How Can Connected Health Improve Patient Pathways?

Transcription

1 How Can Connected Health Improve Patient Pathways? 7 th October 2015 The Landing, Media #McrEcosystem

2 The Global Connector European Connected Health Alliance Bringing Together the future of Health, Social Care & Wellness European Connected Health Alliance International Network of Permanent Connected Health Ecosystems Liz Ashall Payne International Ecosystem Co-ordinator 7 th October Manchester / info@echalliance.com

3 About ECHAlliance Non-Profit Organisation (Community Interest Company) 300+ member organisations Companies, policy-makers, researchers, health & social care providers, patients, insurances, etc. 12,000+ community 30+ countries (Europe, USA, China) International Network of Ecosystems International Events (leadership, mobile world congress, EU-US Marketplace) EU Projects (lead & partner) 3

4 Ecosystems Endorsed ehealth Ecosystems could be the answer to the strain our social security systems are undergoing. If we work together and use the enormous potential technology has to offer us, we can ensure top healthcare for all in Europe Neelie Kroes, Former Vice President

5 Unrivalled Reach and Expertise The ECHAlliance International Network: is an unparalleled network of permanent ecosystems that span the EU and the international stage connects Connected Health Ecosystems across Europe, North America and soon China & Canada 100+ gatherings across Europe are facilitated by the ECHAlliance annually, resulting in over ~15,000 connections and unrivalled insight and expertise The ECHAlliance can join the dots and offer insight from one country that can greatly assist in the health challenges of another

6 ECHAlliance Ecosystems Programme Ecosystem Programme basic principles Geographic coherence Multi-stakeholders Permanent Regular meetings, workshops ehealth strategic agenda/plan Governance through working group(s)

7 Ecosystem Reach ~100 Ecosystems meetings per year in Europe Existing England - Manchester England - North West Coast Estonia Finland Oulu France - Nice-PACA Greece Northern Ireland Poland Republic of Ireland Scotland Spain - Barcelona USA - New York Launching Soon Canada Toronto Czech Republic England -Yorkshire & Humber France Paris Slovenia Spain - Valencia Spain - Galicia Developing Austria Belgium Denmark x 2 England x2 Finland x 2 France x 2 Germany Italy Latvia Netherlands Switzerland Sweden Wales

8 ECHAlliance Connector Community Database (profiles) Collaborative work tools (shared docs, chat/ tool ) Events, workshops, webinars Marketplace / Showroom (solutions, success stories, assessment results) ECHAlliance Connector Virtual matchmaking Management ECHAlliance website Business Intelligence tool (market data, description & contacts, tenders, calls of projects, opportunities) Education and training (Publications, event presentations ) 8

9 Learn more contact Inter-Ecosystem Working Groups To provide a platform for stakeholders responsible for a given topic area, to meet, promote and advance their work across the ecosystem network, therefore maximising knowledge sharing and best practice. Medicines Optimisation Inter-Ecosystem Group Group Chair: Prof Mike Scott Head Pharmacy & Medicines Management, Northern Health and Social Care Trust - Northern Ireland Webinar held - 1st October 2015 ehealth Strategies Inter-Ecosystem Group Group Chair: Ain Aaviksoo, Deputy Secretary General, E-Services & Innovation Estonian Ministry of Social Affairs Meeting planned - November 13 th in Estonia for key stakeholders

10 Digital Health & Wellness Health & Summit Wellness MWC Feb 4YFN conference dedicated to innovative start-ups/smes, and investors 23 Feb Conferences and workshops: high level programme includes international leaders in the health and wellness sector. 24 Feb Conferences and workshops: high level programme includes international leaders in the health and wellness sector at Mobile World Congress 25 Feb - Personalised programme of sites visits & B2B matchmaking - Explore the large Mobile World Congress exhibitions in Fira Gran Via

