Issues And Challenges Of Connected Health A Clinical Perspective - Albert Alonso
- 1. 16th Annual conference and Scientific Symposium Issues and challenges of Connected Health: a clinical perspective Albert Alonso Innovation Directorate
- 2. Why Connected Health? • Enables more informed decision-making and enhanced quality of care • Saves lives through remote consultations, whether urgent or diagnostic • Creates more efficient, convenient and potentially more cost-effective delivery of care • Facilitates earlier – and more accurate – diagnoses • Provides greater and faster access to a patient’s medical history, reducing the risk of negative drug interactions or poor response to a course of treatment • Improves administrative efficiency and coordination. • Allows rural residents to receive expert diagnosis and treatment from distant medical centers. • Increases timeliness of treatment and decreases transfer rates, while reducing medical costs through video technology • Supports real - time treatment by first responders through the use of smartphones. • Enhances senior wellness and preventative care through telemedicine and remote in-home monitoring. HISI Annual Conference, Dublin, November 16th 2011
- 3. Sounds great! Does it fit in our clinical perspective? HISI Annual Conference, Dublin, November 16th 2011
- 4. Meet a 21st century Older Person Who’s Mary? • Aged 79 years • Lives alone (family home) • Arthritis (legs and hands) • Long-standing digestive problem • Mitral valve leakage • Small mental lapses - ? TIAs • Technophobe (ATM, care alarm) • Independent but sociable Adapted from M. Rigby. Social Care Informatics in Support of Integrated Care. INIC, Odense, 2011 HISI Annual Conference, Dublin, November 16th 2011
- 5. Meet a 21st century Older Person What does Mary need? • Nutrition support • Mobility support • Shopping • Bathing support • Socialisation opportunity Adapted from M. Rigby. Social Care Informatics in Support of Integrated Care. INIC, Odense, 2011 HISI Annual Conference, Dublin, November 16th 2011
- 6. Meet a 21st century Older Person Who does help her (informal care)? • No children • Stepson, niece; each 90 minutes away; working • 2 sisters – equally dependent, do not drive • Neighbours – elderly couples 70+, each husband with history of cancer Adapted from M. Rigby. Social Care Informatics in Support of Integrated Care. INIC, Odense, 2011 HISI Annual Conference, Dublin, November 16th 2011
- 7. Meet a 21st century Older Person Who does help her (formal care)? • General Practitioner – uninterested, repeat meds., nothing curable • Cardiologist – medication • Orthopod – undecided • Neurologist – unsure • Geriatrician – peace maker • Home nurse – monthly • Respite care – annually Adapted from M. Rigby. Social Care Informatics in Support of Integrated Care. INIC, Odense, 2011 HISI Annual Conference, Dublin, November 16th 2011
- 8. Meet a 21st century Older Person Social care essentials • Difficult negotiations between family, health care, and social care providers • Daily hot meal delivered 5 days • 1 hour home support • Eventually family also arrange 7 day home visit support including midday meal Adapted from M. Rigby. Social Care Informatics in Support of Integrated Care. INIC, Odense, 2011 HISI Annual Conference, Dublin, November 16th 2011
- 9. Meet a 21st century Older Person Who manages her health? • Health seriously compromised if not helped holistically • Health care and Social care need harmonising • Family and carers’ own needs are factors Adapted from M. Rigby. Social Care Informatics in Support of Integrated Care. INIC, Odense, 2011 HISI Annual Conference, Dublin, November 16th 2011
- 10. Is Connected Health good for Mary? HISI Annual Conference, Dublin, November 16th 2011
- 11. Maybe, but we could do it better HISI Annual Conference, Dublin, November 16th 2011
- 12. To begin, we need to change our clinical perspective HISI Annual Conference, Dublin, November 16th 2011
- 13. HISI Annual Conference, Dublin, November 16th 2011
- 14. A clinical perspective for NCDs Socio economic determinants Health promotion Lifestyle – environment Risk and protective factors Systems Gender Genes biology Biological expression of Chronic diseases Personalised Medicine •Primary prevention Age •Secondary prevention Clinical expression of •Tertiary prevention •Treatment Chronic diseases Adapted from Bousquet et al. Genome Medicine, 2011, 3:43 HISI Annual Conference, Dublin, November 16th 2011
- 15. Classical phenotypes Patient with chronic disease Based on “a priori” ontologies CVD COPD Diabetes Assessment of co-morbidities and severity Classical phenotypes in patients with severe defined diseases and co-morbidities and severity Responsiveness to treatment follow-up Adapted from Bousquet et al. Genome Medicine, 2011, 3:43 HISI Annual Conference, Dublin, November 16th 2011
- 16. New phenotypes Patient with chronic disease Based on statistical models: complex Co-morbidites components of onset, (standardised assessment persistence, prognosis Severity of co-morbidities (standardised assessment) Novel phenotypes in individual patients with severe co-morbidities of chronic disease Responsiveness to treatment follow-up Adapted from Bousquet et al. Genome Medicine, 2011, 3:43 HISI Annual Conference, Dublin, November 16th 2011
- 17. Moving to 4P medicine Predictive, preventive, personalised, participatory Classical • New studies needed on precise patients’ Phenotypes phenotypes and follow up • Systems medicine: Massive amount of patients’ data should be available (new societal responsibility) • ICT are the only way to collect and exploit these data: new information management systems are required, smarter monitoring solutions. New We need this connected health to make integrated Phenotypes care possible HISI Annual Conference, Dublin, November 16th 2011
- 18. Back to Mary Citizen first Care secondary ICT discrete enabler Adapted from M. Rigby. Social Care Informatics in Support of Integrated Care. INIC, Odense, 2011 HISI Annual Conference, Dublin, November 16th 2011
- 19. Thanks for your attention HISI Annual Conference, Dublin, November 16th 2011