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Structure of Health care in the Netherlands Country In Western Europe and 4 islands in the Caribean 17 million inhabitants, 0.2% the size of Russia 90 hospitals, 1200 cardiologists Healthcare Mandatory to purchase a baselevel of insurance Free to choose own insurer and to chance once a year Covers family doctor, hospitalisation, treatment costs 10% of the gross domestic product (€5000/inhabitant)
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Improving prevention
Improve prevention: connect patients to lifestyle community networks, clinical pathways and new technology.
Victor AWM Umans MD PhD FACC
Medical Center Alkmaarthe Netherlands
History of improving infarct outcomes
Vulnerable pts need:
healing environmentknowledgeH2H program
e-adviceeasy access
healthy lifestyle
Critically ill pts need:
Innovation
Structure of Health care in the Netherlands
Country In Western Europe and 4 islands in the Caribean 17 million inhabitants, 0.2% the size of Russia 90 hospitals, 1200 cardiologists
Healthcare Mandatory to purchase a baselevel of insurance Free to choose own insurer and to chance once a year Covers family doctor, hospitalisation, treatment costs 10% of the gross domestic product (€5000/inhabitant)
Cardiovascular health status in the Netherlands
CVD mortality and morbidity: 147 per 100.000 among the lowest in Europe appr: 730.000 CHD, 260.000 AF and 120.000 HF patients
Population changes over time
Who are vulnerable and at risk
Population Determinants are:
Jobless
Low income
Low education
Handicapped
7 years shorter life expectancy compared to the high-educated persons
Why and how to prevent
Why 28% of all Dutch deaths are cardiovascular driven Mainly Coronary Artery Disease, CVA and Heartfailure Lost years-to-live: 11 yrs for men, 9 years for women
How
Population Groups at risk High-risk individuals Patients
Universal and selective prevention
Dutch government and municipalities
Actions to create public communities
National Prevention Compass Promote health and prevent disease in the environment
Healthy school and Young people with Healthy Weight Campaign on healthy food and environment
Alliance Netherlands Smoke-free Create communities for people who stop smoking Restaurants and public buildings 100% smoke-free October is smoke alert month: www.STOPTOBER.nl
Population Groups at risk High-risk individuals Patients
Indicated prevention
Dutch Heart Association and Health Care Insurers
Actions to create clinical pathways
CardioVascular Risk Management Guidelines and Standard Operation Forms for Risk Managment
Chronic Care Model Model to introduce yearly controls in high risk groups Use of internet-accessible personal records
Population Groups at risk High-risk individuals Patients
Care related prevention
Personal digital record
Care related prevention
Cardiologists and nurses
Actions to create patient networks
Hartvolgers.nl
StopAFib.org
Social media groups for education Forum, blogs, you-tube, live chat
Population Groups at risk High-risk individuals Patients
Care related prevention
Cardiologists and nurses
Hartvolgers.nl
Care related prevention
Cardiologists and nurses
Actions to create new technology networks
Wearables Horizons 2020 project Heart Rehabilitation by phone TEXTme trial on lifestyle text messages JAMA 2015;314:1255
Smart Networks Philips Motiva HeartFailure support @ home
Smart Cooking Rehabilitation programs with Weight Watchers Cooking with Jamie Oliver and Philips HomeCooker
Population Groups at risk High-risk individuals Patients
Care related prevention
Cardiologists and nurses
WearablesHorizons 2020 project Heart Rehabilitation
@home
TEXTme trial JAMA 2015:Text messages improved lifestyle adherence
Care related prevention
Cardiologists and nurses
Smart Networks
Philips Motiva HeartFailure support @ home
Use of IoT communication for Atrial Fibrillation
Care related prevention
Cardiologists and nurses
Smart Cooking
Cooking with Jamie Oliver and his HomeCooker
‘the device has been developed byJamie Oliver as part of his mission to get more of us to eat fresh home cooking on a regular basis’
Take home messages
to create healthy populations
It starts with early education
Connect secondary prevention with primary prevention through the healthy living concept