how an onnected health improve patient pathways? · companies, policy-makers, researchers, health...

‘How Can Connected Health Improve Patient Pathways?’

7th October 2015 The Landing, Media City

@Man_Inf #McrEcosystem

The Global Connector

www.echalliance.com / info@echalliance.com

European Connected Health Alliance Bringing Together the future of Health, Social Care & Wellness

European Connected Health Alliance International Network of Permanent Connected Health Ecosystems Liz Ashall Payne International Ecosystem Co-ordinator 7th October 2015 - Manchester

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About ECHAlliance

Non-Profit Organisation (Community Interest Company)

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300+ member organisations Companies, policy-makers, researchers,

health & social care providers, patients, insurances, etc.

12,000+ community

International Network of Ecosystems

30+ countries (Europe, USA, China)

International Events (leadership, mobile world congress, EU-US Marketplace)

EU Projects (lead & partner)

Ecosystems Endorsed…

eHealth Ecosystems could be the answer

to the strain our social security systems are

undergoing.

If we work together and use the enormous

potential technology has to offer us, we can

ensure top healthcare for all in Europe

Neelie Kroes, Former Vice President

“

”

The ECHAlliance International Network:

• is an unparalleled network of permanent ecosystems that span the EU

and the international stage

• connects Connected Health Ecosystems across Europe, North America and soon China & Canada

• 100+ gatherings across Europe are facilitated by the ECHAlliance annually, resulting in over ~15,000 connections and unrivalled insight and expertise

The ECHAlliance can ‘join the dots’ and offer insight from one

country that can greatly assist in the health challenges of another

Unrivalled Reach and Expertise

ECHAlliance Ecosystems Programme

Ecosystem Programme basic principles

Geographic coherence

Multi-stakeholders

Permanent

Regular meetings, workshops

“eHealth” strategic agenda/plan

Governance through working group(s)

Ecosystem Reach

Existing England - Manchester England - North West Coast Estonia Finland – Oulu France - Nice-PACA Greece Northern Ireland Poland Republic of Ireland Scotland Spain - Barcelona USA - New York

Launching Soon

Canada – Toronto Czech Republic England -Yorkshire & Humber

France – Paris Slovenia Spain - Valencia Spain - Galicia

Developing Austria Belgium

Denmark x 2 England x2 Finland x 2 France x 2 Germany

Italy Latvia

Netherlands Switzerland

Sweden Wales

~100 Ecosystems meetings per year in Europe

8

Events, workshops,

webinars Community Database

(profiles)

Marketplace / Showroom (solutions, success stories,

assessment results)

Virtual matchmaking

Collaborative work

tools (shared docs, chat/email tool…)

Business Intelligence tool (market data, description & contacts,

tenders, calls of projects, opportunities)

Education and training (Publications, event presentations…)

ECHAlliance

Connector

ECHAlliance Connector

Management

ECHAlliance

website

Inter-Ecosystem Working Groups

Learn more contact liz@echalliance.com

Medicines Optimisation Inter-Ecosystem Group

Group Chair: Prof Mike Scott Head Pharmacy & Medicines Management, Northern Health and Social Care Trust - Northern Ireland Webinar held - 1st October 2015

eHealth Strategies Inter-Ecosystem Group Group Chair: Ain Aaviksoo, Deputy Secretary General, E-Services & Innovation Estonian Ministry of Social Affairs Meeting planned - November 13th in Estonia for key stakeholders

To provide a platform for stakeholders responsible for a given topic area, to meet, promote and advance their work across the ecosystem network, therefore maximising knowledge sharing and best practice.

22 Feb

23 Feb

24 Feb

25 Feb

4YFN conference dedicated to innovative start-ups/SMEs, and investors

Conferences and workshops: high level programme includes

international leaders in the health and wellness sector.

