1. © Charles Lowe Consulting 2010 From IT to independent living – how to make telehealth & telecare catalyse improved care Charles Lowe Charles Lowe Consulting Ltd. charles.lowe@btinternet.com 07860 619424

2. © Charles Lowe Consulting 2010 DH definitions Telecare – service user to responder: environmental monitoring Telehealth – patient to clinician: vital signs monitoring Telemedicine – clinician to clinician: seeking expert advice eHealth – all the above

3. © Charles Lowe Consulting 2010 The differences

4. © Charles Lowe Consulting 2010 What works best

5. © Charles Lowe Consulting 2010 Why X

6. © Charles Lowe Consulting 2010 What’s the problem? 20-60 75+ Fewer professionals More LTCs Raised expectations

7. © Charles Lowe Consulting 2010 Or to look at it another way All EU UK Denmark

8. © Charles Lowe Consulting 2010 Will remote monitoring work?

9. © Charles Lowe Consulting 2010 The vision – Mrs Smith, a COPD sufferer in 2018 The home hub collects and aggregates information from the connected applications such as the spirometer and home sensors The home sensors detect Mrs Smith’s movements around the home and send an alarm to her family if there is not sufficient movement The home sensors detect when Mrs Smith is sitting for too long a period of time. An alarm is sounded if she sits for too long a period in winter to encourage her to move around to keep warm Mrs Smith provides regular spirometer readings to her nurse which are sent from her home hub If Mrs Smith has an infection, she can provide a sputum sample to be analysed by her home diagnostics kit. This detects the presence of bacteria and sends the results to her doctor from her home hub Mrs Smith’s smart medication dispenser reminds her to take her medication by sounding an alarm. If Mrs Smith fails to take her medication, her family are notified Mrs Smith wears an alarm in case she falls. If she needs assistance, she can sound the alarm to contact a member of her family Mrs Smith accesses her medical records and interactive health information through her home hub 4 Source: Fathom Partners, Health Technology Futures, Kings Fund event

10. © Charles Lowe Consulting 2010 Remote monitoring works…BUT:

11. © Charles Lowe Consulting 2010 …with the result that… X inappropriate

12. © Charles Lowe Consulting 2010 Depression

13. © Charles Lowe Consulting 2010 Dementia prevalence Source: Alzheimer’s Disease International www.alz.co.ukwww.alz.co.uk “Individuals with high mental stimulation had a 46 percent decreased risk of dementia” Michael Valenzuela, Univ. New South Wales http://www.msnbc.msn.com/id/11025839/ http://www.msnbc.msn.com/id/11025839/

14. © Charles Lowe Consulting 2010

15. Before process change

16. © Charles Lowe Consulting 2010 After

17. © Charles Lowe Consulting 2010 Time with Clinician in 3 months

18. © Charles Lowe Consulting 2010 Time when remote monitoring in 3 months

19. © Charles Lowe Consulting 2010 But there are lots of players involved

20. © Charles Lowe Consulting 2010 Is this your health service?

21. © Charles Lowe Consulting 2010 Or this?

22. © Charles Lowe Consulting 2010 How can technology help... Release time to care Catch disasters early at home & away Reduce anxiety Anticipate medical exacerbations Improve disease management Promote self-care Eliminate unwanted human contact Turn rush into quality time Help people to help each other Informate Falls, seizures Oxygen sats, help at hand, GAD7 CHD, COPD Medication compliance, new linkages Expert patient, mental stimulation Esp for learning disabilities Part of working completely differently One way of providing human contact Reduce admin, POCT, self service Resulting in: 1)Improved outcomes 2)Secondary -> primary care 3)Lower costs 4)Discoveries Discover new linkages

23. © Charles Lowe Consulting 2010 Challenges

24. © Charles Lowe Consulting 2010 Trials

25. © Charles Lowe Consulting 2010 Not what you expect? Mobile phones Cognac Tanks ARPAnet Cars Stereo sound Gunpowder Remote monitoring Continuous vs episodic care 24x7x365 Autonomous Decision support Behaviour change Self-management Informating More patients Less travel

26. © Charles Lowe Consulting 2010 Council SMG PCT Board GP Forum PEC CEC LMC Adult Services Board Programme Board Project Boards Management

27. © Charles Lowe Consulting 2010 Leadership

29. © Charles Lowe Consulting 2010 Thank You Charles Lowe Charles Lowe Consulting Ltd. charles.lowe@btinternet.com 07860 619424