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Innovative Practice In Using ICTWorking Together To Improve The
Patient Journey
Dr Roy HarperConsultant Physician and Endocrinologist
The Ulster Hospital (SET)
Visiting Professor, School of Computing and Mathematics, University of Ulster
I Can’t Function NowWithout ICT
Passionate About ?
• e-health / telehealth / telemedicine will transform healthcare (chronic disease)
• Admired exemplars• Feel for this future• Pilots up and running• Integrating new approaches into
clinical care• Developing and testing ‘prototypes’
University of UlsterFaculty of Computing & Engineering
School of Computing and Mathematics
Using ICT effectively to enhance patient care
In collaboration with -
Diabetes in the UK is Increasing
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
1940 1960 1980 1996 2004 2005 2010
Mill
ions
of p
eopl
e
with
dia
bete
s
Adapted from: 1. Diabetes UK. Diabetes in the UK 2004. Diabetes UK, London, 2004.2. Diabetes UK. State of the Nation 2005. Diabetes UK, London, 2005.
EHSSB 3.1%
Ards 3.4%
North Down 2.9%
The News is Good
• Complication rates can be reduced using current treatments
• Shortfall in life expectancy can be reduced
• Patient self-management is the key
• Supported by well organised local diabetes care services
The Answer Lies in Self-Management
• Patient Empowerment through
• Patient Education & Training leading to
• Patient ‘Experts’
• Reliable up-to-date information and regular feedback on progress – essentials in enabling effective self-care in diabetes
The Challenge of Diabetes
• Sheer numbers• Care now complex• Too little time• No intensive ongoing input / support • Large amounts of self care data
but…………• Limited ability to achieve therapeutic
targets• Infrequent therapeutic interventions
ICT can help in so many ways
Supporting Patient Education
Direct Patient Monitoring and Support
Clinical Information and Management Systems
Promoting Healthy Living / Disease Prevention
• Patients increasingly need (and demand) ready access to feedback on their progress with advice from HCPs
• Ongoing Support and Regular Feedback on Progress
Home (self) monitoring technologies can transform episode driven health services into a relationship based
continuum of care
E A Balas 1999
Evidence that ‘Telehealth’ works?
• Improves outcomes - prevents hospitalisation, improves QOL, improves health status
• Economically viable
• Improves patient (and HCPs) satisfaction
• The time for ‘pilots’ is over
Transformation from Industrial Age Medicine to Information Age Connected Healthcare
Source: Adapted from Malaysian Telemedicine Blueprint
Industrial Age Medicine Information Age Medicine
TransformationThrough Cost-Effective
Use of Information & Communication Technologies
Person
Community
Primary
Secondary
Tertiary
Individual Self-Care
Friends and Family
Community Networks
Professionals as Facilitators
Professionals as Partners
Professionals as Authorities
Let’s Develop Better Solutions
• Diabetes portal – web• Virtual diabetes clinic• Linked (intrinsic) Glucometer• E-glucose diary with feedback• Store and forward• Decision support• Alerts to carers / HCPs• Physical activity monitor• Medication reminders• Phone, Music, Camera,
Health Monitor• Etc…..
Lets Get ‘Connected’
• See e-health / telehealth / telemedicine transform healthcare (chronic disease)
• Share the feel for this future• Stop talking about getting ‘pilots up and
running’• Integrate new approaches into clinical care• Develop, test, and promote better solutions
• Seek out collaborators• Seek out support• Share our expertise
