1. Consumer Driven Healthcare John Church CEO Arthritis Ireland

2. Arthritis – a Major Population Health Issue Any Condition Blood Pressure Arthritis High Cholesterol Asthma Chronic Pain Infections Heart Disease Diabetes Depression Cancer Osteoporosis Other Mental Illness Other Serious Illness 2008 2005 1,370,000 1,185,000 355,000 339,000 349,000 310,000 245,000 218,000 196,000 177,000 99,000 137,000 135,000 98,000 156,000 90,000 138,000 87,000 75,000 78,000 55,000 48,000 102,000 46,000 16,000 9,000 98,000 95,000 2008 2005 2008 2005 2008 2005 2008 2005 2008 2005 2008 2005 2008 2005 2008 2005 2008 2005 2008 2005 2008 2005 2008 2005 2008 2005 Source: 2008 Pfizer Health Index

3. Duplication of Conditions All Adults Blood Pressure ArthritisHigh Cholesterol AsthmaChronic Pain Heart Disease Diabetes %%%% Blood pressure 1010025398143630 Arthritis 1025100249 3929 High Cholesterol 7271710012112215 Asthma64591001765 Chronic pain3475910074 Infections45215142- Heart Disease516171441110019 Diabetes4121183617100 Depression23444423 Cancer2*-31--- Osteoporosis3811634910 Source: 2008 Pfizer Health Index

4. 12 Months Early Diagnosis Essential

5. What Do we Do? Supporting People living with Arthritis Finding a Cure Voice of Rheumatology in Ireland

6. Board Make-Up 4 Patients 4 Medics 7 Co-opted members

7. The Challenging Environment Healthcare Budget Cuts –More for Less –Decisions made Now!! Current Rheumatology service issues Ageing Population –More dependency on system –Increased chronic diseases The Patient’s voice –Hierarchy of Medicine Managing Patient expectations

8. Consumer Driven Healthcare Listening to the Consumer Active involvement in care pathway development Education and Health Promotion Promoting active self-management –Taking more Responsinility for their health –Monitor consumer expectations over the years “An Informed patient is a better self manager” (PARE)

9. Consumer’s Role OLDNEW Defer to Providers AuthorityShare Responsibility for own Health Be PassiveBe Active. Self-manage health & condition Share History, when askedShare goals, history, values, beliefs and preferences. Be Assertive Learn about condition from provider Learn from provider, inform self. Access reliable information Don’t worry about medications (it’s all in the medicine cabinet) Share responsibility for keeping medication list up to date Respond to provider questions about progress during clinical visits Keep track of own progress between visists, share duirng visits

10. Consumer Driven Healthcare Best Practice Arthritis Self-Management Programmes –Stanford Model

14. Consumer Driven Healthcare Case Histories Arthritis Self-Management Programmes –Stanford Model Let’s Talk Arthritis

16. Consumer Driven Healthcare Case Histories Arthritis Self-Management Programmes –Stanford Model Let’s Talk Arthritis Patient as Educator

17. Consumer Driven Healthcare Some Early Wins Consumer role in HTA Better Care = Reduced drug dependency = less cost Reform HSE budget system –PCCC versus Hospital Pharmacy Innovative thinking on Resource deployment

18. Thank You