1. Telemedicine on large scale-does it work?
Helene Richardsson - COCIR

2. About the Project
“UNIversal solutions in TElemedicine Deployment for European HEALTH care”
Coordinator: NHS 24/Scotland
Regions in Finland, France, Greece, Italy, Spain, UK, Czech Republic, Slovenia, Germany and Norway
Key numbers:
Three years ( )
> 12K patients in 14 pilot sites
> €10m (of which €5m EU funding)
Builds on:
Renewing Health project ( )
MAST evaluation methodology
Pilots targeting diabetes, Chronic obstructive pulmonary disease (COPD), Congestive heart failure (CHF)
09/11/2018
Vitalis

3. Ambition A deployment study, with emphasis on assessment of:
organisational aspects
efficiency gains
economic aspects
Deliver evidence
Better (more comparable) data than Renewing Health (EU)
Commitment of regions to deploy and promote Telehealth
09/11/2018
Vitalis

4. Innovation and service re-design
Quality of Life
€10,000
€1,000
€100
€10 €1
Adapted from Intel
Specialty Clinic
Community Hospital
ICU
Acute Care
Assisted Living
Skilled Nursing Facility
Residential Care
Independent, Healthy Living
Prevention
Chronic Disease Management
Doctor’s Office
Tele-homecare & mobile care
09/11/2018
Vitalis

5. Diabetes Life-long management, education and coaching Scotland Wales
Northwest Moravia
Slovenia
Campania
Calabria
South Karelia
Central Greece
Berlin.

6. COPD Short-term follow-up after hospital discharge Scotland Wales
Galicia
Southern Norway
North Norway
Berlin.

7. Congestive Heart Failure
Remote monitoring
Scotland
Basque Country
Northwest Moravia
Slovenia.

8. Lifelong monitoring of diabetes
Ongoing Health Coaching
Patient’s home
Health Interface
GENERAL
PRACTITIONER
SERVER
PATIENT
GATEWAY
TELEMONITORING
DEVICE
DIABETOLOGISTS AT HOSPITAL OR
LOCAL HEALTH
DISTRICT 5
REGIONAL CENTRE’S
OPERATOR
OTHER INVOLVED HEALTHCARE PROFESSIONALS
FAMILY
DATA TRANSMISSION
DATA ACCESS
OPTIONAL CONTACT (DIRECT/INDIRECT)

9. Follow-up after hospital discharge - COPD
Patient’s home
Hospital or Primary Care
PATIENT
BRIEFCASE
SERVER
GATEWAY
RESPIRATORY SPECIALIST NURSE OR CLINICIAN
GENERAL
PRACTITIONER
PULMONOLOGITS AT HOSPITAL OR
LOCAL HEALTH
DISTRICT
OTHER INVOLVED HEALTHCARE PROFESSIONALS
DATA TRANSMISSION
DATA ACCESS
TELECONSULTATION (VIDEO OR TELEPHONE)
OPTIONAL CONTACT

10. Remote monitoring of CHF
Patient’s home
Hospital or primary care or eHealth centre
SERVER
PATIENT
GATEWAY
REGIONAL CENTRE’S
OPERATOR
TELEMONITORING
DEVICES
GENERAL
PRACTITIONER
CARDIOLOGIST
AT HOSPITAL OR
LOCAL HEALTH
DISTRICT
OTHER INVOLVED HEALTHCARE PROFESSIONALS
The patient at home uses the provided devices for the measurement of his heart rate, blood pressure, pulse-oximetry and weight.
The telemonitoring devices collect the data and send them to the gateway wirelessly which then transmits data to the system server.
Operator checks the data sent accessing to the portal.
If clinical parameters are out of range the systems detects the alert situation and the operator manages it following a standard protocol. Depending on the alarm severity, the operator contacts the GP, specialist or emergency service.
The patient at home uses the provided devices for the measurement of his heart rate, blood pressure, pulse-oxymetry and weight at least once per week.
The telemonitoring devices collect the data and send them to the gateway wirelessly which then transmits data to the system server.
Operator checks the data sent. Accessing them through the portal.
In case of clinical parameters out of normal range the system’s software detects the alert situation and the operator manage it following the standard protocol set by the physicians. Depending on the alarm severity, the operator contacts the GP, reference specialist or activated the emergency service.
Clinician accesses the relevant portal to check patient data and take the proper actions at any time (not only in case of alert).

11. Target deployment numbers and sources of funding

12. Actual patient recruitment as at March 2015
Pathology
New pilots funded by ICT PSP
New pilots funded from other sources
Existing RENEWING HEALTH partners
Total
Scotland (UK)
Basque Country (ES)
Wales (UK)
Southern Norway (NO)
Northwest Moravia (CZ)
Slovenia (SL)
Campania (IT)
Calabria (IT)
Nord Pas De Calais (FR)
Galicia (ES)
North. Norway
South Karelia
Central Greece
Berlin DM 65
123 21
300 10
232 50 62
295
1158
COPD
128 79 60
332 4 92
695
CHF 88 73 44
117
322
HTN
669
281
202
417
387
2844
11/9/2018
Vitalis

13. Gender & Age group
Age group

14. Is there anyone who assist the patients at home?

15. Are they familiar with the use of technology?

16. Educational level

17. Industry Advisory Team Membership
Beneficiaries
COCIR
Continua Health Alliance
GSMA
Companies
Bosch Healthcare
Intel
Orange
Philips

18. Findings
Limited integration of telehealth services into existing healthcare delivery or IT systems
Fragmented and complex regulatory environments
Slow take-up of interoperable equipment (reasons analysed in assessment report)

19. Our scope Intention was to better understand:
the methodologies the regions used to select the technical solutions implemented at the pilot sites
what industry or vendors should propose
when is the best time during an acquisition timeline for a region to interact with industry
the procurement process
Overall goal was to better understand how and why interoperable solutions are or are not chosen by a region.

20. Methodology Group interviews: IRL demo
Clinical staff who knows the content and the organization of the telemedicine intervention
Project leader from the site
People involved in the procurement
Professionals using the system
IRL demo

21. Site visits
Spain 30 Sep 2014 Italy 10 Oct 2014 Slovenia 20-21Oct 2014 Czech 23 Oct 2014 Wales 5 Nov 2014 Scotland 7 Nov 2014 Finland Nov 2014 Norway 19 Dec 2014 (phone)

22. Procurement process
Procurement of a function rather than devices / system
No procurement
Free software and devises
Bring your own devises
Re-use of existing devises
Cost under EU procurement level
Use of existing national framwork
Constrction of a consortium in order to be able to buy from one vendor
Procurement at EU level
31/3/2015

23. Recommendations on procurement from U4H
Buyers like vendors to be present in the regions
Vendors should listen more
Vendors should build trust and show solutions that have worked in other regions
Buyers should emphasize the need for standards
Healthcare organizations should aim for solutions that can be integrated and interoperable, not stand-alone
Broadband issues, flexible solutions are needed
Bring your own devices is happening, we all need to accommodate this
Vendors should look upon system development as a real opportunity to understand the processes in healthcare

24. Lessons learned and conclusions
Healthcare professionals see the benefits for the patient and their practices
There is a desire to continue with the service
Need for a change in clinical workflow
Happy patients
Less time needed for face2face meetings
Systems up and running regardless of chosen technology

25. A happy patient in Wales!
Spends less time with doctor
Feels taken care of
Takes “Florence” to her friends
BUT has to stand on the second floor in order to transmit data

26. Testimonials and Conference Podcasts (1/2)
31 March 2015
WP2 - Review Year 2