Toni Dedeu in the Oulu SMart City seminar on Wed 6th May, 2015

Impact of health & careinnovation initiatives at aEuropean regions levelOULU, 6 MAY 2015

Smart City Seminar │ 4 – 6 May 2015 │ Oulu - Finland

DIGITAL HEALTH & CAREINSTITUTE - SCOTLAND

DR TONI DEDEU

D I R EC TO R R ES EA R C H A ND K N OW L E D G E E XC H A NG E

Bringing Regions & Municipalities Together For BetterHealth & Care

DR TONI DEDEUCHAIR


Digital Healthrevolution

ü Wireless devicesü Hardware sensors and software sensing

technologiesü Microprocessors and integrated circuitsü The Internetü Social networking

ü Mobile/cellular networksü Body area networksü Health ITü Genomicsü Personal genetic information

Big Data

Essential elements Lexicon


Regional Health Research & InnovationStrategies

How to Scale-up in the best way?


Scaling up at different levels

qAcross MunicipalitiesqWithin the RegionqWithin the CountryqAcross EU Regions

Role of Regions & Municipalities in the R&I scaling-up process


Role of regions in the R&I scaling-up processSetting up a system for changePlanning and initiating the innovative service

Securing political supportScotland

Establish multi-stakeholderCollaboration

N Ireland

Alliances, new relationshipsBasque Country, Valencia

Formalised agreements between partiesSouth Holland

Securing financial support

Performance-based fundingSkåne

Combination and groupingof funding from various sources

Regions Ile-de-France and Pays de la Loire

Configuring the businessand reimbursement model

Catalonia

Self-financingLiguria


Training and re-skilling the workforceNoord Brabant

Knowledge exchange and learningPiemonte

Communicating to raise awarenessand acceptance

Wales, Liverpool

Educational courses to citizens and professionals,formal and informal carers

Galicia

Making technological anddesign choices

to ensure interoperabilityand scalability

Configuring the businessand reimbursement model

Catalonia

Implementing the technical solutionand integrating in daily practice

Saxony

Organisational process and design choices

Integrating new softwaremodules in the system

Campania, Andalusia

Applying service re-design andorganisational changes (change management)

South Denmark, Andalusia

Communicating to raiseawareness and acceptance

Campania

Role of regions in the R&I scaling-up process


Regional Integrated Care Delivery - Dimensions of Maturity

ManagingInnovation

Removalof Inhibitors

Structure &Governance

Readiness toChange

PopulationApproach

Breadth ofAmbition

Use ofInformation &Infrastructure

Standardisation/Simplification

CapacityBuilding

EvaluationMethods

Financing& Funding

CitizenEmpower

-ment


*European Innovation Partnershipon Active and Healthy Ageing

Integrated Care Action Group B3

EIP AHA B3*


qAcross MunicipalitiesqWithin the RegionqWithin the CountryqAcross EU Regions




qAcross MunicipalitiesqWithin the Region - e.g. ScotlandqAcross EU RegionsqWithin the Country



Scotland’s Needs§ There is an immediate worldwide need that is affecting Scotland:üPeople live longerüThey live with more long term conditionsü Over the next 10 years the proportion of over 75s in Scotland’s population will increase by over 25%

§ Sustainability:ü Global health and care efficiency must improve by over 35% to

maintain current standards of care for increasing numbers andrequirements

§ DHI focuses on the enablement of:

ü Health and social care integrationü Citizen centric services.

The current systems are not sustainable, so we must innovate and through that stimulate oureconomy at the same time.


qPublic funded organisation established by its founders

• NHS24• University of Edinburgh• Glasgow School of Arts

q Innovation Centre funded by the Scottish Funding Council

qThe DHI is all about collaborative working to create digitalinnovation in Scotland in health and care and focusses ondelivery of three things:

• ACADEMIC IMPACT• BUSINESS IMPACT• CIVIC IMPACT


The Challenge§ We need to change

£34.7 billion controlled by the Scottish GovernmentAround £11.9 billion is spent on health (15 billion Euro)

§ We need to consider how we INVEST in health andwellbeing§ There were 1.65 million A&E visits in Scotland in 2012/13

Equivalent to 1 every 20 seconds

(Source: ISD Emergency Department Activity and Waiting Times)

§ NHS Hospitals in Scotland and the demand for hospital bedsis growing daily


14

Population: 5.3 million Density: 67.5/km2 │ 5.5 mil (85% live intowns and cities)

