June 16th 2011

Dorking, UK

Eric Schlangen, Project leader TCares Pantein, NL

Presentation Businesscase Pantein

TCares Final Meeting Dorking

Approach NHS 8 steps

Business case Pantein

Telecare implementation review

Overview

Business case for Dutch pilots is accepted by board

Part of the pilots will be writing a business case for large scale implementation

The importance of having a good BC was part of our telecare review, identified as an important success factor

BC is a working document, it should be refreshed from time to time

Business Case

Looking for a good approach:

Telecare BC are difficult to write because of the many variables in the process:• Many stakeholders• Technology evolves quickly• Integrating and thus changing more services• Financial insecurities: write off, revenues, many claims but little proof

Document NHS provides good information on writing a BC.

Business Case

NHS states 8 steps to follow to create a BC•Identifying the needs•Establishing buy-in (involving stakeholders)•Considering technology•Workforce requirements (change management)•Designing the evaluation•Planning the implementation•Stating the business case•Sharing best practice

Business Case

Project 1 (July/August 2011)

Pantein community (Pantein Home Care 50 clients)

Information, news, health, wellbeing, activities, neighbourhood.

Project 2 (September 2011)

Independent Living (Pantein residential Care 25+10 clients)

Project 1 plus: video contact, home automation/surveillance

Project 3 (September 2011)

Telemonitoring Heartfailure (Pantein Hospital 20 clients)

Dutch Pilots (not People funded)

Started out as personal alarm unit

More functions surveillance added (movement, fire)

Controlling house electronics (light, power, climate, RTV)

Video contact with doctor or nurse

Video contact friends and relatives

Games, information

In NL the social aspect of telecare is becoming the key feature for independent living

Nature of telecare is changing

Passive websites

Interactive websites and webshops

Social media and web communities

Create new opportunities for communication based on shared interests, free from boundries of location

Facebook 700 M members 10% of the world population

LinkedIn 100 M members (professionals)

Dutch community Hyves 11 M, 66% of all Dutch

We want a platform to combine telecare and Social Media

Social media and telecare

Founded in 2006 as reaction to technology driven telecare

Lots of possibilities the users didn't want

Caregivers wanted communication tool to prevent housecalls

Clients want safety, interaction, games and most of all: simplicity

'09: PAL 4 awarded best practice by Dutch ministry of health

PAL 4 is an open platform that provides all this and can develop and add new functionalities

PAL 4: Personal Assistant for Life

Development of supply and demand of care

Growing expenditure from 4000 to 6300 Euro pppy in 2020

Shift from hospital to care-home to home care

Social and cultural changes in clients (& in finance, knowledge)

Growing number of chronically ill to 2020:

Diabetes / COPD / Heart failure > 36-43%

Dementia > 41%

More complex technology: biotech, nanotech, smart drugs

Market dynamics: quality and service become important

Background and trends

New forms of supply for professional and informal carers• Reducing workload• Increasing efficiency• Substituting labor with technology

Government: telecare policies: AWBZ, ZVW, DBC’s

Municipalities (informal care: WMO) lagging behind

Health information now in top 10 internet activities in NL

Importance innovative ICT

Chances for Pantein

Telecare

· new product & revenues

· improving efficiency

Informal carer support

· customer satisfaction

· improving efficiency

Service and information

· extra revenues

· supporting CRM

Welfare support

· substituting care with wellbeing

· prevention

Binding strategic partners

· strengthening market position

· more services for clients

Founded in 2006 with 4 healthcare providers

Now recognised for upscaling by ministry

Currently joint venture with 35 care providers

Co creation: content group every three months

Personal content: news, activities, games (editorial desk)

Secure HQ video technology (German police)

Open technology with webinterface to other applications (patient files)

Integrating physical and virtual reality

PAL 4 background

Choice for user: start with base kit

Ususally followed by alarms (KIWA Quality Mark)

Automatic locks (Police Quality Mark)

Sensors

Extra: Video surveillance (walking digital rounds)

For the Hospital pilot: COPD & Heartfailure•Information and clarification materials•Video support (consultation hours)•Telemonitoring or coaching with daily risk profiles

PAL 4 connected: menu card

Planning:

1. Businesscase and investmentplan

2. Application Healthcare Infrastructure Policy (AWBZ clients)

3. On approval of application pilot will start

4. Paralel application for the Care Innovation Policy for screen to screen care

5. 24 months two fased upscaling • 2011: 35+20 • 2012 another 45

6. All get base kit, 50 get extra sensors from the menu

7. Leasing with option to buy

Pantein proposition

The cost include:

o Subscription and licensing fees

o Equipment (Touchscreen, Alarm, + av. 1 extra sensor per user)

o 1 Video-control room station (to be placed on location of choice)

o 2 Video-team posts

o 1 Medical-team post (in the hospital)

o Internet connections with 50% of the users

o Installation and instruction in users homes

o Editorial services incl. help desk and “virtual activities” (*e.g. bingo)

o Project consultancy by project leader PAL4 (besides internal project leader Pantein)

Pantein proposition

SummaryCost for Pantein (100 clients) Euro

Subtotal net investment 24 months 83.122

Subtotal net operating cost clients 24 months 434.713

Subtotal net operating cost clients 24 months 35.557

Total cost video and content network 553.410

Financing for Pantein

Healthcare infrastructure policy: investment 83.122

Healthcare infrastructure policy: clients operations 434.713

Healthcare infrastructure policy: carers operations 35.557

Care production AWBZ (4hrs/conn./month) reminder

Care innovation policy (indic. time) reminder

Total financing from policies 553.410

Potential Other possible revenues (100 clients) Euro

Care production under AWBZ performance contract 4hrs per connection per month at 65 euro per hour for 24 months

468.000

Acceptance care innovation p[olicy or Screen to screen policy 5 minutes telecare weekly for 24 months 43.333

Extra income Pantein web-community (payment by third parties, municipalities, serviceproviders) pm

Total result Pantein before deducting personel cost 511.333

Result per year before deducting personel cost 255.667

In the defined region where Pantein worksNew developmentsNew contentMarketing toolsPR and communications from PAL4

Will be made first available to Pantein. If people want to subscribe to PAL4 through the national

PAL4 website they will be referred to Pantein

Preferred partnership

Success and failure factors identifiedImplementation Project management Business model

Telecare implementation review

Implementation: success factorsUsers like the social aspects of video communicationUsers see privacy as a medium of exchange for safetyUsers ask more during e-consultsUsers will use services they didn't expect to use at the startUsers are prepared to pay after they have experienced

added value

Safety features are most wanted, convenience remote 2nd

Showing benefits are greater than costs

Telecare implementation review

Implementation: failure factorsRegulations are not compatible with innovation of technologyUsers are not being involved: est. needs, designing, etc.Care workers see it as threat to and impoverishment of careTechnology often not reliableNo continuation plan: after pilot it falls apart

Telecare implementation review

Project management: failure factorsProjects are complicated to oversee / manageNo clear allocation of responsibilities between partiesNo chain responsibility (“my part is OK”)

Project management: success factorsEnlarging the scale through cooperation

Telecare implementation review

Business model: failure factorsNot investing enough to make it workNo structural funding or profitmodelNo transparent cost overview for userProducts are reliant on single/few supplier

Business model: success factorsSaving cost with open source softwareStanding out as care organization by providing e-health

Telecare implementation review

Eric Schlangen

habipro

E: ericschlangen@habipro.nlT: +3150254686