Conferences and workshops: high level programme includes

international leaders in the health and wellness sector at Mobile World

Congress

- Personalised programme of sites visits & B2B matchmaking

- Explore the large Mobile World Congress exhibitions in Fira Gran Via

Health & Wellness @ MWC 2015 Health & Wellness @ MWC 2015 Health & Wellness @ MWC 2015 Health & Wellness @ MWC 2015 Digital Health & Wellness Summit – Barcelona 2016

The Investors Challenge

Start-ups & SMEs competition

- Best Digital Health Start-ups & SMEs

- Best Innovations on Digital Health, wearables, IoT, active ageing…

- Key customers involved (governments, hospitals, insurances)

Roadshow across:

- Europe (25+ countries & regions),

- North America (USA & Canada)

- China

From September 2015 to February

2016

Great Final @ Digital Health &

Wellness Summit 2016

Health & Wellness @ MWC 2015 Health & Wellness @ MWC 2015 Health & Wellness @ MWC 2015 Health & Wellness @ MWC 2015 Digital Health & Wellness Summit – Barcelona 2016

www.echalliance.com / info@echalliance.com

Contacts Brian O’CONNOR, Chair – brian@echalliance.com

Liz ASHALL-PAYNE, Outreach Co-ordinator- liz@echalliance.com

Julien VENNE, Strategic Advisor – julien@echalliance.com

Damian O’CONNOR, Director of Operations – damian@echalliance.com

European Connected Health Alliance

The Global Connector in Healthcare We bring people, organisations, needs and solutions together

We invite you to join us - learn about membership at www.echalliance.com

GM AHSN Introductions and Priorities

Professor Donal O’Donoghue

Medical Director GM AHSN

AHSN – National Context

Innovation Health and Wealth

AHSN Licence Focus on the needs of patients and local populations Speed up adoption of innovation into practice to improve clinical outcomes and patient experience Build a culture of partnership and collaboration Create wealth through co-development, testing, evaluation and early adoption and spread of new products and services.

Greater Manchester AHSN – Local context

GM AHSN footprint

4 Universitie

s

1 Ambulance Service

Executive team

Mike Burrows Managing Director

• Martin Gibson

• Gary Leeming

• Sarah Thew

Research and Informatics

• Linda Magee

• Keith Chantler

Industry and Wealth

• Donal O’Donoghue

• Jane Macdonald

• Cara Afzal, Dai Roberts, Zulfi Jiva

Health and Implementation

Health and Implementation

1. Cardio-vascular Disease

– Atrial Fibrillation

– Familial Hypercholesterolaemia

– CKD, as a marker of vascular risk

2. Patient Safety

– Medicines Optimisation

Medicines Optimisation / Patient Safety

Jane Macdonald

Director of Nursing and Improvement

GM AHSN

In a Devolved GM System the ambition is

to: Have 64,000 less people with chronic condidtions 10% less visits to urgent care 700,000 people with chronic conditions able to manage their health in a way that suits them

In a Devolved GM System the challenge

is: • The most common

health intervention is prescribed medication

• 40% of GM population

take medication on a regular basis.

• 30-50% of medication

are not taken as intended

• 5-8% of hospital admissions are caused by preventable adverse reactions to medicines.

Medicines Optimisation

What does it actually mean to those that take medicines …….

https://www.youtube.com/watch?v=84C0QMAIYj4&feature=youtu.be

NICE Guideline (NG 5)– Medicines Optimisation NG5 2015 Definition used in the guideline: ‘a process that aims to ensure a person-centred approach to safe and effective medicines use, enabling people to obtain the best possible outcomes from their medicines’ • Topic areas covered:

– Systems for identifying, reporting and learning from medicines-related patient safety incidents

– Medicines-related communication systems when patients move from one care setting to another

– Medicines reconciliation – Medication review – Self-management plans – Patient decision aids used in consultations involving medicines – Clinical decision support – Medicines-related models of organisational and cross-sector working

Safety - Preventable medicines harms in general practice

• Prescribing errors 1 in 20 items with an error – 1 in 550 with a serious

error 1 billion items in 2012 = 1.8 million serious prescribing

errors

• Preventable medicines related admissions to hospital 4.68% of emergency admissions – 250,000 admissions

