evert jan hoijtink, portavita.nl, pour la journée e-health 2013
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TRANSCRIPT
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FP7-ICT-2011-7 Contract no 287841
C o l l a b o r a t i v e P r o j e c t
7th Framework Programme P r i o r i t y F P 7 - I C T- 2 0 1 1 - 7
I n f o r m a t i o n S o c i e t y Te c h n o l o g i e s Proposal No 287841
http: //www.commodity12.eu/
Sierre, June 7th, 2013 Evert Jan Hoijtink
CEO Portavita BV�
Patient oriented Integrated Care “Role of the Patient”
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FP7-ICT-2011-7 Contract no 287841
Agenda
1. Short Introduction Portavita & COMMODITY12
2. Short History of Disease Management in The Netherlands Start, Finance and Issues
3. Diabetes Integrated Care Examples 1. Role of the Organization
2. Role of the patient
4. What is the added value!
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FP7-ICT-2011-7 Contract no 287841
Introduction Evert Jan Hoijtink
Work
• Portavita BV – Founder & CEO
• MGRID BV – Founder & Director
• eMbrace – Founder & Vice Chairman
Functions / Standardization
• OIZ (Health IT Suppliers) – Vice Chairman (standardization)
• NEN (Dutch ISO chapter) – Policy Committee 303 Health IT
• IHE – member (Steering Committee)
• HL7 – member (RIMBAA Technical Workgroup)
• CIMI - Contributor
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FP7-ICT-2011-7 Contract no 287841
1 | Introductie Portavita
• Founded 2002 by management en Agis Health Insurances;
• 48 employees;
• Software as a Service - Care Management System; • 70 medical organisations / accounted care groups:
• 380.000 patients of which ± 60.000 Self Management / Digital Patient
• 5.000 medical professionals
• ± 30 customer hits per second and 1.900 database transactions per second
• 3 countries: Netherlands, Germany and Russia;
• New in 2013: Switzerland, Poland and France;
• Treatments (Preventive & Care): Anticoagulation, Diabetes, Asthma/COPD, CVRM & Palliative;
• Individual Care Plan, Elderly care, ...
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FP7-ICT-2011-7 Contract no 287841
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Pa
tie
nts
Number of Patients NL Anticoagulation Diabetes COPD CVRM Total number of patients
Number of patients NL >380.000 (2%)
Tariff
CVRM
Start Diabetes
Self Management
Project funding
Tariff Anticoagulation
Self Management
Tariff
Diabetes & COPD
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FP7-ICT-2011-7 Contract no 287841
COMMODITY12 | Consortium
IMPERIAL COLLEGE OF SCIENCE, TECHNOLOGY
AND MEDICINE United Kingdom
HAUTE ECOLE SPECIALISEE DE SUISSE OCCIDENTALE
Delemont, Switzerland
UNIVERSYTET MEDYCZNY W LODZI.
Lodz, Poland
BODYTEL EUROPE Bad Wildungen, Germany
CENTRE NATIONAL DE LA RECHERCHE CIENTIFIQUE
Paris, France
HOSPICES CANTONAUX CHUV
Lausanne, Switzerland
PORTAVITA BV Netherlands
DEUTSCHES FORSCHUNGSZENTRUM FÜR KÜNSTLICHE INTELLIGENZ
Saarbrücken, Germany
ROYAL HOLLOWAY AND BEDFORD NEW COLLEGE
United Kingdom
PORTAVITA Netherlands
Providing their leading Disease Management Module for Diabetes Mellitus I & II
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FP7-ICT-2011-7 Contract no 287841
Moreover, the COMMODITY12 system will build a new level in
patient empowerment, providing the tools for self-management
support. Indirectly, this system will also help wider implementation of
Personal Health Systems, reinforcing leadership and innovation
capability of the European industry in that area.
COMMODITY12 | Vision
COMMODITY12 aims to design, build, and validate an intelligent
system for the analysis of multi-parametric medical data. It will
uptake the existing cutting-edge technologies and extend these
technologies by combining state-of-the-art networks, software
interoperation, and artificial intelligence techniques in order to realize
the concept of translational medicine by means of a Personal Health
System.
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FP7-ICT-2011-7 Contract no 287841
Introduction of Integrated Care
• Start of Pilots for Diabetes in The Netherlands in 2006. 10 Care Groups ± 80.000 patients in a Government pilot
• Official Tariff since 2009;
• Currently around 90 Care Groups with Disease Management Software. Not all with Patient Self Management;
• In 2013 still lot of problems with Health Insurance companies to have it contracted;
• Health Insurance companies worry about the business case;
• Still a lot of General Practitioners do not want to work in a Disease / Integrated Care management system;
• Patients are enthusiastic;
• New Disease Management (COPD, CVRM) starts up slow.
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FP7-ICT-2011-7 Contract no 287841
GP Centre
Before lack of coordination
Diabetes Treatment
Risk
Analysis
Lab
Research
Quarterly
Control
Eye
Check ....
Foot
Control
Diet
Advice
GP Centre Laboratory … Hospital
Diagnosis
Internal Medic
X Y X Z …
Communication on paper between the medical silo’s
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FP7-ICT-2011-7 Contract no 287841
GP Centre
Disease oriented new Role & IT
Diabetes Treatment
Risk
Analysis
Lab
Research
Quarterly
Control
Eye
Check ....
