e-health in a remote and rural setting in the north of scotland – an evolving success story [4 cr3...
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Cumming, G. et al.:e-health in a Remote and Rural Setting in the North of Scotland – An Evolving Success Story
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e-health in a remote and rural setting in the North of Scotland
an evolving success story
Grant Cumming NHS Grampian & UHIAndrew Fowlie NHS GrampianAdrian Baker NHS HighlandThomas Heneghan NHS GrampianNeil Hamilton University of AberdeenStefan Agamanolis Distance Lab
1.demographic change
2.health care expensive
3.doctor shortage & changing role
4. treatment prevention
5.patient’s expectations
need to connect and collaborate
e health
Changes in health care are inevitable
The Vision & the Mission
Moray
Elgin biggest town population 20,000
Population 120,0002238km2
Remote and rural population
Poor road infrastructure
current models of health care unsustainable
Track record to date
Patient tailored - Independent clinician led websiteWomen consulted
No 1 site in UK sites and world sites if google
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
2002 2004 2006 2008
average hits/day
Miscarriage Matters (CSO pilot study)
Cumming G, Klein S, Bolsover D, Alexander D, Hamilton NThe development and evaluation of a miscarriage-related website for women and partnersfollowing early pregnancy loss : A pilot study11th World Congress on Internet in Medicine 2006: 26
Paper presented and published abstract
Patient driven (needs assessment)Low level psychological intervention
CAL dept
Resource additional information before during or after visits to health professionalFor online support groups and forums For online consultation As a therapeutic interventionFor research/surveysFor prescribing
Summary
HADS anxiety & depression scores significantly improved
SF-36 scores all approximated to the norm at 3 months (apart from general health)
SF-36 scores showed no significant improvement at 3 months cf baseline
In those who had access to the website:
Miscarriage impacts negatively on HADS and SF36 scores
In those who did not have access to the website:
New developments
STRATEGY FOR THE DIVERSIFICATION OF THE ECONOMY OF MORAY FOLLOWING RESTRUCTURING OF THE RAF BASES
AT KINLOSS AND LOSSIEMOUTH
December 2005
1/5/ 07 - 21/4/08
Baby feeding matters Statistics
Baby feeding videoconferencing study
Internet Protocol(IP)
Integrated Service Digital Network
(ISDN)
Dr Grays Buckie
VC unit - spilt screen VC unit – split screen
BFM websiteBFM website
patientHealth
pro
www.babyfeedingmatters.co.uk used as interactive teaching aid
Dufftown is situated in Moray in the North-East of Scotland 54 miles from Aberdeen 58 miles from Inverness
16 miles from Elgin
The Dufftown Project
Dufftown Pilot• Promote Self Care• Home monitoring blood pressure• Empowerment using Digital medium• Access on-line tools• Purpose built website
??as good as conventional care?? more economic
The future
PEDI principle
• Personalised predictive health care plans
• Evidence based health and care
• Digital consultations with health care professionals
• Interactive Web based care (Web 2.0 & Web 3.0)
good quality of lifephysical (community health-e-space.com Northern Scot)psychological
emotional management dealing with long term conditionrole management (coming to terms with change in life role)
online electronic support groupspersonal storiesillness narrativescomputerised cognitive behavioural therapy
spiritual – research project proposed
disease preventionbehavioural change (eg exercise, diet, smoking, alcohol)
SAE, goal setting, self monitoring, feedbackwww.babyfeeding matters & videoconferencingpredictive modelling
disease management & treatment SAE, goal setting, intervention, self monitoring, feedback
eg urinary incontinenceDufftown hypertension pilot
Hospital Care
Exte nded GPPractic e
ManagedCare
MainlySelf
Caring
Level 170-80% of
People
Level 2High risk
Service Users
Level 3Highly
complexpatients
Making e health real health
treatment → prevention (self care)