WELCOME

Steven Dodsworth Head of Life Sciences, HIE HIE Updates

Dr George Crooks Chief Operating Officer,NHS 24 Telehealth Deployment at scale; Opportunties and Challenges:

TELEHEALTH Deployment at Scale Opportunities and Challenges Dr George Crooks OBE 24 th August 2011

Efficiency Productivity

1 The NHS in Scotland is facing growing demand for its services and NHS boards need to consider new models of care such as telehealth to help manage current and future demand. Targeted appropriately, telehealth offers the potential to help NHS boards deliver a range of clinical services more efficiently and effectively. NHS boards should consider the use of telehealth when introducing or redesigning clinical services.

NHS boards should: ensure that telehealth initiatives are supported by business cases that consider the long-term clinical, organisational and cost benefits resulting from the use of telehealth

We estimate that telehealth management of COPD patients at home might help NHS boards avoid costs of around £1,000 per patient per year, mainly from lower hospital admission rates. This may not equate to cost savings unless the telehealth initiative is on a large enough scale to reduce hospital

17 Additionality

18 Substitution

Something Interesting……

European Union Citizens 65+81m (2008) 151m (2060) 86%

Number of Carers↓ Number requiring care

and another FACT……..

2012 1,000,000,000,000 (trillion) devices connected to the internet

USA 31/12/10 Majority of Internet Access is by Mobile Devices

Scottish Assisted Living Programme Phase One: DALLAS (Demonstrating Assisted Living Lifestyles at Scale)

WHY?

Number of Carers↓ Number requiring care

Long Term Conditions 80% of GP consultations x2 as likely to be admitted to hospital 60% of hospital bed days

Diabetes 5% of EU population NOW 15% of world population by 2025

COPD in Scotland 2007 to % rise or 99,139 to 127,188 patients

Monitoring patients with COPD at home may help NHS boards avoid costs of around £1,000 per patient per year Prepared for the Auditor General for Scotland August 2011

The Solution……………

internet TV telecare Face 2 Face SMS video mobile

SCOTTISH DALLAS

Strategic Requirements The Scottish DALLAS Programme will: –Satisfy and deliver the programme goals set by the Technology Strategy Board –Be designed to deliver the National Telehealth Strategy for Long Term Conditions in partnership with local health & care partnerships –Aim to achieve the innovation potential of the programme through partnership with the Scottish Enterprise Companies –Be sensitive to and supportive of wider national and European strategies –Provide an effective, widely adoptable choice for users and carers

Programme Features ‘Team Scotland’ approach Trail blazer for Scotland-wide roll out, not individual ‘projects’ A true national deployment – 10,000 users minimum Build on Scottish successes in Telecare/health Incorporate lessons learned Evidence-based implementation Leave a legacy beyond programme

Programme Process The programme will tackle difficult implementation tradeoffs by: –Taking a lifestyle perspective – not just monitoring –Adopting technology to enable service innovation and evidence-based service evolution through the programme lifetime –Involve key practitioners, technologists, service users and carers in shaping the programme –Aim for substitution rather than additionality to tackle real need

Programme Process The concern is to balance the tradeoffs between: –The needs of current services: Support front line services Careful management of primary care workload –Demonstrable impact: Responsive systems, Seamless escalation Support/sustain more people at home –Working with suppliers An element of innovative competition Shaping the market

Competition Design –Documentation - what success will look like and the challenges the winners must tackle. –One key challenge is to balance: The needs of the cared-for/carer in developing a sustainable, independent, lifestyle The aspirations of the health and care teams by ensuring that essential control remains with the local team and the service users The economies of scale/cost benefits that must be realised to meet the demographic challenge –Ensure the fittest companies win to maximise: Job creation & economic opportunities Opportunities for SME’s

Technology –Based on commodity systems –Supports mobility –Supports service innovation and incremental evolution of deployed services –Rapid and simple deployment –Good diagnostics and accessible repair in the community –Provides a platform for a range of innovations –Usable with little or no training

Shared Learning –Must harmonize with DALLAS evaluation across UK wide sites –Impact assessment will be built in –Will not be a randomised control trial –Capture & disseminate experience as progress –Evidence will drive service innovation and evolution of deployed services –Complementary research opportunities –Share learning & support all of Scotland!