Foot
Control
Diet
Advice
GP Centre Laboratory … Hospital
Central role: coordinating all participants in the treatment.
DMS
X Y X Z …
Central Treatment
Data. HL7
Version 3
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FP7-ICT-2011-7 Contract no 287841
GP Centre
New Role(s) Patient: Self Management
Diabetes Treatment
Risk
Analysis
Lab
Research
Quarterly
Control
Eye
Check
Self
Control
Foot
Control
Diet
Advice
GP Centre Laboratory … Hospital
Patient & Medical Professional work together.
DMS
X Y X Z …
Home
DMS
Patient has her own Role in her
treatment. Access to all Treatment Data needed!
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FP7-ICT-2011-7 Contract no 287841
COMMODITY Extension
Improving the current generic treatment algorithms to become more patient
specific advices using Artificial Intelligence
• Genetic Data
• Sensor / Continuous Monitoring Data
• Other Medical Data of the Patient from other sources
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FP7-ICT-2011-7 Contract no 287841
What problem are we trying to solve
Cost of complications / opportunity (NL):
• 1 Feet amputation = € 45.000
• 3.000 amputations = € 135 million
• Possibility for improvement = 50% less complications = € 67 million
Source: Nitel
Source: VU, Hoornse study
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FP7-ICT-2011-7 Contract no 287841
A person will use his browser and the Internet connection to log in to his “Digital Logbook” Security : Username + Password
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FP7-ICT-2011-7 Contract no 287841
A person can have more than one role! He / Can be a patient or not yet a patient. Can also be patient and doctor in the same time. Can be both a Family Doctor and Anticoagulation Specialist ...
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FP7-ICT-2011-7 Contract no 287841
This person uses his “Digital Logbook” for both his Diabetes Treatment and for his preventive Cardio Vascular Risk Management
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FP7-ICT-2011-7 Contract no 287841
Patient can use the the “Digital Logbook” to fill in medical measurements. In COMMODITY12 we want to automate the input BUT ... still need input from the patient.
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FP7-ICT-2011-7 Contract no 287841
Patient can see all the Laboratory Results and the individual Treatment Goals he / she will make with the doctor
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FP7-ICT-2011-7 Contract no 287841
Patient and medical professionals all work in the same Medical Database! They therewith share the same data!
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FP7-ICT-2011-7 Contract no 287841
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FP7-ICT-2011-7 Contract no 287841
Here an example of how we will use the HES-SO Artificial Intelligence knowledge to improve decision making!
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FP7-ICT-2011-7 Contract no 287841
The system will calculate the severity and the Risk of this patient to develop a problem with the feet!
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FP7-ICT-2011-7 Contract no 287841
In the overall view of the medical professional the “Treatment Advice” will be shown!
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FP7-ICT-2011-7 Contract no 287841
Patient can see whether he or she has received the
treatment according to the protocol.
Patient is always informed on process!
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FP7-ICT-2011-7 Contract no 287841
How to further improve the treatment
Improve the quality of medical decisions
• By having more information regarding the patient (examinations, profile, laboratory results, Genetic data, body sensor data, ...)
• By applying all medical knowledge available to the individual patient Using Agent technology and Medical Rules Engines
• Will lead to: Improved and more personalized treatment plan for patients. Implementation, use and and evaluation starting in 2013 in Lausanne and Lodz!
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FP7-ICT-2011-7 Contract no 287841
Thank you very much!
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FP7-ICT-2011-7 Contract no 287841
Extra Slides
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FP7-ICT-2011-7 Contract no 287841
GP Centre
Issue: Other Diseases / Treatments
Diabetes Treatment
Risk
Analysis
Lab
Research
Quarterly
Control
Eye
Check
Self
Control
Foot
Control
Diet
Advice
GP Centre Laboratory … Hospital
DMS
X Y X Z …
Home
DMS
COPD / Asthma Cardio Vascular
Risk Management DMS DMS ?
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FP7-ICT-2011-7 Contract no 287841
GP Centre
Vision - Individual Care Plan:
Diabetes Treatment
Risk
Analysis
Lab
Research
Quarterly
Control
Eye
Check
Self
Control
Foot
Control
Diet
Advice
GP Centre Laboratory … Hospital
DMS
X Y X Z …
Home
EHR
COPD / Asthma Cardio Vascular
Risk Management DMS DMS
Individual
Care Plan EHR
Central Patient Data.
HL7 CCD IHE
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FP7-ICT-2011-7 Contract no 287841
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UN
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anagem
ent 3
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E)
CO
MM
UN
ICATIO
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Managem
ent (IH
E)
CARE Management
(Process)
DATA Store Data Warehouse
Treatment Rules
Workflow Authorization
HL7 V3 RIM
ATNA
EUA
BPPC
XDS
PIX
Business Intelligence
eHealth in the Box – ECO System
User Access
Data Management
Snomed CT
XD
S
larg
e
Billing Auditing
Medical Knowledge
Producing Medical
Knowledge
Medical Treatment
Administrative Data
Examination Data
Laboratory Data
Genetics Data
Sensor Data
... ...
RFD
XDW
CT
XUA