11 Digital Health & Wellness Health & Summit Wellness MWC The Investors Challenge Start-ups & SMEs competition - Best Digital Health Start-ups & SMEs - Best Innovations on Digital Health, wearables, IoT, active ageing - Key customers involved (governments, hospitals, insurances) From September 2015 to February 2016 Roadshow across: - Europe (25+ countries & regions), - North America (USA & Canada) - China Great Digital Health & Wellness Summit 2016

12 European Connected Health Alliance The Global Connector in Healthcare We bring people, organisations, needs and solutions together We invite you to join us - learn about membership at Contacts Brian O CONNOR, Chair brian@echalliance.com Liz ASHALL-PAYNE, Outreach Co-ordinator- liz@echalliance.com Julien VENNE, Strategic Advisor julien@echalliance.com Damian O CONNOR, Director of Operations damian@echalliance.com / info@echalliance.com

13 GM AHSN Introductions and Priorities Professor Donal O Donoghue Medical Director GM AHSN

14 AHSN National Context Innovation Health and Wealth AHSN Licence Focus on the needs of patients and local populations Speed up adoption of innovation into practice to improve clinical outcomes and patient experience Build a culture of partnership and collaboration Create wealth through co-development, testing, evaluation and early adoption and spread of new products and services.

15 Greater Manchester AHSN Local context GM AHSN footprint 4 Universitie s 1 Ambulance Service

16 Executive team Mike Burrows Managing Director Research and Informatics Martin Gibson Gary Leeming Sarah Thew Industry and Wealth Linda Magee Keith Chantler Health and Implementation Donal O Donoghue Jane Macdonald Cara Afzal, Dai Roberts, Zulfi Jiva

17 Health and Implementation 1. Cardio-vascular Disease Atrial Fibrillation Familial Hypercholesterolaemia CKD, as a marker of vascular risk 2. Patient Safety Medicines Optimisation

18 Medicines Optimisation / Patient Safety Jane Macdonald Director of Nursing and Improvement GM AHSN

19 In a Devolved GM System the ambition is to: Have 64,000 less people with chronic condidtions 10% less visits to urgent care 700,000 people with chronic conditions able to manage their health in a way that suits them

20 In a Devolved GM System the challenge is: The most common health intervention is prescribed medication 40% of GM population take medication on a regular basis % of medication are not taken as intended 5-8% of hospital admissions are caused by preventable adverse reactions to medicines.

21 Medicines Optimisation What does it actually mean to those that take medicines. QMAIYj4&feature=youtu.be

22 NICE Guideline (NG 5) Medicines Optimisation NG Definition used in the guideline: a process that aims to ensure a personcentred approach to safe and effective medicines use, enabling people to obtain the best possible outcomes from their medicines Topic areas covered: Systems for identifying, reporting and learning from medicines-related patient safety incidents Medicines-related communication systems when patients move from one care setting to another Medicines reconciliation Medication review Self-management plans Patient decision aids used in consultations involving medicines Clinical decision support Medicines-related models of organisational and cross-sector working

23 Safety - Preventable medicines harms Prescribing errors in general practice 1 in 20 items with an error 1 in 550 with a serious error 1 billion items in 2012 = 1.8 million serious prescribing errors Preventable medicines related admissions to hospital 4.68% of emergency admissions 250,000 admissions >50% of these admissions were associated with the following groups of drugs: anti-platelets, diuretics, NSAIDs and anticoagulants

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25 Patient Safety Topics

26 NICE CG Current prescribing of anticoagulants for AF in England Treatment Percentage of AF Population Number of people No treatment 28.99% 258, 000 Aspirin 22.49% 200,000 Warfarin 34.32% 305,000 NOACS 14.20% 126,000 NICE Costing report: AF (2014) IMS Disease Analyser 2012/13 and GRASP-AF database download April 2014

27 Why is this not safe 1 in 6 strokes occurs in people with AF Of the next 10 patients with AF who have a stroke: 8 would have been known to be high risk of stroke 6 should have been on warfarin / NOAC 3 will go home 5 will end up in supported care 2 will die...

