Smart SpecialisationStrategies: Implementing European Partnerships Bench-Learning Conference for Pioneering Innovation Regions June 18th 2014 eHealth Tuija Hirvikoski, PhD Laurea University of Applied Sciences | UusimaaRegional Coordination Committee | European Network of Living Labs (ENoLL) | Greater Helsinki HorisonInitiative (GH2I) | Sendai-Finland Wellbeing Center [email protected] http://www.laurea.fi/en/Research/Pages/default.aspx also on twitter@Laurea_RDI,Linkedin,facebookand Slideshare The Committee of the Regions, Rue Belliard/Belliardstraat 99-101, Brussels Organized by The Committee of the Regions, the S3 Platform and the Helsinki-Uusimaa, Province of Utrecht and Valencia Regions ”Innovation is about mindset and heart” AN OVERVIEW OF THE MAIN ISSUES & DILEMMAS RELEVANT TO EHEALTH/MHEALTH Possibilities and Challenges of mHealth According to the Green Paper on mobile Health (Consultation open until 3 July 2014, bit.ly/ECmHealth) By the European Commission Mobile health (hereafter ”mHealth”) covers ”medical and public health practice supported by mobile devices, such as mobile phones. Patient monitoring devices, personal digital assistants (PDAs), and other wireless devices” – World Health Organization ”mHealth – New horizons for health trough mobile technologies, Global Observatory for eHealth series – Volume 3”, page 6 mHealth also includes applications (”apps”) that may connect to medical devices and sensors as well as personal guidance systems, health information and mediation reminders provided wirelessly. Challenges of European healthcare systems • Ageing population • Increased budgetary pressure Potential of mHealth • Shift towards prevention • Detecting the development of chronic condition • Helps in overcoming patients’ reluctance to seeking help because of stigma or shame related to their condition • Potential to improve quality of life and extend life expectancy • A more engaged and healthier population can reduce the financial pressure on the healthcare system • Reduced unnecessary consultations Potential of mHealth • Better prepared professionals • Use of mobile devises can reduce time spent on accessing and analysing information • Big data • Facilitating the mining of large amounts of health data • Growth of personal sensor data • Vital element in epidemiological research • Looking for patterns on a large scale or drawing conclusions for instance on the relation between the development of a medical condition and environmental factors • Maximising the potential of the data could lead to increased productivity and cuts of cost in the healthcare sector • Empowered patients • Raising awareness trough easy-to-understand medical information Market potential • mHealth driven in high-income countries by the imperative to cut healthcare costs, while in developing countries by need for access to primary care • Advent of mobile apps and wireless communication • mHealth app market is dominated by individuals and small companies • 70% of mHealth apps target the consumer, 30% of apps target health professionals Challenges of mHealth • Security issues • Loss or theft of devises • Unwanted sharing to third parties (employers, insurers) • Suitable security safeguards: encryption and authentication mechanisms • Article 8 of the Charter of Fundamental Rights of the European Union • Requires re-design of existing infrastructures • Change in the role of professionals • Unclear legal framework • Reliable information regarding mHealth solution • Certification • Specialized app stores • Safety concerns due to improper use of eHealth solutions • Not meant to replace doctors • Liability • Equal access • Introduction may require training of both professionals and patients • Only a third of Europeans have mobile internet access, significant differences between Member States • Legislative package ”Connected Continent: building a Telecoms Single Market” adopted by the commission • Interoperability (semantic, technical, organisational, legal) • Reimbursement models • 3rd parties: e.g. an insurance company promoting healthy behaviour by rewarding: free eHealth app or smartphone EXAMPLES FROM HELSINKIN UUSIMAA REGION Laurea Living Labs @service Tapiola Health Center - The Wellbeing Plaza Soukka Service Center - The Wellbeing Kiosk Tikkurila Library - Technology Library Greater Helsinki Horison Initiative GH2I – RDI actors activate the ecosystem For greater impact and better funding opportunities GH2I promotes multi-stakeholder collaboration, pre-award –project knowhow, and internationalisation, moreover, GH2I proactively influences policy makers and public funding instruments - Leading research institutions, Business ecosystem User communities Public procurers and service providers Regional policy makers Education and training Holistic platform and systemic innovation for - designing better services and products - empowering users / citizens - improving quality of life - developing innovative procurement - Improving return of investment - reduce the financial pressure on the healthcare system University of Helsinki, LERU • Centre of Excellence in Molecular and Integrative Neuroscience Research • Centre of Excellence in Cancer Genetics Research Aalto VTT Laurea - eHealth • Health Factory bridges the gap between research and innovations • Translational Engineering in Health and Medicine • Technical Research Centre of Finland is a globally networked multitechnological applied research organization - Use-cases - Piloting , testing - Service design - CIDe Cluster Finland - Spinno incubator - Training WEF: Finland tops Europe in ccompetitiveness (HEI’s ROI nr 1 ) National Health related growth strategy driven by HEIs and research institutions Active and healthy ageing in Europe - Co-creating solutions to European single market Sendai-Finland Wellbeing Centre an access point to South East Asia - Cross Border Living Labs EU-US eHealth MoU an access point to US - Health 2.0 Fall Conference 2014 Taltioni – a Finnish personal health records platform provides a single platform for the storage of information on the health and well-being of Finns. Focus on competitiveness Research: Health & Wellbeing solutions (user-centric focus) Joint RDI project proposals Innovation: User-driven innovation Law incubators PCP / PPI Research deployment: Connecting Europe Facility (CEF) from 2014 Cohesion policy: EIP on Active and Healthy Ageing Commercialization Call for partners : 1 What are the health related challenges your region would like to solve together with Helsinki - Uusimaa? 