Connected Health & Wellbeing – Collaborating with Healthcare for Innovative Service Development
1. Connected Health & Wellbeing –
Collaborating with Healthcare for Innovative
Service Development
Prof. Jonathan Wallace
Professor of Innovation
Director of Knowledge & Technology Transfer,
Faculty of Computing & Engineering, University of Ulster, Northern Ireland
Faculty of
Computing &
Engineering
2. Faculty of
Computing &
Engineering
Outline
• Track Record
• From Connected Health To Connected Wellbeing
• Pervasive Technologies
• Effective Evaluation of Connected Health Service Solutions
• Healthcare Service Innovation Collaborative Case Studies:
– utell
– SaSSI
– Motivation & Behavioural Change
– NOCTURNAL
– ACTION
3. Faculty of
Computing &
Engineering
Prof. Jonathan Wallace – Track Record
• Established track record in Telemedicine, Telecare,
Telehealth, Connected Health over 20 years.
• Sit on Connected Health & Technology Advisory Boards
of number of Health Trusts.
• One of the 5 judges for the UK National annual Crystal
Awards for Excellence Telehealth & Telecare.
• Board Member BioBusiness.
• Founder Member BCS Health NI.
4. Faculty of
Computing &
Engineering Current Connected Health research interests:
– User-Centred Design for Connected Health Service Solutions;
– Connected Wellbeing - individualised prediction, prevention and early
detection as well as education, motivation and behavioural change;
– Mobile Service Solutions – exemplars u-tell & SaSSI
– u-tell: intelligent spoken dialogue and web portal service solution
with clinical decision support track and trend remote monitoring.
– Successful track record over 7 years monitoring diabetic
patients in South Eastern Health & Social Care Trust.
– Mid-way through RCT for new INR module.
– New service being developed for obesity and pre-diabetics.
Prof. Jonathan Wallace – Track Record
5. Faculty of
Computing &
Engineering
What Exactly Is Connected Health ?
• Not one specific technology or service solution
!
• Spans every echelon of health care from first
response/emergency medical systems through
tertiary medical speciality consultations to the
support of informal care in the home including
motivation and behavioural change, education
and information dissemination.
• It has to be user-centred, multidisciplinary,
standards-based e.g. HL-7 and ensure
interoperability.
6. Faculty of
Computing &
Engineering
“The Wellness Paradigm”
• The “Wellness Paradigm” – shift of responsibility
for health and well-being into patients’ hands
• “Home-centred capability is expected to become
a catalyst for a huge health paradigm shift from
last-minute heroic intervention to consumer-
driven individualised prediction, prevention,
early detection and maintenance”
(Herman, 2001)
7. Faculty of
Computing &
Engineering
Level 0: Population Wide Prevention
Level 1: Self Care / Supported Self Management
(70-80% of chronic disease patients)
Level 2: Disease Management
(High Risk)
Level 3: Case
Management
(Complex Risk)
Kaiser Triangle Model
13. Patient Enters Information
At Home Or On The Move
• Weight
• Blood Sugar
• Blood Pressure
u-tell: DIABETES Architecture Schematic
PSTN
VoiceXML
Interpreter
Primary / Secondary
Care Provider Intranet
• Patient Details
• Clinical Targets
• Protocols
Electronic Care
Record (ECR)
Database
• Data Management
• Visualisation
• Trend Analysis
• Decision Support
• Evidence Based Medicine
Clinical Professional
Access Through
Clinical Workstation,
Tablet or
Smart Phone Browser
u-tell:DIABETES
Clinical Decision Support Portal
Regular Health Report
Print-Outs Sent To Patient
Secure
Web Portal
Gateway
Additional Option For Patients
To Submit & Review Their Own
Readings Via Secure Web Portal
14.
15. The Problem
• Patient assessments at bedside still mostly paper-
based.
• 20+ paper-based assessments per patient and
growing due to new mandatory requirements.
• ~15% of staff time spent on unnecessary
paperwork.
• Additional time and cost for Audit /Compliance.
• Poor accountability, non-completion, inconsistency,
duplication issues.
• NHS currently failing to meet mandatory patient
safety assessments.
• Existing ECR and EDM systems NOT solving
this problem.
16. Royal Cornwall Hospitals NHS Trust
Exemplar
2010 - 2011
• 119,364 Admissions
• 600,000 patient records across 3 sites
• 100,000 records in circulation at any given time
• 2 Health Records Libraries
• 3 Clinic Preparation Departments
• 1 Disclosure Office
• Typical month:
• 47 staff send & file ~92,000 sets of notes
• 110 tonnes paper moved in & out of
departments
17. • SaSSi - Innovative web-based integrated service
solution.
• Allows clinicians to use tablets, smartphones,
laptops or desktops to access clinical information
at the Client/Professional Interface (CPI) both at
the patient bedside and on the move within the
hospital.
• Designed to enable information capture at the point
of care, place key decision-making data in the
hands of clinical staff, and allow real-time
monitoring and auditing of clinical activities.
• Most importantly all leading to improved in-patient
care /outcomes.
• Current modules - VTE, MUST & MEWS
• Next Priority – Nursing Assessment
The Solution
Integrating pharmacogenomics into therapy is an agency-wide initiative. “ For the first time physicians will have a chance to treat patients as “ individuals ” not as members of a “ population ” We will be able to treat patients based on the biology of disease rather than the symptoms of disease ” (Janet Woodcock MD, FDA). FDA Regulations relating to labelling: “ If evidence is available to support the safety & effectiveness of a drug in a selected subpopulation with a disease, the labelling shall describe the evidence and the specific tests needed for selecting and monitoring the patients who need the drug ” (21 CFR 201.57)
Integrating pharmacogenomics into therapy is an agency-wide initiative. “ For the first time physicians will have a chance to treat patients as “ individuals ” not as members of a “ population ” We will be able to treat patients based on the biology of disease rather than the symptoms of disease ” (Janet Woodcock MD, FDA). FDA Regulations relating to labelling: “ If evidence is available to support the safety & effectiveness of a drug in a selected subpopulation with a disease, the labelling shall describe the evidence and the specific tests needed for selecting and monitoring the patients who need the drug ” (21 CFR 201.57)