28 TELL ME Would you want to save 365 AF related Strokes before this time next year in Greater Manchester?

29 THE CASE FOR CHANGE - SHARE DATA Reflect our members data back Equal and equitable access Discuss variation with a fair comparison Percentage Absolute numbers Per 100k population ONS matched PHE matched

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31 PREVALENCE AND INCIDENCE Quality Outcomes Framework* (QOF) AF disease register Stroke register *Publically available data

32 THE NUMBER AND COST OF STROKE Hospital Episode Statistics* (HES) *Publically available data

33 PATHWAY OF CARE Hospital Episode Statistics* (HES) Admission route From where to where Discharge destination to home or to a home *Publically available data

34 DATA ON THOSE THAT HAVE AN AF RELATED STROKE Sentinel Stroke National Audit Programme* (SSNAP) *Publically available data

35 APPROPRIATE TREATMENT OF THOSE AT RISK GRASP-AF* Read code data interrogation tool Helps to find patients that could benefit from anticoagulation treatment *Available from NHS IQ

36 TREATMENT epact (electronic Prescribing Analysis and CosT)* By drug By pack By practice Great for NOACs Useless for warfarin and aspirin *Publically available data

37 TREATMENT epact (electronic Prescribing Analysis and CosT) Drug By pack By practice Great for NOACs Useless for warfarin and aspirin Publically available data

38 THE MISSING PIECE WAS - ANTICOAGULATION CONTROL WITH VITAMIN K ANTAGONISTS NICE Guidance (CG180) 2 INR values higher than 5 or 1 INR value higher than 8 within the past 6 months? 2 INR values less than 1.5 within the past 6 months? TTR less than 65%? But we now have that data too!!

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40 In a Devolved GM System the ambition is to: Have 64,000 less people with chronic condidtions 10% less visits to urgent care 700,000 people with chronic conditions able to manage their health in a way that suits them

41 CALL TO ACTION THE GM AHSN NEEDS YOU! So we have the ambition, the data, the case for change... the Ecosystem now needs to respond and enable step change, system wide solutions that deliver at pace and scale

42 Discussion Groups 1) How Can Connected Health Help Address Patient Safety/ Medicines Optimisation & Vascular Disease? 2) How can the Manchester Ecosystem best engage to deliver @Man_Inf #McrEcosystem

43 Networking Lunch & Market Place

44 Health Innovation Manchester

45 What are we trying to solve? Despite UK reputation in healthcare research & innovation, the UK is slow to adopt innovation into routine practice Missed opportunity to improve care and close funding gaps Greater Manchester has great organisations across different sectors, but the system is highly fragmented and doesn t function as a coherent system. As a consequence: Areas of excellence are not leveraged widely Resource allocation not optimised across the system Duplication & gaps We don t exploit potential synergies Potential industry collaboration & investment not optimised Potential for the region (& UK) not realised

46 Our Vision To transform the health of our population by driving research and innovation into daily practice Our Purpose (What we intend to do) Driven by the health needs of our population and working in partnership we will mobilise a system wide approach to the discovery, development and delivery of innovation across Greater Manchester for the benefit of all

47 We will do this by Develop GM into a world-leading health innovation ecosystem Cohere, leverage and build-upon existing foundation organisations Deliver common goals that no single organisation can do alone System thinking & co-ordination Like the tactics for a football team Build the network / ecosystem so that people feel part of something greater than just their own institution Seamless, simple industry interface, aligned with our needs / strengths

48 Close collaboration across H&SC providers, Academia and Industry is key to delivering our vision Health & Social Care Providers Health Innovation Manchester Academia Industry

49 Initial Priorities for Health Innovation Manchester: Developing an innovation ecosystem centred around clinical validation & rapid scaled implementation Precision Medicine Clinical Trials Health Informatics Innovation into Clinical Practice Coordinated Business Engagement Networking / Community Build / Communications

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51 Health North: Connected Health Cities Powering UK Health and Wealth Transformation John Ainsworth October 2015

52 Life expectancy at birth, UK, to from period life tables Source: ONS

53 The next government will inherit an NHS that faces growing pressures on all fronts. It will need to act quickly to ensure that there is sufficient funding to sustain as well as transform services in the next parliament. The NHS is working at or very close to its limits and patient care will suffer unless more resources are found.