Area Total: 78,387 km2 390,920 km²

Health devolved to Scottish Parliament Health care policy isprimarily the field ofMinistry of Social Affairsand Health

NHS Funding: EUR 15 billion EUR 17.5 billion

Social Care Funding: EUR 4 billion 32,5% of the GDP

14 + 8 Health Boards, 32 Local Authorities Health care servicesresponsibility of themunicipalities

From the 1st April 2015 32 Health & Social Care PartnershipsPublic Service funded through taxation (no co-payments)From urban/post industrial cities to very remote and rural andislands

Scotland


q Public Service Reform

q Public Bodies (Joint Working) (Scotland )Act 2014

q Reshaping Care for Older Peopleprogramme

q Telehealth and Telecare Delivery Plan forScotland 2015

q eHealth Strategy

q Innovation Centres (8)

National Policy Drivers


14 Scottish Health Boards / 32 Local Authority areas

Public bodies joint working


BeforeIntegration

(before April 2015)

CurrentlyApril 2015

32 Local Authoritiesresponsible for social care,education, housing,transport

32 new “Health andSocial CarePartnerships”jointly responsible for deliveryof social care, communityhealth / primary care andsome hospital services

14 NHS BoardsAcute, hospital, community,primary care health services

NHS Boards and LocalAuthorities will continue toprovide a range of otherhealth and care services


Understanding ofDigital Health & Care

as a marketü Its opportunitiesüThe possibilities

Our viewConvergence of

The DIGITAL Revolutionswith

HEALTH & CARE

… are going to be revolutionary


Firstly, What is Innovation?

DHI isempowered to

üBetter track, manage and improveour own and our family’s health

and wellness

üReduce inefficiencies in healthcaredelivery

ü Improve access, reduce costs

ü Increase quality

üMake medicine more personalisedand precise


Scottish Environment

19 Higher Education Institutions14 Territorial Health Boards6 Specialist Health Boards32 Local Authorities>250 Third Sector Organisations1,200 High Growth Companies

ACB

ACADEMIC CIVIC BUSINESS


Set out ‘the challenge’

DHI brings together:AcademiaPatients, Users of Services and theirfamilies/friendsClinicians, Social Workers, Carers, andother public, third sector specialists andprofessionalsIndustry


Why Scotland?

3 Star Reference Site Status (EIP AHA) in EuropeLeading the Integration Agenda in the EULeaders in Health InnovationPerfect Test BedKey Public Sector Organisation SupportScottish Government Backing


Live Projects: 72Members: > 500Funding: £11.4m + Other

Team: Filled all personnel vacancies in Edinburgh and ForresFacilities: Process underway to ensure DHI is NEUTRALValues: Established Open, Transparent and Fair

Events: Developed programmeCommunity: Started recruitment of MembersProjects: Launched the intake process

Structure: Designed an optimal solution considering the range of skills requiredProcesses: Created the operational processesCriteria: Understood Academic; Business; Civic

Board: Recruited the DHI Board and agreeing the DHI Corporate Governance ModelLegal: Established baseline principlesPolicy: Consulted on ‘HOW’ we are going to be transformational

Business as Usual

Building the DHI

Academic

• Research

• Knowledge Exchange

• Outcome Focused

Business

• Capability

• Enablement

• Growth

Civic

• Health

• Social Care

• Third Sector

• Citizens

Facility

• Capable

• Ambitious

• Networked

• Demand

• Opportunity

Community

• All Sectors

• Business Models

• Inclusion

• Involvement


DHILaunch

Oct2013 6March

2014 16May2014 28June

2014 • 64Oct2014

From idea to marketFrom idea to end users

•EngagmentTeam

Engagement

•Membership•215 at 12/08/2014

•Assessment

Call forproposal •Criteria

EvaluationTeam

•Feasibility•Pertinence

Approval Panel•Contract

Collaborationagreement

•Involvement

Project intake•Mixmethodologies

Evaluation

APR 2015 72Smart City Seminar │ 4 – 6 May 2015 │ Oulu - Finland

ExploratoryIdeas

Questions

Experience LabPrototypeReal Life

FactorySolutions

Pilots

What is it?The DHI Model


£

Exploratory

Exploratory

ExperienceLab

Factory


Exploratory │ Addressing Citizens Needs

KnowledgeDynamic range ofindividuals/skills

Real lifeEvery angle O

PPORTUNITIES

1. Goes back toexploratory

2. Moves toLaboratory

3. Moves toFactory

4. Complete

Constant monitoring and evaluating

Health & Care ProfessionalsDecision makers

Health & Social care managersAcademicsTechniciansDesigners

HumanisticCarers and Families

…

EvidenceGood Practices

International knowledgeexchange

Exploratory

?Actions

StepsFlows

?


