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‘How Can Connected Health Improve Patient Pathways?’
7th October 2015 The Landing, Media City
@Man_Inf #McrEcosystem
The Global Connector
www.echalliance.com / [email protected]
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 7th October 2015 - Manchester
3
About ECHAlliance
Non-Profit Organisation (Community Interest Company)
3
300+ member organisations Companies, policy-makers, researchers,
health & social care providers, patients, insurances, etc.
12,000+ community
International Network of Ecosystems
30+ countries (Europe, USA, China)
International Events (leadership, mobile world congress, EU-US Marketplace)
EU Projects (lead & partner)
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
“
”
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
Unrivalled Reach and Expertise
ECHAlliance Ecosystems Programme
Ecosystem Programme basic principles
Geographic coherence
Multi-stakeholders
Permanent
Regular meetings, workshops
“eHealth” strategic agenda/plan
Governance through working group(s)
Ecosystem Reach
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
~100 Ecosystems meetings per year in Europe
8
Events, workshops,
webinars Community Database
(profiles)
Marketplace / Showroom (solutions, success stories,
assessment results)
Virtual matchmaking
Collaborative work
tools (shared docs, chat/email tool…)
Business Intelligence tool (market data, description & contacts,
tenders, calls of projects, opportunities)
Education and training (Publications, event presentations…)
ECHAlliance
Connector
ECHAlliance Connector
Management
ECHAlliance
website
Inter-Ecosystem Working Groups
Learn more contact [email protected]
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 13th in Estonia for key stakeholders
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.
22 Feb
23 Feb
24 Feb
25 Feb
4YFN conference dedicated to innovative start-ups/SMEs, and investors
Conferences and workshops: high level programme includes
international leaders in the health and wellness sector.
Conferences and workshops: high level programme includes
international leaders in the health and wellness sector at Mobile World
Congress
- Personalised programme of sites visits & B2B matchmaking
- Explore the large Mobile World Congress exhibitions in Fira Gran Via
Health & Wellness @ MWC 2015 Health & Wellness @ MWC 2015 Health & Wellness @ MWC 2015 Health & Wellness @ MWC 2015 Digital Health & Wellness Summit – Barcelona 2016
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)
Roadshow across:
- Europe (25+ countries & regions),
- North America (USA & Canada)
- China
From September 2015 to February
2016
Great Final @ Digital Health &
Wellness Summit 2016
Health & Wellness @ MWC 2015 Health & Wellness @ MWC 2015 Health & Wellness @ MWC 2015 Health & Wellness @ MWC 2015 Digital Health & Wellness Summit – Barcelona 2016
www.echalliance.com / [email protected]
Contacts Brian O’CONNOR, Chair – [email protected]
Liz ASHALL-PAYNE, Outreach Co-ordinator- [email protected]
Julien VENNE, Strategic Advisor – [email protected]
Damian O’CONNOR, Director of Operations – [email protected]
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 www.echalliance.com
GM AHSN Introductions and Priorities
Professor Donal O’Donoghue
Medical Director GM AHSN
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.
Greater Manchester AHSN – Local context
GM AHSN footprint
4 Universitie
s
1 Ambulance Service
Executive team
Mike Burrows Managing Director
• Martin Gibson
• Gary Leeming
• Sarah Thew
Research and Informatics
• Linda Magee
• Keith Chantler
Industry and Wealth
• Donal O’Donoghue
• Jane Macdonald
• Cara Afzal, Dai Roberts, Zulfi Jiva
Health and Implementation
Health and Implementation
1. Cardio-vascular Disease
– Atrial Fibrillation
– Familial Hypercholesterolaemia
– CKD, as a marker of vascular risk
2. Patient Safety
– Medicines Optimisation
Medicines Optimisation / Patient Safety
Jane Macdonald
Director of Nursing and Improvement
GM AHSN
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
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.
• 30-50% of medication
are not taken as intended
• 5-8% of hospital admissions are caused by preventable adverse reactions to medicines.
Medicines Optimisation
What does it actually mean to those that take medicines …….
https://www.youtube.com/watch?v=84C0QMAIYj4&feature=youtu.be
NICE Guideline (NG 5)– Medicines Optimisation NG5 2015 Definition used in the guideline: ‘a process that aims to ensure a person-centred 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
Safety - Preventable medicines harms in general practice
• Prescribing errors 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
Patient Safety Topics
NICE CG 180 - 2014
Current prescribing of anticoagulants for AF in England NICE Costing report: AF (2014) IMS Disease Analyser 2012/13 and GRASP-AF database download April 2014
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
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....
TELL ME …
Would you want to save 365 AF related Strokes before this time
next year in Greater Manchester?
