Presentation meeting 2 Hasvold

self-management andpreventionPer Erlend Hasvold, MScSection Manager - Home-based services and personal health systemsper.hasvold@telemed.noNorwegian Centre for Integrated Care and Telemedicine - NSTUniversity Hospital of North Norway - UNN HFchallenges•Government white-paper:•today every 6th child in secondary schooltake a health or care related education•in 2035 every 3rd child must get a healthor care related education if we shalldeliver the same services to the sameparts of the population as todaythis is not sustainable!challenges•a Danish colleague calculated the amountof time the worst COPD patients spentvisiting health services: 0,02%•i.e. more than 99,98% of the time seriouslyill patients spend alone, making all criticaldecisions that will affect their healthchallenges•healthcare organizations are a complexsystems•healthcare organizations characterized byprofessional roles and ethics, and high rateof ad-hoc decisions•healthcare has been slow at making changesour objectivesto find ways of applying technology:•to deliver better care, using fewer resources•to support self-management•to motivate changes in lifestyle to a more healthyone•to prevent secondary disease•to reduce the risks leading to injury and healthproblemsa sociotechnicalperspectiveServiceTechnology Organizationthe diabetes diary•result of 12 years of research•examples: bluetooth interface for blood glucose meters; SMSservice for parents of child with type 1 diabetes•user involvement in all aspects of development•focus on usability; supporting self-management•current version is available for free at Google Play and AppStore•features mechanism for analyzing data to find similar situations;seeing trends and patterns•future: tailoring; gamification; investigate gender differenceseRehabilitation•current projects:•COPD patients receive treadmill, pulse-oxymeter, iPad - follow up by physiotherapist•post cardiac surgery rehabilitation, tailoredsupport to encourage adherence to training•we achieve better adherence and compliance,improvements in quality of life, reduction ofreadmissions to hospitalwelfare technology•participation in national networks on welfaretechnology•support of projects on municipality level on smarthomes for the frail•use of virtual presence robot - the Giraf•the serenity button: use of mHealth to connect theresources around the patient•discuss aspects of welfare technology and possibleconsequencesmental health•apply eHealth to create low thresholdservices to reach people with mild mentalhealth problems•create models of care that gives morecitizen services with less use of resourcesapps and mHealthFitbit.comWhitings.comapps•apps are maturing•ecosystems of apps•integration with legacy systems•advanced data analysis (in phone or online)•dashboard interfaces•tailoringhealth information•apps and devices collect data about the user - morethan health professionals can deal with•using big-data and multivariate analysis we turn hugeamounts of data into useful information•important in terms of bridging the personal healthsystems to the professional health information systems•citizen services: erdusyk.no•real-time dashboard for infections in the region:snow.telemed.noeHealth trends•national survey on use of eHealth and interaction withhealth care services through the net: 2000, 2001, 2003,2005, 2007, 2013•November 2013:•26% has used a foreign eHealth service•44% wants to be able to send email to GP•48% are worried that information will not beavailable in an emergency situation•41% are worried about health information privacyHar erfaring med eHelse100 %90 %80 %70 %60 %50 %40 %30 %20 %10 %0 %15-18 19-25 26-35 36-50 51-66 67-80Aldersgruppetailored eHealth•slutta.no smoking cessation - part of thenational health portal•tailoring: feedback and type of follow updepends on psychological profile -stratification of user types•tailoring leads to better adherence andcompliance - i.e. better outcomesuniversal access•privacy laws require use of BankID to log onto national portal helsenorge.no to accesspersonal information and services•however, if you are blind, you need someoneto help you with the BankID code generator- i.e. the assistant has full access to the healthinformation (as well as banking services)!•mHealth is a challenge in terms of UAKnowledgeTrustSafety requires:Technology- Equipment must be made for the task- Equipment must be well maintained- Equipment must be used correctlygaming and gamification•gaming is used to award healthy behavior andto attract users to a health service•gaming used for activating people and tomeasure cognitive performance - might beuseful in diagnostic and monitoring•gamification is to build in the factors thatattract people to become active in games tomake people adhere to lifestyle changeprograms, and to educate: e.g. sjekkdeg.nothank you!per.hasvold@telemed.no