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55 1. Valderas JM, et al. Defining comorbidity: implications for understanding health and health services. Annals of family medicine; 7(4): Fortin M, et al. Randomized controlled trials: do they have external validity for patients with multiple comorbidities? Annals of family medicine 2006 Jan

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57 Sci Transl Med Nov 10;2(57):

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59 Healthcare Evidence History Evidence Evidence Evidence Debate Translation System Practice Practice Practice Scientific basis of medicine Evidence based care Learning health systems Sci Transl Med Nov 10;2(57):

60 Vision The world s first civic partnerships exploiting data: drive public sector reform for better health and care by providing actionable information fuel region-wide health science that citizens trust accelerate business growth for the digital health revolution

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62 Connected Health City: Ark-enhanced Information Flows Services Public sector encounters Targeted by need Data Targeting Tools Which services and how? Ark Involved Citizens Problem Owners Data Managers Public Health Analysts Care Service Analysts Statisticians Informaticians Social Scientists Health Economists Health Service Researchers Communications Experts Farr Institute & NIHR Centres Spin-in/out Laboratory SME Insights Global Corp. Service Planning and Policy

63 Ark Integration for Combinatorial Innovation in Health Data Analytics 2015: Dilute, Duplicated Data Processing 2020: Ark Integrated Data Processing Literature Literature Raw Data One size fits all Policies Raw Data Policies Extract, clean, describe x 5 NHS Commissioning NHS Quality Intelligence Public Health Intelligence Social Care Management Research and Innovation Extract, clean, describe x 1 Ark Public Involvement Targeting System NHS Commissioning NHS Quality Intelligence Public Health Intelligence Social Care Management Self-care and Personal Health Combinatorial Research and Innovation Transparent Interface with Industry

64 Interpret Results Analyse Data Deliver Tailored Message Learning Health System Cycle Assemble Data Take Ac on To Change Prac ce Collect Data Initiate A health system organised to optimise the delivery of care based on the evidence produced through delivering care.

65 Feedback Ark Care Pathway Analyser: Care Opportunities Detector Exclude if quality standard inappropriate Find patients with target disease Exclude if quality standard achieved Identify how care could be improved e.g. chronic Kidney disease e.g. terminal illness e.g. blood pressure target e.g. drug treatment optimisation Health System Integrated Care Record Secure Web Interface Practice-level Audit + Patient-level Decisions GP + Hospital Data; then + Pharmacy + Social Care + Self-reports, sensors & apps Care Professionals (+ Patients *future+)

66 Data Action Latency Time Data Production Data Action Latency Data Production Analysis Redesign

67 Outcomes Civic partnerships Effective model for patient and public involvement Four pilot CHCs Blueprints and plans Test learning health system methodology Understand data needs Workforce Increase capacity Innovation Model for driving economic growth Response to the needs of industry

68 Public Empowerment & Trust Innovation Intelligence Evidence Records Informatics

69 ERDF : Science Commercialisation Call Helen Wilding, Deputy Director, Business and Science New Economy 7 October 2015

70 GM EU Structural and Investment Funds Types of investment 356m Competitive Places ( 22m ERDF) Sites / premises Critical infrastructure Competitive Business ( 70m ERDF) Start up & Growth Business Finance Internalisation Leadership & Management Science & Innovation ( 52m ERDF) Science tech assets (capital) Tech business base (revenue) Science Tech Skills (ESF) Low Carbon ( 50m ERDF) LC investment vehicle LC infrastructure e.g. Heat Networks LC transport Low Carbon skills Whole building efficiency European Social Fund ( 161m ESF) The following summarise the key thematic objectives (TOs) proposed by Government for ESF activity : Promoting employment and supporting labour mobility Promoting social Inclusion and Combating Poverty: Active inclusion in particular with a view to improving employability Investing in education, skills and lifelong Learning

