‘….over de weg naar duurzame en goede zorg’
een beschouwing vanuit internationaal maatschappelijk-economisch perspectief
NEVI zorgcongres 05-02-2015
Dr. Nick Guldemond | Associate Professor Integrated Care & Technology
1
| Social-economic developments
2
| Healthcare paradigm shift
3 |
Health & Technology
4 |
Data, information, intelligence
5 |
Community centred health solutions
Roadmap
Dr. Nick Guldemond
Social-economic developments
2007
EU
•
average
≈
1:4
•
differences
between
countries
2050
EU
•
1:3
(NL)
•
1:1.5
(Italy
and
Spain)
•
average
≈
1:2
2050
China
•
average
≈
1:<1
population aged (>65) in proportion to working
population (15-65)
Dr. Nick Guldemond
…emerging economies
Dr. Nick Guldemond
% population with 1 or more chronic diseases
2005
> 1 chronic disease 1 chronic disease 0 chronic disease NL population age Dr. Nick GuldemondOverall
increase
since
2005
17%
Increase
co
‐
morbidity
since
2005
26%
…current healthcare system sustainable?
Dr. Nick Guldemond
Healthcare paradigm shift
medical
curative
model
community care specialized institutions local institutions
social
(interconnected)
health perspective
community care advanced local care centres high specialized cureParadigm shift
Dr. Nick Guldemond self management delivery system decision support information systems supportive environment public health community actionIntegrated Care
Health Systems
Community
improved outcomes
interactions
productive
activated community
support
Dr. Nick Guldemond
clinical
pathway
/
patient
journey
Example falls prevention
Critical
zone
fitn
es
s
time
assessment
screening +
intervention
rehabilitation
monitoring
Education
Integrated Care
Fall detection Home monitoring Nutricial intervention Balance training Dr. Nick GuldemondPrevention fitness CURE recovery maintenance
before
admission
after
Chain of (planned) care
hospital
community care
community care
Dr. Nick Guldemond
pro-active screening
GP practise (single entry point)
assessment intervention follow-up monitoring
Chain of (planned) care
hospital
community care
community care
Prevention Fitness CURE Recovery Maintenance
before
admission
after
multidisciplinary meetings & consultations
multidisciplinary care plan Case management Evidence Based Practise technology assisted integrated care
Dr. Nick Guldemond
Organising informal and professional care
Dr. Nick Guldemond
Health & Technology
….a smarter community care
Health status over time
0
‐
35
36
‐
65
66
‐
80
>
80
heal
th
y
heal
th
y
chr
o
nic
chr
o
nic
acut
e
ca
re
acut
e
ca
re
life
style
‐
health
education
‐
risk
monitoring
self
‐
management
support
tools
(home)
care
technology
dependent
independent
assisted
dependent
age
living
hea
lth
st
at
u
s
no technology with technologyhe
alth
te
chology
Dr. Nick GuldemondHealth status & technology
cure
technology
Breakdown healthcare spending
Key figures medtech sector
•
sector global
$ 221 miljard
•
sector EU
$ 124 miljard
•
growth rate EU
5%
•
variety of products
0.15 cents to $ 30.000
•
EU companies
22.500
•
jobs
500.000
•
R&D investments
$ 7,5 miljard (8% of sales)
•
SME
80% < 250 employees
•
short R&D cycles
18-24 months
•
reduction hospital stay
-13%
•
health expenditure
≈
4,2%
Medtech return on investment
($100)
S&P 500
health care equipment index S&P 500 general index pharmaceuticals indexCardiovascular Care Cycle Process
Dr. Nick Guldemond
Home care technology & Assisted Living
Dr. Nick Guldemond
Dr. Nick Guldemond
Interactive Health Information
Anytime, Anywhere, AnyDevice,
Real-time
social (interconnected) health team
instruction advise task allocation planning monitoring & control coordination Dr. Nick Guldemond
Decision
making
Logistics
Health data & informatics
INTERACTION
USER PROFILE
& SERVICE
INTEGRATION
Commuting Travels Meetings Communications Sleeping Wake‐up times Office time Location patterns People’s behavior User attention EmotionSmartphones communicator & Sensor of Human Behavior
INFORMATION
Dr. Nick Guldemond
Dr. Nick Guldemond
wearable sensor technology
Health
promotion
Systems medicine
Determinants,
risk factors
& pathways
Disease
interaction
Dna transscription
Dr. Nick GuldemondEnvironment
Society
Quatified
Self
Personalised local
Care
Point of Care
Diagnostics
Dr. Nick GuldemondINTERACTION
INFORMATION
Real-time interaction research & care
UMC’s
Localities
monitoring
behaviour
effect
outcome
quality
standards
Data analytics public health management
Dr. Nick Guldemond
annotation
tagging
Classification
algorithms
rules
Conversion
Information
data
fusion
Context
data
reference
data
Interpretation
protocols
guidelines
decision
support
patient
profile
tailored
care
personalised
Plan
Practise team
Cloud
device
environment
demographic
data
Building Engagement by stimulating reprocity
Interconnected community
Dr. Nick Guldemond
Data analytics & clinical decision support
Dr. Nick Guldemond
Descriptive
Diagnostic
Predictive
Prescriptive
Add
e
d
va
lu
e
Difficulty
What?
Actual status
Why?
Cause
‐
Effect
Anticipate?
Argumented
pro
‐
actions
How?
Scenarios &
likelihood
Big data
Dr. Nick Guldemond
Data security & Privacy
Dr. Nick Guldemond
Data
functionality
Legislation
Technology
anonymization vs pseudonymisation
Implementatie
Dr. Nick GuldemondAfstemming en harmonisatie (interoperabiliteit) op
verschillende niveaus
Afstemming
en
management
van
zorgprocessen
Afspraken tussen organisaties
ZorgICT
applicaties,
uitwisselingsformaat,
UI
Communicatie,
netwerken,
servers,
databases
Compatibele wet
‐
en
regelgeving
Datasets,
coderingen
Zorgprocessen
Beleid
Informatie
Applicaties
Infrastructuur
Wet
‐
en
regelgeving
Security,
Pri
vacy,
Go
vernance
Creating community
centred
health solutions
Policy
level
e.g Horizon
2020
e.g EIP
‐
AHA
EU
National
Regional
Local
community
based
co
‐
creation
infrastructure
Dr. Nick GuldemondEU Framework for development,
implementation & up-scaling innovations
Community Based Co-creation
Health insurers Healthcare
professionals Patient organisations & consumers Social workers & charities Inventors Local SME’s Local government Public organisations Knowledge institutions Industry Dr. Nick Guldemond
initial
engagement
1
stmovers
community
engagement
co-creation
design
workshops
co-creation
prototyping
workshops
user-testing
validation
implementation
implementation
up-scaling
insights
&
ideas
early
prototyping
specifications
feedback
refinement
value
models
Community Based Co-creation
Dr. Nick Guldemond
Ecosystems/Living Labs
Dr. Nick GuldemondThank you!
Dr. Nick Guldemond
Email: [email protected]
Mobile: +31 6 48 26 19 29
Dr. Nick Guldemond