2 What are the emerging eHealth solutions you would like to test and pilot in Helsinki Uusimaa ? OPEN QUESTIONS Specific challenge: Citizens in an ageing European population are at greater risk of cognitive impairment, frailty and social exclusion with considerable negative consequences for their quality of life, that of those who care for them, and for the sustainability of health and care systems. The earlier detection of risks associated with ageing, using ICT approaches, can enable earlier intervention to ameliorate their negative consequences.Expected impact: Evidence for the benefits of risk detection and intervention, based on proof of concept and involvement of relevant stakeholders. Clear improvements of outcomes for individuals, care systems and wider society from new therapies and interventions based on early risk detection in comparison with current practices. Global leadership in ICT based innovation for active and healthy ageing. PHC-27-2015 Self-management of health and disease and patient empowerment supported by ICT Specific challenge: Empowering citizens and patients to manage their own health and disease can result in more cost-effective healthcare systems by enabling the management of chronic diseases outside institutions, improving health outcomes, and by encouraging healthy citizens to remain so. Several clinical situations would be prevented or better monitored and managed with the participation of the patient him or herself. Care sciences may complement the medical perspective without increasing the cost. This requires research into socio-economic and environmental factors and cultural values, behavioural and social models, attitudes and aspirations in relation to personalised health technologies, mobile and/or portable and other new tools, co-operative ICTs, new diagnostics, sensors and devices (including software) for monitoring and personalised services and interventions which promote a healthy lifestyle, wellbeing, mental health, prevention and self-care, improved citizen/healthcare professional interaction and personalised programmes for disease management. Support for knowledge infrastructures is also required. Implementation of programs or applications for different target populations to capture gender- and age-dependent differences in health, behaviour and handling of devices is encouraged. This topic is a continuation of PHC 26 – 2014 giving more and different opportunities to develop solutions and services for self-management of health and diseases. Expected impact: Improving the participation of the patient in the care process. Improving the management of a disease by reducing the number of severe episodes and complications. Increasing the level of education and adherence of individuals, patients and care givers related to application of ICT for personalised care. Improved interaction between patients, their relatives, providers of health-, social-, and informal care givers. Strengthened evidence base on health outcomes, quality of life, care efficiency gains and economic benefits from the use of ICT in new care models. Reinforced medical knowledge with respect to efficient management of comorbidities. Increased confidence in decision support systems for disease/patient management. Involvement of health care providers/authorities with increased commitment in the deployment of innovative services empowering the patient. PHC-28-2015 Self management of health and disease and decision support systems based on predictive computer modelling used by the patient him or herself Specific challenge: Several clinical situations would be prevented or better monitored and managed with the participation of the patient him or herself. In order to promote the self-management, predictive personalised models can be combined with personal health systems and other sources of data (clinical, biological, therapeutic, behavioural, environmental or occupational exposure, lifestyle and diet etc.) and used by the patient him or herself, in order to raise individual awareness and empower the patient to participate in the management of his or her health, with application in lifestyle, wellbeing and prevention, in monitoring of the disease etc. This will improve the quality of life of patients and the self-management of disease and lifestyle. Expected impact: Improving the participation of the patient in the care process. Improving the management of a disease by reducing the number of severe episodes and complications. Increasing the importance of the prevention sector in healthcare using predictive modelling. Boosting the development of personal devices used for self-management of health. Improving individual self-control of health and of disease prevention PHC-29-2015 Public procurement of innovative eHealth services Specific challenge: The sustainability of pilot and demonstration solutions and services is broadly perceived as one of the biggest challenges in streamlining healthcare delivery processes and in improving cost efficiency while maintaining or improving patient safety. The pace of development has been slow and penetration of ICT still has high growth potential in healthcare compared to other public or private sectors. This activity facilitates public purchasing of innovative solutions in healthcare which have not yet been deployed on a large scale. Expected impact: As applicable, contribution to regulatory and legal process development addressing possible barriers to procurement of innovative solutions in healthcare. Growing awareness and successful use of public procurement by the procurers to boost innovation in the application of ICT in the sector concerned. Support to interoperability and defragmentation of the market. Sustainable implementation of services and creation of economic conditions that support long-term development. More forward-looking, concerted, public sector approach to eHealth. Reduced fragmentation of public sector demand across a number of EU Member - or Associated States by enabling public purchasers to collectively implement PPI strategies, which due to their nature are better addressed jointly, or which they would not have been able to tackle independently. Increased opportunities for wide market uptake and economies of scale for the supply side for ICT based solutions and services by forming critical mass on the public demand side. PHC-30-2015 Digital representation of health data to improve disease diagnosis and treatment Specific challenge: Digital personalised models, tools and standards with application for some specific clinical targets are currently available. There is however a need for greater integration of patient information, for example of multi-scale and multi-level physiological models with current and historical patient specific data and population specific data, to generate new clinical information for patient management. Any such integrative digital representation (Digital Patient) must also allow meaningful knowledge extraction and decision support. Expected impact: Better coherent use of health data available for a subject in conjunction with the existing medical knowledge in clinical decision making. Design of predictive and therapeutic interventions. Better management of complex clinical situations. Enabling use of the same information by different medical services and the other relevant healthcare professionals. Better control and inter-service coordination in the management of the patient health. Providing a consistent view of a patient's care needs Possible work programmes PHC-21-2015 Advancing active and healthy ageing with ICT: Early risk detection and intervention
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