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ECG ePatch : Turning patients into citizens World of Health IT 2011 Regional eHealth Forum

ECG ePatch : Turning patients into citizens World of Health IT 2011 Regional eHealth Forum Janne Buck Christensen & Anne Mette Ølholm Dept. of Quality and Research/HTA, OUH Odense University Hospital og Svendborg Hopital, DK. Presentation overview.

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ECG ePatch : Turning patients into citizens World of Health IT 2011 Regional eHealth Forum

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  1. ECG ePatch: Turning patients into citizens World of Health IT 2011 Regional eHealth Forum Janne Buck Christensen & Anne Mette Ølholm Dept. of Quality and Research/HTA, OUH Odense University Hospital og Svendborg Hopital, DK

  2. Presentation overview • The Danish healthcare sector and the regional burden of chronic conditions • Health Agreements and regional supporting strategies • Technology’s role in the provision of services at OUH Odense University Hospital and Svendborg Hospital • ECG ePatch • How does ECG ePatch support the regional strategy?

  3. Overview of the Danish healthcare sector • 5,5 million citizens • Healthcare is provided directly by the public sector • Tax paid • No user charge for hospital services • 5 regional health authorities (60 public hospitals) • 98 municipalities (homecare and rehabilitation services) • Private system of GPs (2000), specialists (1100), hospitals (15), pharmacies (330)

  4. The Region of Southern Denmark • Population: 1,2 million residents • One in three adults has a chronic condition • 30-40.000 with a heart disease, 25.000 admissions, 35.000 outpatient visits • Increasing numbers due to age and lifestyle • Chronic condition seize about 70% of healthcare resources

  5. Tools and strategies • Health Agreements • Background: Structural reform in DK New health legislation • Objectives: Continuous dialogue and cooperation between hospitals, municipalities and general practice • Regional strategy for management of chronic conditions • Prolonged and continuous effort rather than acute and episodic • 21 concrete initiatives • Values and visions: • Coherent care pathways • Active involvement of patients • Prevention and early detection • Regional strategy for Health-IT • Joint strategy across hospitals, municipalities and generel practice • Objectives: • Support the vision of coherent care pathways • Support a close interaction between patients and the healthcare system • Provide more time for care

  6. Technology’s role in health service provision at OUH 4 examples of running telemedicine applications: • Home-hospitalisation for COPD patients • Treatment of patients with chronic diabetic foot ulcers • Videoconferencing for discharge planning, doctors’ conferences and language interpretation • At-home monitoring with ECG ePatch

  7. Project background • Development project sponsored by the PWT Foundation (Public Welfare Technology) • Public – private cooperation • Atrial fibrillation (irregular heart rhythms):  common cause of syncope, dizziness and palpitations  independent risk factor for sudden cardiac death or stroke • DK prevalence: 1 % of population < 65 yrs. of age 5 % of population > 65 yrs. of age • Average 8 bed days per patient

  8. Current diagnostic pathway • Diagnostics: Cardiac telemetry ECG monitoring • Hospital admission for 1 -2 days average (syncope) or 5 -6 days average (palpitations, pharmaceutical heart rate control) • Referral to ambulatory monitoring (Holter) if ECG non-diagnostic

  9. Event Event Hospital cardiologist Future diagnostic scenario – ECG ePatch • Wireless sensor technology for at home monitoring • Continuous monitoring – storage of clinical events only • Transmission to cardiologist twice daily • Real-time diagnosis • Improved data quality • Improved patient compliance

  10. Expected outcome • Reduced number of bed-days from 1-5 per patient to 0 – 1 days • Reduced demand of hospital service functions • Reduced demand on ambulatory resources for Holter data analysis

  11. Regional eHealth so far… • Technology and organisational change are inseparable in telemedicine • Self-monitoring equipments are coming - and are welcome - but raises questions • Stratification – who will benefit? • Issues concerning integration with existing IT systems • Distribution of healthcare resources – who pays and who gets? • Ethical and legal factors - new risks of adverse events • Sectorial boundaries – who’s responsible? • Health Agreements as an effective tool • Lack of evidence is a challenge within telemedicine (MAST)

  12. Thank you for your attention For more information please contact: Janne.buck.christensen@ouh.regionsyddanmark.dk Anne.mette.oelholm@ouh.regionssyddanmark.dk

  13. Initial development Steady state • health technology assessment (HTA) • Business case (BC) • Formative approaches Effect- cost ratio. Time Maturity and evaluation

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