71 Calls already issued Competitive Places ( 22m ERDF) Science & Innovation ( 52m ERDF) 1. Asset base science infrastructure ( 15m) 2. Innovation ( 3.95m) broad purpose is to provide universal innovation advice to SMEs 3. Asset Base Science Infrastructure ( 4m) second round following allocation of 11m in first call Competitive Business ( 70m ERDF) 1. MAS and UKTI national ( 5.75m) 2. Sector Programmes / Manufacturing Advisory Service / Low Carbon Support ( 4.495m) 3. Growth Hub & Services ( 4.55m) 4. Start Up Support ( 3m) 5. Access to Finance ( 1M) Low Carbon ( 50m ERDF)

72 Update & Timings Currently negotiating IB status with Government Timetable for future calls unclear CLG currently working on timetable IB should give us control over timing and content of calls Still awaiting output definitions and allocations Exchange rate changes may impact the ERDF allocation

73 Strategic Context: Science & Innovation Greater Manchester Strategy prioritises placing our city region at the leading edge of science and technology Evidenced world-leading strengths in advanced materials and health innovation converging with a thriving digital technology business base 60,000+ Science + Tech employees in GM + 100,000+ in manufacturing Circa 100,000 students across 5 HEIs one of the largest student populations in Europe University of Manchester in UK s top 5 for research (REF 2014) Graphene City leading the translation of discovery into economic gain Home of the national Cancer Research UK Institute Corridor (Innovation District) employs 60,000 people, home to largest biomedical campus in Europe, generating c 3.0bn GVA pa Key challenge Translating world leading fundamental research into economic growth, increasing productivity of our business base

74 Science & Innovation: key issues Despite science excellence levels of company innovation and productivity in GM remain low. Particular issues include low levels of Innovate UK investment, R&D expenditure and product or process innovation We need to bridge the gap between cutting edge science within academia and levels of innovation within GM s business base encouraging knowledge exchange and collaborative working We need to increase levels of entrepreneurship and business formation amongst graduates of GM s HEIs Removing gaps in critical pathway from invention to successful commercialisation is crucial - bridging valley of death Throughout the UK there is an evidenced lack of investment in early forms of support for scientific businesses in the UK

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76 Objectives: science commercialisation call Activity will centre on growing GM s science and technology business base linked to our key areas of excellence. Supporting companies to innovate, exploit commercialisation opportunities and leverage GM s key assets is key. This includes driving closer linkages between HEIs, the NHS and the commercial sector. We expect to see specialist support to bring new products and processes to market including; Industrial Research & Development Projects Early stage investment in scientific discoveries Knowledge Transfer Commercial exploitation of new scientific developments arising from the HEI knowledge base

77 For Discussion: indicative actions (GM call) Industrial Research & Development Projects Support SMEs to research and develop technologically innovative products Collaborative / applied research projects linked to GM s smart specialisation strengths Programmes for current and future technologies and support to develop prototypes Early stage investment in scientific discoveries Investing in proof of principle and pathfinder projects in GM s areas of scientific strength Stimulating and de-risking graduate start-ups and spin-outs Knowledge Transfer Knowledge transfer programmes particularly linked to key growth areas / technology development Particularly interested in approaches that bring teams together from across disciplines to solve business issues Exploiting new scientific developments arising from the HEI knowledge base Outreach to help companies / entrepreneurs think about how developments in HEIs might help them to innovate including support to exploit commercial potential of new scientific developments

78 Questions?

79 Panel Q & #McrEcosystem

80 Thanks for attending the October 2015 Ecosystem- GM AHSN Meeting. Next Meeting: 14 th January 2016