• >50% of these admissions were associated with the following

groups of drugs: anti-platelets, diuretics, NSAIDs and anticoagulants

Patient Safety Topics

NICE CG 180 - 2014

Current prescribing of anticoagulants for AF in England NICE Costing report: AF (2014) IMS Disease Analyser 2012/13 and GRASP-AF database download April 2014

Treatment Percentage of AF Population

Number of people

No treatment 28.99% 258, 000

Aspirin 22.49% 200,000

Warfarin 34.32% 305,000

NOACS 14.20% 126,000

Why is this not safe…

1 in 6 strokes occurs in people with AF

Of the next 10 patients with AF who have a stroke:

– 8 would have been known to be high risk of stroke

– 6 should have been on warfarin / NOAC

– 3 will go home

– 5 will end up in supported care

– 2 will die....

TELL ME …

Would you want to save 365 AF related Strokes before this time

next year in Greater Manchester?

THE CASE FOR CHANGE - SHARE DATA

Reflect our members data back Equal and equitable access Discuss variation with a fair comparison • Percentage • Absolute numbers • Per 100k population • ONS matched • PHE matched

PREVALENCE AND INCIDENCE

*Publically available data

Quality Outcomes Framework* (QOF) • AF disease register • Stroke register

THE NUMBER AND COST OF STROKE

*Publically available data

Hospital Episode Statistics* (HES)

PATHWAY OF CARE

*Publically available data

Hospital Episode Statistics* (HES) • Admission route • From where to where • Discharge destination – to home or to a home

DATA ON THOSE THAT HAVE AN AF RELATED STROKE

*Publically available data

Sentinel Stroke National Audit Programme* (SSNAP)

APPROPRIATE TREATMENT OF THOSE AT RISK

*Available from NHS IQ

GRASP-AF* • Read code data interrogation tool • Helps to find patients that could benefit from anti-

coagulation treatment

TREATMENT

*Publically available data

ePACT (electronic Prescribing Analysis and CosT)* • By drug • By pack • By practice • Great for NOACs • Useless for warfarin and aspirin

TREATMENT

ePACT (electronic Prescribing Analysis and CosT) Drug By pack By practice Great for NOACs Useless for warfarin and aspirin Publically available data

THE MISSING PIECE WAS - ANTICOAGULATION CONTROL WITH VITAMIN K ANTAGONISTS

NICE Guidance (CG180) • 2 INR values higher than 5 or 1 INR value higher than

8 within the past 6 months? • 2 INR values less than 1.5 within the past 6 months? • TTR less than 65%?

• But we now have that data too …!!

In a Devolved GM System the ambition is

to: Have 64,000 less people with chronic condidtions 10% less visits to urgent care 700,000 people with chronic conditions able to manage their health in a way that suits them

CALL TO ACTION – THE GM AHSN NEEDS YOU!

So we have the ambition, the data, the case for change ….. …. the Ecosystem now needs to respond and enable step change, system wide solutions that deliver at pace and scale

Discussion Groups

1) How Can Connected Health Help Address Patient Safety/ Medicines Optimisation & Vascular Disease? 2) How can the Manchester Ecosystem best engage to deliver better outcomes?

@ @ @Man_Inf #McrEcosystem

Networking Lunch & Market Place

Health Innovation Manchester

What are we trying to solve?

• Despite UK reputation in healthcare research & innovation, the UK is

slow to adopt innovation into routine practice

• Missed opportunity to improve care and close funding gaps

• Greater Manchester has great organisations across different sectors,

but the system is highly fragmented and doesn’t function as a coherent

system. As a consequence:

– Areas of excellence are not leveraged widely

– Resource allocation not optimised across the system

• Duplication & gaps

– We don’t exploit potential synergies

– Potential industry collaboration & investment not optimised

– Potential for the region (& UK) not realised

Our Vision

To transform the health of our population by

driving research and innovation into daily practice

Our Purpose (What we intend to do)

