Visioita tulevaisuusorientoituneesta terveysteknologiasta

Tutkimusprofessori Niilo Saranummi

niilo.saranummi@vtt.fi

11/11/2011 2

ICT for Health at VTT

VTT is an internationally recognised innovator and research institute partnering with industry and health service providers

In ICT for Health our areas of expertise include:

Health Data Mining

mHealth and Beahaviour change support

Ambient Assisted Living

More information: www.vtt.fi/health

Turnover 232

M€

Personnel

2,740

76% with

higher

academic

degree

5,730

customers

Established

1942

VTT has been

granted ISO

9001:2000

certificate.

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Sisältö

ICT trendeistä

SOTE-sektorin haasteista

SOTE + ICT ja joitakin esimerkkejä

Lopuksi

11/11/2011 4

ICT: MIHIN OLLAAN MENOSSA

11/11/2011 5

Main ICT trends in 2010

ROADMAP

for Communication Technologies, Services and Business Models 2010, 2015 and Beyond

Tekes, VTT, 2010

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6

Ubiquitous computing sensors everywhere!

(c) Modified, original from Pertti Huuskonen,

Nokia ResearchCenter

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Digital platforms

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Yksinkertaistaen

Liittymä

Verkko

Resurssit

Äly Tietovarastot

Tiet

otu

rva

Pilvi

Kännykkä, PC, …

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SOTE-SEKTORIN HAASTEET

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Grand Challenges (in all OECD countries)

Health expenditure vs. value

What is produced with €’s

Quality & Access concerns

Expectations & Awareness

Main drivers

Ageing & Care ratio (huoltosuhde)

Life styles

Science, Technology and Innovation

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70 % of disease burden in Europe is

caused directly and indirectly by

chronic diseases and conditions

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Determinants of health

SA Schroeder: We Can Do Better - Improving the Health of the American People. N Engl J Med 2007; 357:1221-8

McGinnis et al., Health Affairs 21(2), 2002

1. Quality/Efficacy of

Healthcare services

2. Behavioural patterns-

Lifestyle, environmental

factors, Societal

circumstances

3. Genetic predispositions,

Acquired genetic

changes

Healthcare

delivery system

Nature

Endogenous

determinants

Nurture

Exogenous

determinants

Impact on premature

death

10%

60%

30%

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Vaikuttaminen terveyteen

14 11.11.2011

Reactive

Proactive

Health & Care

Professionals

Citizen-

Patient C

on

necte

d H

ealt

h

ch

oic

es

Dependency

Patients as

passive objects

Individuals as

co-producers of

Health & Care

Yksilön uusi rooli

”Responsibility Response Ability”

Traditional

Model

Co-Producer Model

Illness Management of health and

care

”Outsourced” ”Insourced”

Reactive Proactive

Episodic Continuous

GP’s and

Hospitals

Value based business

models (shops, retail

clinics, value-added

processes, user networks)

Fee for

Service

Value based reimbursement

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Characterizing medical knowledge Intuitive (I) Experimental (E) Precision (P)

Diagnostics / Therapies

Diseases and

health problems can be positioned to this continuum

I E P

Christensen’s ideas are based on the idea that different business models are needed when dealing with health problems for which medical knowledge is intuitive, experimental or precise.

Christensen, CM., Grossman, JH. & Hwang, J. (2009) The Innovators prescription: a disruptive solution for healthcare. McGraw-Hill.

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Business models in healthcare need to be separated (Clayton Christensen)

Coherent solution shops

To sort out disorders that are still in realm of intuitive medicine

Value generation by people (experts)

Retail clinics

Caring for our everyday rules-based disorders

Value generation by processes & application of rules

Value adding process businesses

For procedures that are performed after definitive diagnosis has been made

Value generation by processes and equipment

Facilitated user networks

Helping patients in caring for their behavior dependent chronic ailments

Value generation by organizing, facilitating, maintaining networks

Terveyskioski

(Ylöjärvi, Lahti)

COXA

Terveyshyöty-

malli ???

Terveyskeskus &

sairaala ???

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SOTE + ICT

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Tulevaisuuden palapeli

Kuluttaja – potilas

Terveydenhuollon

ammattilaiset

Ikääntyvät itsenäinen suoriutuminen

Muut palvelun

tuottajat

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Kuluttajan – potilaan palvelut Taltioni

Sitra, SADe

KanTa-palvelut

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Changing context – Changing ground rules © Petra Wilson, Cisco / Continua

Virtualised

resources

Prevention and

Health maintenance

Physical

resources

Diagnose and

cure

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”Etähoito”

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Ohjelmistojen regulaatio tulossa

Pohjana Medical Device Directives (samat vaatimukset kuin FDA:lla)

Tavalliset lääkintälaitteet (MD)

Implantoidut laitteet (in-vivo MD)

Laboratoriolaitteet (in-vitro MD)

Lisäksi

+ Medical software tullut voimaan

+ mHealth tulossa

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VTT – Supporting diagnostics

Health

problems

Diagnostics

Data quantification

• Tools for extracting objective

measures from data: images,

signals (e.g. EEG), molecules

from blood.

Decision support

• Analyze databases: compute distributions for

healthy and diseased

• Visualise my patient against all other cases in

the database.

Database

Volume 2000 ml Volume 2000 ml

Having atrophy? Having Alzheimer’s disease?

