FeelGood 5. työkokous 9.30 Aamukahvi 10.00 Avaus, Antti Larsio, Microsoft 10.15 FeelGood-hankkeen nykytila, Niilo Saranummi, VTT 10.45 SADe-ohjelma, Silja Hiironniemi, VM 11.15 Ryhmätyö Miten jatketaan FeelGood-polulla 12.30 13.30 Buffet lounas 1
Michael Porter, Harvard: Today, 21 st century medical technology is delivered with 19 th century organization structures, management practices, and pricing models. Eric Dishman, Intel: Create the PHR ecosystem: Get real Get out of denial about the thinking it s not possible yet. Get large Create the ecosystem and make it in sufficient scale. Get loud Stop battling one another, join voices and work together European Connected Health Campus Manifesto: Governance + Engagement + Procurement + Implementation Enough evidence, no pilots needed, instead implementations at real scale FeelGood Status report 27.8.2009 Niilo Saranummi niilo.saranummi@vtt.fi
The Finnish ecosystem MINISTRY OF SOCIAL AFFAIRS AND HEALTH
Participants Goal: What is FeelGood Do a roadmap for an ecosystem of PHR based products and services and Start implementing it Funded trough Tekes / FinnWell and participants Roadmap delivered in April 2009, Implementation ongoing IT industry & service providers Avain MediWare Technologies Elisa Fujitsu Innofactor Itella Information Logica Mawell Microsoft Nokia ProWellness Pfizer Tieto Vivago Content providers Duodecim Finnish Broadcasting Company Insurance Ilmarinen Pohjola Social Insurance Institute (Kela) Employers (Corporate Wellness) Metso Corporation Finnish Broadcasting Company Public Health Service Providers Etelä-Karjala Social and Health Services District Helsinki Uusimaa Hospital District Turku City Other public bodies (Integrating Agencies) Finnish Innovation Fund, Sitra Finnish Funding Agency for Technology and Innovation (Tekes) Ministry of Social Affairs and Health VTT, Technical Research Centre of Finland
We started with this picture Make platforms interoperable Authentication Devices Multi channel (mobile, PC, digi-tv, SMS, ) Aplications Applications Applications Sovellukset Applications Applications Applications Applications Applications KANTA eprescription earchive Copy of EHR Platform Platform Platform PHR A PHR B PHR C Ecosystem A Ecosystem B Ecosystem C
And were guided by the Health and illness continuum Acute Care CARE of ILLNESS SELF CARE Active Health Worried Well Fitness Ageing Independently Ambient Assisted Living Home care care & Independent living Wellness management Elevated risk risk factors Disease Management Chronic disease Rehabilitation Acute illness (episode) PRO- ACTIVE RE- ACTIVE
The roadmap process QUESTION: How far are we willing to take cooperation in the ecosystem Technical (architecture) Business Who should / need to be included into the ecosystem 4 workshops Roadmap report State of the art in Finland & globally Architectural aspects Stakeholders / business ecosystem Other relevant issues 7
Finland SOA in Finland & Globally Cooperation between funding bodies (STM, Sitra, Tekes, RaY, ) Tekes programs: SOTE, AAL 169, Testbed (?) Health and Wellness SHOK Numerous projects in the public sector earchive & eprescription services Strong industry interest SADe preparations kansalaisen asiointitili Global Industry collaboration IHE, Continua, European Connected Health Campus PHR products, applications, platforms GoogleHealth, HealthVault, ICW,
Several viewpoints / issues Evidence of value Value Business models Customers Value generation Value network Stakeholders Deployment Products Applications Architecture Semantics Interoperability PHR Procurement Installing Change management Use and maintenance Service Position on Health Continuum
Separate patient data from care processes modified from Anthony Nowlan, Personal Health Systems Focused on individual Independent of institutional configurations Incremental growth Focused on institutions Corporate institutional responsibility 10
PHR vs. EHR Service providers Health Public sector Occupational health Private Illness PHR EHR
EHR and PHR are separate and complementary Management of Health & Wellness Chronic care & Rehabilitation Care of illness Personal Health Record Repository Semantic & technical interoperability (IHE, Continua) Privacy Security Electronic Health Record Repository (Archive)