Driven by the health needs of our population and working in

partnership we will mobilise a system wide approach to the

discovery, development and delivery of innovation across

Greater Manchester for the benefit of all

• Develop GM into a world-leading health innovation ecosystem

• Cohere, leverage and build-upon existing foundation organisations

• Deliver common goals that no single organisation can do alone

• System thinking & co-ordination

• Like the ‘tactics’ for a football team

• Build the network / ecosystem so that people feel part of something

greater than just their own institution

• Seamless, simple industry interface, aligned with our needs /

strengths

We will do this by

Health Innovation

Manchester

Close collaboration across H&SC providers,

Academia and Industry is key to delivering

our vision

Health & Social Care Providers

Industry Academia

Precision Medicine

Clinical Trials

Coordinated Business Engagement

Networking / Community Build / Communications

Health Informatics

Innovation into Clinical

Practice

Initial Priorities for Health Innovation Manchester:

Developing an innovation ecosystem centred around clinical

validation & rapid scaled implementation

www.healthinnovationmanchester.com

@healthinnovmcr

Health North: Connected Health Cities

Powering UK Health and Wealth Transformation

John Ainsworth John.ainsworth@manchester.ac.uk

October 2015

Life expectancy at birth, UK, 1980-82 to 2008-2010 from period life tables Source: ONS

“The next government will inherit an NHS that faces growing pressures on all fronts. It will need to act quickly to ensure that there is sufficient funding to sustain as well as transform services in the next parliament. The NHS is working at or very close to its limits and patient care will suffer unless more resources are found.”

http://www.who.int/features/2013/amr_conserving_medicines/en/

1. Valderas JM, et al. Defining comorbidity: implications for understanding health and health services. Annals of family medicine; 7(4):357–63. 2. Fortin M, et al. Randomized controlled trials: do they have external validity for patients with multiple comorbidities? Annals of family medicine 2006 Jan

Sci Transl Med. 2010 Nov 10;2(57):

Healthcare Evidence History

Evidence

Practice

Debate

Evidence

Practice

Translation

Evidence

Practice

System

Scientific basis of medicine

Evidence based care

Learning health systems

Sci Transl Med. 2010 Nov 10;2(57):

Vision

The world’s first civic partnerships exploiting data:

• drive public sector reform for better health and care by providing actionable information

• fuel region-wide health science that citizens trust

• accelerate business growth for the digital health revolution

Connected Health City: Ark-enhanced Information Flows

Data

Public sectorencounters

Services

Targetedby need

TargetingTools

Ark

Involved CitizensProblem OwnersData Managers

Public Health AnalystsCare Service Analysts

StatisticiansInformaticians

Social ScientistsHealth Economists

Health Service ResearchersCommunications Experts

Service Planning

and PolicyInsights

SME Global Corp.

Which services and how?

Spin-in/out Laboratory

Farr Institute & NIHR Centres

Ark Integration for Combinatorial Innovation in Health Data Analytics

2015: Dilute, Duplicated Data Processing 2020: Ark Integrated Data Processing

NHS Commissioning

Research and Innovation

Public Health Intelligence

Social Care Management

RawData

NHS Quality Intelligence

Extract, clean, describe x 5

One size fits all

Ark

Public Involvement

NHS Commissioning

NHS Quality Intelligence

Public Health Intelligence

Social Care Management

Self-care and Personal Health

RawData

Extract, clean, describe x 1

CombinatorialResearch and Innovation

Literature

Policies

Literature

Policies

Targeting System

TransparentInterface

with Industry

1

2

3

4

5

6

Learning Health System Cycle

Initiate CollectData

AssembleData

AnalyseData

InterpretResults

DeliverTailoredMessage

TakeAc onToChange

Prac ce

A health system organised to optimise the delivery of care based on the evidence produced through delivering care.