Diseased

cases

Healthy

cases

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Disease State Fingerprint (PredictAD) for early diagnostics of Alzheimer’s Disease

Lack of tools for efficient quantification of patient data is a major bottleneck in the spread of automated and objective analysis tools into clinical practice

VTT has developed a clinical decision support tool for detecting complex diseases at an early stage and for monitoring their treatment efficacy

The tool provides a disease state index reflecting the state of the patient and allows easy visualization of the patient status

The approach is generic and able to combine heterogeneous and incomplete data

The technology is implemented and clinically validated in the for the diagnosis of Alzheimer’s Disease, but can be applied to other complex diseases

25 11.11.2011

Personal wellness management tool in the mobile phone based on cognitive-behavioral self-management models

Diary for health and wellness related self-observations + calendar

Simple and fast self-observations + automatic feedback

Available in situations where lifestyle choices are made

Integration into daily life and time management

NOKIA:

Wellness Diary

26 11.11.2011

Our approach in behavior change support:

Combining personal health technologies and psychological

intervention methods

Personal health technologies can integrate behavior change support into people’s daily lives

Computer-aided interventions have been shown to be effective in treatment of depression, anxiety, and various health problems

Mobile and wearable technologies are especially suitable for daily self-observation and maintenance of well-being

Cognitive-behavioural interventions provide skills to evaluate personal values and lifestyle, set personal goals, and plan lifestyle changes

Personal

health

technologies

Psychological

intervention

methods and

physiological

knowledge

Tools for

behavior

change + =

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Personalised feedback: Remote patient monitoring

combined with decision support

Upload

monitoring data Personal Health

Record (PHR)

rule-engine

for selecting

feedback messages

among

~250 candidates

Measurements

- blood pressure

- blood glucose

- weight

- daily steps

Messages,

alerts

PHR/EHR

view

Alerts appear in the

professional's worklist

View data & react

&

Evidence-based

decision support Personalized

feedback

and alerts

28 11.11.2011

Sipoo Health centre pilot architecture

Medinet

Personal health

record

Patient centered

data storage

Mediatri

Electronic health

record

Principal

clinical

data

storage

Decision support

system

Monica application

- Upload data

- Get feedback

Continua

xHRN-interface

29 11.11.2011

AmIE –

Ambient Intelligence for the Elderly

Aikavälillä 05/2007-02/2010 toteutettu

tutkimus-projekti, jossa tutkittiin ja testattiin

ikääntyneiden kotona asumista tukevia

älykkään ympäristön ratkaisuja

ITEA2-projekti, jossa mukana VTT:n lisäksi yli

20 partneria 6 eri maasta: Suomi, Belgia,

Ranska, Alankomaat, Espanja ja Turkki

VTT:n tutkimuksen sisältöä

Ikääntyneen kokonaisvaltainen hyvinvoinnin

arviointi (perustuen Oulun kaupungin

Hyvinvointiprofiiliin)

Tiedonkeruu, -käsittely ja visualisointi eri

loppukäyttäjäryhmille

Laitteiden välinen yhteensopivuus ja tiedon

yhdistäminen eri antureista

Hyvinvoinnin arviointiohjelma (monitorointi ja

päiväkirja)

Muistutukset

Interaktiivinen henkinen ja fyysinen harjoittelu

kosketusnäyttösovellusten avulla

Teknologian evaluointi kenttäkokeilla

30 11.11.2011

Ikääntyvän hyvinvoinnin

arviointiohjelma

OMINAISUUDET

Jatkuva hyvinvoinnin tarkkailu

Apu ikääntyvän huolehtimisessa

Mahdollistaa nopeamman reagoinnin hyvinvoinnin

muutoksissa

Etähallinta internetin kautta

Tukee ikääntyvän päivittäisiä rutiineja

Mahdollistaa muiden sovelluksien helpon käyttämisen

Yksinkertainen käyttää kosketusnäytöllä

KÄYTTÖKOKEMUKSET

Laitetta on testattu 9 ikääntyvällä kotiympäristössä

Saatu myönteistä palautetta, mm.

”Helppo käyttää”

”Hyödyllinen”

TULEVAISUUS KEHITYSTYÖSSÄ

Sosiaalinen verkostoituminen yksinäisyyden estämiseksi

Hyvinvointiprofiilin kehittäminen

Hyvinvointitiedon kerääminen ympäristöstä

Sensoritiedon lisääminen

Ennaltaehkäisevät toimet hyvinvoinnin parantamiseksi

Hoitoprosessiin liittäminen

31

LOPUKSI …

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Rahoitusinstrumentteja

Tekes

SOTE-ohjelma

EU 7. Puiteohjelma

ICT for Health

eInclusion

CIP / PSP

ITEA (Eureka)

Artemis

AAL JP

Suomen Akatemia

JPI:t

+ Active and Healthy Ageing – European Innovation Partnership

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Systeemimuutos

Laitteet

Infrastruktuuri

Palvelut

Prosessit

Organisaatio

Asiakkaat

Organisatoriset

innovaatiot

Asiakasrajapinta- ja

jakeluinnovaatiot

Teknologia- ja

tuoteinnovaatiot

Uuden tyyppiset

verkostot ja

arvoketjut

Markkina

Työvoima

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VTT creates business

from technology