1. “ Telehealth: Supporting Diabetes Self-Care ” 9 th Annual INET Mini-Conference June 20 2007 Four Season Hotel, Toronto

2. “ Facilitating Superior Chronic Disease Management Through A Knowledge-based Systems Development Model ” Presented by: Steve Goldberg President INET International Inc., Research Associate, Center for the Management of Medical Technology, Stuart Graduate School of Business, Illinois Institute of Technology 9th Annual INET Mini-Conference June 20 2007 Four Seasons Hotel, Toronto

3. Chronic Disease Management Chronic diseases account for 70% of all deaths, more than 60% of health care costs, and for 33% of the years of potential life lost before age 65 in Canada (Rachlis, 2006.) Diabetes, depression, congestive heart failure, hepatitis and asthma are examples of chronic diseases. A critical success factor for Chronic Disease Management is self-management support.

4. Significant Change In The Health System (New Health System of) Self- management support is where people play an active role in their own care rather than the traditional (Current Health System) view of patients as passive participants.

5. Chronic Disease Management Model

6. Years Traditional Large-Scale Systems Development Life Cycle Project (SDLC) Improved Patient Outcomes © Goldberg 2003, 2004, 2005 Systems Development Life Cycle (SDLC) PeopleProcessProtectionPlatform Implement Maintain Design & Build Enhanced Health System

7. People Hypertension 4.0 million Canadians have high blood pressure Asthma 2.2 million Canadians with Asthma Diabetes 1.3 million Canadians with Diabetes More…. People with DiseaseHealthcare Team Members Physicians 31,672 Primary Care Physicians and 21,918 Specialists Nurses 157,489 Hospital 33,419 Community Health, and 28,965, Nursing Home / Long Term Care More….

8. Process

9. Protection Inside the Fence Legal users of YOUR medical records www.patientprivacyrights.org

10. Platform

11. Implementation Years Traditional Large-Scale Systems Development Life Cycle Project (SDLC) Improved Patient Outcomes PeopleProcessProtectionPlatform Implement Maintain Design & Build Enhanced Health System

12. A Gap Between SDLC and the Medical Practice. A systems development life cycle was created by technologists and is typically macro focused to implement large-scale change. - whereas – Discovering that successful Health System changes are led by physicians that are narrowly focused to facilitate medical specialty or sub specialty, mitigate patient risk, and to accurately measure outcomes.

13. The Potential Impact On The SDLC Years Improved Patient Outcomes PeopleProcessProtectionPlatform Implement Design & Build Traditional Large-Scale Systems Development Life Cycle Project Enhanced Health System

14. & Knowledge-base Systems Development Model Center for the Management of Medical Technology (CMMT)

15. In Diabetes, study how changes in the SDLC can best facilitate healthcare team members and patients use of chronic disease management, telehealth, and wireless technology to improve patient outcomes

16. Deliver A Simple to Use Program Program Medical Director: Dr. Sheldon Silver M.D.

17. A New SDLC Project Physician Led SDLC Project Design & Build Implement Maintain

18. Traditional 1 to 5 Year Systems Development Life Cycle Project Refocus 1 to 5 year systems development life cycle into small manageable pieces © Goldberg 2003, 2004, 2005 Systems Development Life Cycle (SDLC) Improved Patient Outcomes Years Enhanced Health System

19. Traditional 1 to 5 Year Systems Development Life Cycle Project Refocus 1 to 5 year systems development life cycle into small manageable pieces Physician-led SDLC Projects © Goldberg 2003, 2004, 2005 Systems Development Life Cycle (SDLC) Improved Patient Outcomes Years Enhanced Health System

20. Summary Health System Enhancements for Chronic Disease Management and Prevention Effective and Efficient Ways To Implement National Chronic Disease Management Programs Wireless Technology use as a Key Enabler to Support Rapid Transformations In Healthcare Delivery Creating a Knowledge-based Systems Development Model in Healthcare facilitate:

21. Thank you