Reference architecture interfaces and components for interaction between PHR and clinical information sources Clinical information system (e.g. EHR) Monitoring server PHR service (client) Measurement device Portable storage media EHR archive interfaces and components for health monitoring data handling covered by Continua guidelines PHR service directory PHR service (server) PHR interfaces and components for service discovery Trusted software or system (incl. another PHR service) Authentication service interfaces and components for interaction between PHR and non-clinical information sources 13
Positioning on the health continuum Family Health Manager (yksilö, perhe, vanhemmat) Worried Well (huolestuneita terveydestään) Active Health (urheilijat, kuntoilijat, terveesti elävät) Akuutit ja elektiiviset terveysongelmat Elintapariskit (luettelo riskitekijöistä alla) Krooniset sairaudet (luettelo alla) Independent living (luettelo alla) Neuvola Tarha Koulu Työ Eläke terveysvastaava Primääripreventio Sekundääripreventio Independent living: Turvallisuus, yksityisyys, sosiaaliset kontaktit, asiointi, koti, liikkuminen, kommunikointi, Elintapariskejä: tupakointi, alkoholi, huumeet, stressi, masennus, unen laatu, ravinto, paino, liikunta, MBO, geeniperimä, Kroonisia sairauksia: CVD, diabetes, COPD, astma,
Users are different One size does not fit all Business owners (consumer, employer, healthcare) Personal profile (life stage, life style & behaviour, risk factors, motivational issues) Disease & Best Clinical practice 15
Procurement Which As a Technology As a Service (internal use, external IT operator) As a full Service Controlling risks e.g. life cycle approach Unlearning / change management 16
Terveystaltio hahmotelmaa ja palveluesimerkkejä Esimerkkejä palvelukokonaisuuksista Kuntoilu Painonhallinta Terveysseuranta Terveysvalmennus Tietojen omaehtoinen tallennus ja käyttö Vertaisryhmät Kotimittaukset Kotihoidon apu Pitkäaikaistiedot - lääkitys, allergiat, rokotukset Edellyttää julkisen sektorin yhteistyötä Tietojen välitys hoitoyksikköön Kanta-tietojen katselu integroituna Omien tietojen kopiointi omaan käyttöön Meneillään Kela earkisto eresepti ekatselu Terveydenhuollon yksiköt Terveystaltio - tietovarasto Erityshoitoa tms. vaativat lapset Kansalainen Suostumus ja oikeudet Ikää ääntyneet vanhemmat
PHASE 2 Setting up the PHR ecosystem PHR and EHR are complementary Both earchive (Kela) and citizens PHR service The full PHR ecosystem of relevant stakeholders is needed Value networks Industry (products, applications, platform services) Service providers (public / private, Corporate Wellness) Payers (municipalities, insurance agencies, ) Context setters & regulators National bodies Government (relevant ministries) 18
Benefits of PHR For citizens Activating citizens to manage their health and care and that of their families Citizen as a co-producer of health, not just and object of care Tools and services for citizens to take on the responsibility For public & private healthcare Enabling selfcare with ICT based services For corporate wellness For employees: Life style management improved wellbeing For employers: Less costs of sickness and early retirement For PHR ecosystem partners Critical mass to get real results, impact and international business 19
Recognized PHR related challenges Education & Marketing how to use ICT in Health Market creation Value networks of providers international competition Proof of value Procurement skills capability-maturity model Change management all levels Making use of virtualized resources, IPU s, Interoperability technical and semantic Delivering value to users and customers 20
Ekosysteemin osapuolet VM LVM Terveydenhuoltojärjestelmä Kunnat TEM STM Itsepalvelu, toiminnan tehostuminen ja kustannusten aleneminen Terveysmenojen aleneminen Yritysverotuloa Sairauspoissaolot, eläköityminen kustannusten aleneminen Elinkeinoelämän voimistuminen ja vaihtotaseen paraneminen Tilaa KELA kansalaisen katseluyhteyden Kansalliset tunnistautumisja maksamisratkaisut Kansalliset nimikkeistöt ja koodistot Terveystaltio - alustapalvelut Palvelukehitys Kilpailukykyä ja markkinoiden kehittymistä Terveystaltiopalvelut Palvelutarjoajat ja palveluratkaisut Kansalainen / kuluttaja / asiakas / potilas Omahoito, itsepalvelu, oma 21 vastuu
Ryhmäkeskustelun teema Terveystaltion asemointi Onko raportin kuvaus OK? Suhde KANTA-palveluihin ja sähköiseen asiointiin Kansallinen terveystaltio vai markkinavetoinen? Perustetaanko ekosysteemi Millaisia pelisääntöjä tarvitaan? Mitä tehdään yhdessä (tietojen yhteiskäyttöisyys, arkkitehtuuri, palvelualusta, näytön hankinta, liiketoiminta, Valtion rooli Seuraavat askeleet Osallistutaanko SADe-prosessiin, miten FeelGoodin jatko, esim. Tekesin päärahoituksella? 22
VTT creates business from technology 23