QUESTION:How to monitor a person with COPD at home?• Anything that can monitor COPD from a distance? - Innovation• We look at all aspects of information about COPD - Evidence• What is currently done? – Real life• What do we want to do? - Needs• Who is involved?

• Health sector• Care sector• Suppliers: e.g. Oxygen at home, …

• MORE QUESTIONS RAISED?• Any Opportunity?

Exploratory

How we run an exploratory

?


Chronic ObstructivePulmonary Disease

Bespoken ExploratoriesNot all solutions require the same process nor the same methodology

Examples

Scottish Ambulance Service RedesignMental Health AppsMusic therapy solutionsAtrial FibrillationBaby in incubator and mHealthTreatment AdherenceNext Generation of Digital RecordsBlood donation service redesignOutpatient care redesignLong Term Care Revolution

Exploratory


QUESTION:

ExploratoryHow we run an exploratory

?


kRyTKaL ThyNkiNg

Exploratory

ExperienceLab

Exploratory

ExperienceLab

Factory


Experience Labs

In the Experience Labs we have a question but noanswer. We work with academic, business and civicpartners to design an environment where we canexperiment with ideas and build prototypes againand again.


ExperienceLab

It’s about doing it together

Experience Lab: Next Generation AmbulanceWhat is the Challenge?• In recent years the Scottish Ambulance Service (SAS) has

seen a steady shift in service demand, from an emergencyfocus to a more complex variety of demand

• A major overhaul for the design of ambulance technologyis due to come into effect in 2016.

• An opportunity to take consider how the needs of thepublic and SAS staff have changed and to empower thesegroups in the design of next generation ambulance

Who is in the DHI Collaboration?

• The Scottish Ambulance Service

• The Glasgow School of Art

• The Digital Health Institute

What have we done?3 experience laboratory workshops are complete

These workshops involved a mix of group work, using product design methods,clinical scenario role playing, interviews and prototyping exercises.

What is the result?

A set of recommendations bringing the user needs sharply into focus andstrengthening confidence in this procurement programme

Participating Clinicians felt valued and empoweredSmart City Seminar │ 4 – 6 May 2015 │ Oulu - Finland

Factory

Exploratory

ExperienceLab

Factory


Factory

Exploratory

ExperienceLab

Factory

Piloting prototipes in real scenarios involving individualsImplementation process in defined geographic areaswith the involvement of health, social & third careprovidersCo-design / Co-productionCo-participation: Business / Industry involvementTest-bedReadiness to scaling-upEvaluation


Factory

[ Reshaping ]

Defining problems for development,creating prototypes, scaling upsolutions

Exploratory

ExperienceLab

Factory


Factory: Atrial Fibrillation (AF)WHAT IS AF?

• AF is the most prevalent sustained heartrhythm disorder

• Just under 100k Scottish citizens arediagnosed with AF

• Estimated 30k citizens with AF have yet to bedetected

Who is in the DHI Collaboration?AliveCor and their technology

Five NHS boards in Scotland

Twenty GP Practices

Two Scottish Universities

Up to 10,000 Patients

Stats Source : Atrial Fibrillation Association – The AF Report, Preventing a Stroke Crisis

• AF increases an individual’s risk of suffering astroke by five times

• Millions of pounds of avoidable expenditurein the NHS in Scotland

• In 20 years there has been a 60% increase inhospital admissions due to AF

What are we going to do?Evaluate whether you can take accurate ECGs anywhere atlow cost

Determine the percentage of undetected AF

Conduct an academic & health economic analysis on longterm consequences of undetected AF and stroke highprevalence


Factory

DHI - Scotland’s Hub forDigital Health and Care Innovation

It’s about doing it together

‘Nobody is as smart as everybody’

Questions?

www.dhi-scotland.com

Social Mediawww.facebook.com/dhiscotland

www.linkedin.com/company/digital-health-institute

www.twitter.com/dhiscotland

www.youtube.com/user/dhiscotland

[email protected]

[email protected]

www.euregha.net

[email protected]

Thank [email protected]

[email protected]

www.euregha.net

Toni Dedeu in the Oulu SMart City seminar on Wed 6th May, 2015

Healthcare

Transcript of Toni Dedeu in the Oulu SMart City seminar on Wed 6th May, 2015