionals & usage of NHS services
Reduced monitoring
Enables focus to remain on right meds
Collaborative experience for patient and provider of care.
Link to current packages of care by monitoring real time behavioural patterns bringing a sense of ‘security’ and support to patients careers and HCPs.
Provide motivation to a patient via encouragement and reinforcement of positive behaviours
Personalised medicine –individually tailored management
A Time to Eat More Chips ?
Sumit K. Nagpal
President & CEO
Alere Accountable Care Solutions
Alere
Breakout Sessions
Next Steps
Dr Liz Mear
Chief Executive
North West Coast Academic Health Science Network