The European Innovation Partnership Healthy and Active Ageing

P4 Pitching Sessions

P4 Spotlight Sessions Vector 76

Dave Heaney P4 Spotlight Sessions Centre for Rural Health

European Union European Regional Development Fund Innovatively investing in Europe’s Northern Periphery for a sustainable and prosperous future Implementing Transnational Telemedicine Solutions (ITTS) P4 Digital 2 nd /3rd November 2011

European Union European Regional Development Fund Innovatively investing in Europe’s Northern Periphery for a sustainable and prosperous future Existing work from previous project : Competitive Health

Inverness Scotland Tromsø Norway Oulu Finland Umeå Sweden Teledialysis Wound care EyeMo The Bag Speech therapy

Teledialysis

After… Dialysis patients see the consultant remotely via VC in alternate months More time freed up for outpatient clinics Urgent consultations can take place by video – this may save patient travel Twice weekly nursing updates between Wick and Inverness by video link Nurses join in education and training remotely Dieticians, pharmacists and the physiotherapist plan to use the link too Selected outpatients may be offered video appointments in future

A few statistics… March – September 2010 Routine staff updates 37 Virtual ward rounds (patient/doctor consultations) 38 In-house training 8 Unscheduled consultations 2

example of travel savings resulting from Teledialysis in Highland Unnecessary journeys by new out-patient referrals have fallen from 76% to 4%, maintaining local care provision and saving 6,180 miles of patient travel annually with associated carbon emission reductions of approximately 2,445kg CO 2 e

European Union European Regional Development Fund Innovatively investing in Europe’s Northern Periphery for a sustainable and prosperous future New Project : ITTS

European Union European Regional Development Fund Innovatively investing in Europe’s Northern Periphery for a sustainable and prosperous future Partners Scotland: Centre for Rural Health + NHS Highland + NHS Orkney Norway: Norwegian Centre for Integrated Care and Telemedicine Finland: OuluArc Subregion Sweden: County Council of Västerbotten Ireland: Smart Assisted Ambient Living, University of Galway N. Ireland: European Centre for Connected Health

ITTS Demonstrators VC links for speech therapy services VC links for renal services VC links for emergency psychiatry services. VC links for remote diabetes services Smart phones for tracking physical activity Smart phones and internet support for diabetes Smart phones for inflammatory bowel disease Remote support in medical and social care emergencies Remote exercise classes for rehabilitation Home based service delivery for patients with multimorbidity.

Argyll P4 Spotlight Sessions

Specialist Risk Technology & Service Provider Specialist Risk Monitoring Provider Engaged by Industry and Stakeholders Commercial Model – Partners - Vertical Sectors Specific Focus – Global Healthcare & Public Safety About Argyll

1.6 million employees within social care (includes 678,000 statutory paid duty providers) 30,000 care provider organisations employ 922,000 employees 61% older people services (559,000) 19% disabilities services (177,000) 13% childrens services (123,000) 7% mental health services (63,000) 2011 figures indicate drop of 4% in public sector Scotland 198,000, Wales 70,000, Northern Ireland 30,000 5 million unpaid carers and 2 million service users - but growing! Statistics

Auditing Quality of Care Managing Delivery of Service Management of Duty of Care The Challenges

PRiSM – for management of risk Companion – for end users & lone workers PocketCare – for Care Delivery Service Providers Archangel – for Stakeholders A Solution.....

Intelligence Sharing & Partnership Working Staff Confidence & Support PRiSM Incidents & Corporate Risk Integrated Risk Management - PRiSM Secure Internet Service – No Capital Outlay Shared Risk Data Geo-Centric Marker Tailored Marker Types (eg Violence, Weapons, Alzheimers etc) Proactive Alerts

Companion – intelligent monitoring Mobile and Body Worn Device – DDA compliant Platform Controlled Risk Management 2-way Communication Between End User and Responder Fall Detection and Location Technologies Lightweight (c25g) and 24 Hours between recharge

Smartphone Calendar Appointments into Job Assignments Capture/Sync Notes & Multimedia GPS to Audit Service Delivery Export/Integrate to CRM/EPR systems PocketCare

All-in-one solution for recording, storing and retrieving mobile voice and data communications Secure Internet Service SIM based or Application Based options Meet FSA Policy Statement 10/17,14 th November deadline, without cost or complexity of on-premise solutions Extensible platform to deliver long-term value ✔ FSA compliant Mobile Call Traffic Recording

Archangel - Integrated Care Solution Scalable Secure Internet Services – no capital outlay Combined Lone Worker and Vulnerable Person Risk Monitoring Platform Integrated Map Tools & Reports Flexible and Intelligent Call Handling & Routing Simple Integration with Back Office Systems (eg HR records; medical records) via 3 rd party API

Incident Response - Argyll ARC

The Benefits Estimated 20% increase in patient contact Shared and Common Service Platform Integrated Care Services Local Stakeholder Engagement

Commercial models for Telehealth- An Industry View Tony Bowden Business Development Director,iSOFT A CSC