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
PREVALENCE AND INCIDENCE
*Publically available data
Quality Outcomes Framework* (QOF) • AF disease register • Stroke register
THE NUMBER AND COST OF STROKE
*Publically available data
Hospital Episode Statistics* (HES)
PATHWAY OF CARE
*Publically available data
Hospital Episode Statistics* (HES) • Admission route • From where to where • Discharge destination – to home or to a home
DATA ON THOSE THAT HAVE AN AF RELATED STROKE
*Publically available data
Sentinel Stroke National Audit Programme* (SSNAP)
APPROPRIATE TREATMENT OF THOSE AT RISK
*Available from NHS IQ
GRASP-AF* • Read code data interrogation tool • Helps to find patients that could benefit from anti-
coagulation treatment
TREATMENT
*Publically available data
ePACT (electronic Prescribing Analysis and CosT)* • By drug • By pack • By practice • Great for NOACs • Useless for warfarin and aspirin
TREATMENT
ePACT (electronic Prescribing Analysis and CosT) Drug By pack By practice Great for NOACs Useless for warfarin and aspirin Publically available data
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 …!!
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
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
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 better outcomes?
@ @ @Man_Inf #McrEcosystem
Networking Lunch & Market Place
Health Innovation Manchester
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
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
• 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
We will do this by
Health Innovation
Manchester
Close collaboration across H&SC providers,
Academia and Industry is key to delivering
our vision
Health & Social Care Providers
Industry Academia
Precision Medicine
Clinical Trials
Coordinated Business Engagement
Networking / Community Build / Communications
Health Informatics
Innovation into Clinical
Practice
Initial Priorities for Health Innovation Manchester:
Developing an innovation ecosystem centred around clinical
validation & rapid scaled implementation
www.healthinnovationmanchester.com
@healthinnovmcr
Health North: Connected Health Cities
Powering UK Health and Wealth Transformation
John Ainsworth [email protected]
October 2015
Life expectancy at birth, UK, 1980-82 to 2008-2010 from period life tables Source: ONS
“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.”
http://www.who.int/features/2013/amr_conserving_medicines/en/
1. Valderas JM, et al. Defining comorbidity: implications for understanding health and health services. Annals of family medicine; 7(4):357–63. 2. Fortin M, et al. Randomized controlled trials: do they have external validity for patients with multiple comorbidities? Annals of family medicine 2006 Jan
Healthcare Evidence History
Evidence
Practice
Debate
Evidence
Practice
Translation
Evidence
Practice
System
Scientific basis of medicine
Evidence based care
Learning health systems
Sci Transl Med. 2010 Nov 10;2(57):
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
Connected Health City: Ark-enhanced Information Flows
Data
Public sectorencounters
Services
Targetedby need
TargetingTools
Ark
Involved CitizensProblem OwnersData Managers
Public Health AnalystsCare Service Analysts
StatisticiansInformaticians
Social ScientistsHealth Economists
Health Service ResearchersCommunications Experts
Service Planning
and PolicyInsights
SME Global Corp.
Which services and how?
Spin-in/out Laboratory
Farr Institute & NIHR Centres
Ark Integration for Combinatorial Innovation in Health Data Analytics
2015: Dilute, Duplicated Data Processing 2020: Ark Integrated Data Processing
NHS Commissioning
Research and Innovation
Public Health Intelligence
Social Care Management
RawData
NHS Quality Intelligence
Extract, clean, describe x 5
One size fits all
Ark
Public Involvement
NHS Commissioning
NHS Quality Intelligence
Public Health Intelligence
Social Care Management
Self-care and Personal Health
RawData
Extract, clean, describe x 1
CombinatorialResearch and Innovation
Literature
Policies
Literature
Policies
Targeting System
TransparentInterface
with Industry
1
2
3
4
5
6
Learning Health System Cycle
Initiate CollectData
AssembleData
AnalyseData
InterpretResults
DeliverTailoredMessage
TakeAc onToChange
Prac ce
A health system organised to optimise the delivery of care based on the evidence produced through delivering care.
Feedback
Integrated Care Record
Care Pathway Analyser: ‘Care Opportunities Detector’
GP + Hospital Data; then + Pharmacy+ Social Care + Self-reports, sensors & apps…
Find patients with target
disease
Ark
Practice-level Audit
Patient-levelDecisions
Exclude if quality standard
inappropriate
Exclude if quality standard
achieved
Identify howcare could be
improved
Health System Secure Web Interface
+
Care Professionals(+ Patients *future+)
e.g. chronicKidney disease
e.g. terminalillness
e.g. blood pressuretarget
e.g. drug treatmentoptimisation
Data Action Latency
Time
Data Production
Analysis
Data Production Data Action Latency
Redesign
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
Reco
rds
Eviden
ce
Intelligen
ce
Inn
ovatio
n
Informatics
Public Empowerment & Trust
ERDF 2014-20: Science
Commercialisation Call
Helen Wilding, Deputy Director, Business and Science
New Economy
7 October 2015
GM EU Structural and Investment Funds 2014 – 2020
Types of investment £356m
Competitive Places (£22m ERDF)
Sites / premises
Critical infrastructure
Science & Innovation (£52m ERDF)
Science tech assets (capital)
Tech business base (revenue)
Science Tech Skills (ESF)
Competitive Business (£70m ERDF)
Start up & Growth
Business Finance
Internalisation
Leadership & Management
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
2014-20:
•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
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)
Calls already issued
• 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
Update & Timings
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
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
• 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
Objectives: science commercialisation call
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
Panel Q & A
@Man_Inf #McrEcosystem
Thanks for attending the October 2015 Ecosystem- GM AHSN Meeting.
Next Meeting: 14th January 2016
