UMC Utrecht eHealth vision & strategy

“From waiting room to living room”

World of Health Care

The Netherlands

Hyleco Nauta

27 September 2017

Why are we doing this?

Patient: “my confidence has doubled”

“in myself”

“in healthcare”

How do we -as healthcare provider- earn a place into the network of the

patient?

“IoT = New business models” (World Econ.Forum). How about Healthcare?

The healthcare paradigm is tilting…

How can patients get more controle?

How to facilitate selfmanagement?

Mutual benefits and value?

Towards a better Continuum of Care Our context: online/real time, IoT, eHealth, Mobile, Analytics, …

• Patient in control – Selfmanagement only when needed/wanted

• Process of healthcare is changing - Just in Time, personalized

• MD/Nurse/Caregiver stays close with the patient (digitally)

• More focus on care – not only cure, but present in the daily life of the patient

• Collaboration between all healthcare professionals

• Data driven - only if the quality and context of the data are known

This is our new world

Patient portal

2008-2015 Connected with

patients

Continuum of Care

2015-2016 A better ‘patient

process’

Applied data analytics

Digital hospital

> 2017 More personalized

care

Real time access to your personal data

• EHR (internal treatment reports, medications, measurements, outcome and results, referral letters …)

• Tasks (for example fill out a questionnaire)

• Appointments

• E-consults

• Order repeat prescriptions

• Instructions/ E-learning/ Video

• Up-to-date Information (address, email, ..)

• Security standards of Dutch Govt.

All patients, no delay due to hospital procedures

Patients: “this is important and we are excited”

Next step: enhancing the Continuum of Care

• Pilots with patientgroups (in-patients, out-patients)

• Hypertension (complex), essential, pregnancy and post surgery Carotis patients

• ALS (Amyotrophic lateral sclerosis) • Juvenile arthritis • Psychiatry: medication doses, post-therapy questionaires • Clinic (oncology) : vital signs after complex surgery • Pediatric: pain monitoring/general conditions • Radiology: 3D-images (incl. second opinions)

• Pilots focus on broad application in healthcare and are scalable

• Monitoring, Just-in-time response, different roles patient/care-givers

• Scientific research and evaluation (Thinc)

Facts Shared information Proceed

Home Hospital Integration

Reuma2go-app Standard care

Example: Juvenil arthritis

“Outpatient clinic visit” versus Continuous Data

Collection by Patient

Monitored data by clinician at visit: 2 moment in period 15 Sep – 16 Nov

One joint (R. Knee) Score: Painful en Movement restriction (22 Sept)

Score: Movement restriction (9 Nov)

Girl 12 years

Monitored data by Patient in R2G: 39 moments in period 22 Sep – 2 Nov

6 joints (R. Knie, Middelvinger r.hand #3

Middelvinger r.hand #2; Ringvinger r.rhand #2; Ringvinger r.rhand #3; Rechter Pols; Linker AC gewricht)

Score: No Pain=0; Mild= 1; Moderate=2; Severe=3

“Social Contract”

How are you doing? Well, … this week 45

hrs sleep, 28078 steps, 065 extra kilogrammes, high bloodpressue when going to the bathroom

Positive experiences stimulate to proceed

Less: visits, medication

Just-in-time support and information; instant communication

Confidence (‘MD monitors and knows my situation’);

More knowledge about disease and opportunities to influence; self reflection

Patient …

More insight, more personalized treatment possible

Measurements more representative (less ‘hospital-effect’)

Earlier interventions when threshold values exceeded

Controled reduction of medication

Smoother cooperation with referring colleagues and GPs

… MD/nurse …

More digital data (home situation)

Opportunity to combine various research-initiatives

… scientific research…

Agile development together with patients and partners

vision 3-6

sprints evaluation

2 months 4-5 months

live 3 months

What extra value can data analytics generate

for the treatment of individual patients?

Our first steps with data analytics applied in a clinical setting…

Data Analytics applied in the medical practise

• Likely diagnosis, recommendation re. lab-research, medication etc.

• Risk assessment

• Prediction of disease progression

• Continuous monitoring and live feedback re. changes in patients’

condition

• Patternmatching, identification of relevant markers

• Assessment patient-outcomes

• Development of algorithm’s to improve healthcare

Terrabytes of data

manu sources

New technologies analytics, machine learning,

deep learning

A new way of using data, directly implemented in

the clinic

External partners

Rule-based data

selection

Implementation of

existing algorithm’s

Developement of

new algorithm’s

Psychosis

Reuma NICU

Cardio- vasculair

Circulatory Health

Voorstelpilot

Speerpunten

Brain

I&I

CancerCenter

ChildHealth

Overstijgend

February 2018 evaluation

4 Pilots

From waiting room to living room

• eHealth/IoT new services, new roles, new partners, new

business models, also in Healthcare

• eHealth/Big Data Analytics the promise is more effective

and personalized treatments

• Positive experiences of patients and providers enforce our

ambition and invite to proceed rapidly

• But:

• we are still learning and any evidence/best practise is most

welcome; evaluate, evaluate, evaluate.

• New skills required and enough challenges to realize

Less waiting, more living

eHealth:

Courtesy: UMC Utrecht/Focuscura