Feedback

Integrated Care Record

Care Pathway Analyser: ‘Care Opportunities Detector’

GP + Hospital Data; then + Pharmacy+ Social Care + Self-reports, sensors & apps…

Find patients with target

disease

Ark

Practice-level Audit

Patient-levelDecisions

Exclude if quality standard

inappropriate

Exclude if quality standard

achieved

Identify howcare could be

improved

Health System Secure Web Interface

+

Care Professionals(+ Patients *future+)

e.g. chronicKidney disease

e.g. terminalillness

e.g. blood pressuretarget

e.g. drug treatmentoptimisation

Data Action Latency

Time

Data Production

Analysis

Data Production Data Action Latency

Redesign

Outcomes

• Civic partnerships – Effective model for patient and public involvement

• Four pilot CHCs – Blueprints and plans

• Test learning health system methodology – Understand data needs

• Workforce – Increase capacity

• Innovation • Model for driving economic growth • Response to the needs of industry

Reco

rds

Eviden

ce

Intelligen

ce

Inn

ovatio

n

Informatics

Public Empowerment & Trust

ERDF 2014-20: Science

Commercialisation Call

Helen Wilding, Deputy Director, Business and Science

New Economy

7 October 2015

GM EU Structural and Investment Funds 2014 – 2020

Types of investment £356m

Competitive Places (£22m ERDF)

Sites / premises

Critical infrastructure

Science & Innovation (£52m ERDF)

Science tech assets (capital)

Tech business base (revenue)

Science Tech Skills (ESF)

Competitive Business (£70m ERDF)

Start up & Growth

Business Finance

Internalisation

Leadership & Management

Low Carbon (£50m ERDF)

LC investment vehicle

LC infrastructure e.g. Heat Networks

LC transport

Low Carbon skills

Whole building efficiency

European Social Fund (£161m ESF)

The following summarise the key thematic objectives (TOs) proposed by Government for ESF activity

2014-20:

•Promoting employment and supporting labour mobility

•Promoting social Inclusion and Combating Poverty: Active inclusion in particular with a view to improving

employability

•Investing in education, skills and lifelong Learning

Competitive Places (£22m ERDF) Science & Innovation (£52m ERDF)

1. Asset base science infrastructure (£15m)

2. Innovation (£3.95m) – broad purpose is to

provide universal innovation advice to SMEs

3. Asset Base Science Infrastructure (£4m) –

second round following allocation of £11m

in first call

Competitive Business (£70m ERDF)

1. MAS and UKTI – national (£5.75m)

2. Sector Programmes / Manufacturing Advisory

Service / Low Carbon Support (£4.495m)

3. Growth Hub & Services (£4.55m)

4. Start Up Support (£3m)

5. Access to Finance (£1M)

Low Carbon (£50m ERDF)

Calls already issued

• Currently negotiating IB status with Government

• Timetable for future calls unclear

– CLG currently working on timetable

– IB should give us control over timing and content

of calls

• Still awaiting output definitions and allocations

• Exchange rate changes may impact the ERDF

allocation

Update & Timings

Strategic Context: Science & Innovation

• Greater Manchester Strategy – prioritises “placing our city region at the

leading edge of science and technology”

• Evidenced world-leading strengths in advanced materials and health

innovation converging with a thriving digital technology business base

• 60,000+ Science + Tech employees in GM + 100,000+ in manufacturing

• Circa 100,000 students across 5 HEIs – one of the largest student

populations in Europe

• University of Manchester in UK’s top 5 for research (REF 2014)

• ‘Graphene City’ – leading the translation of discovery into economic gain

• Home of the national Cancer Research UK Institute

• Corridor (Innovation District) – employs 60,000 people, home to largest

biomedical campus in Europe, generating c£3.0bn GVA pa

• Key challenge – Translating world leading fundamental research into

economic growth, increasing productivity of our business base

Science & Innovation: key issues

• Despite science excellence levels of company innovation and

productivity in GM remain low. Particular issues include low levels of

Innovate UK investment, R&D expenditure and product or process innovation

• We need to bridge the gap between cutting edge science within academia

and levels of innovation within GM’s business base encouraging knowledge

exchange and collaborative working

• We need to increase levels of entrepreneurship and business formation

amongst graduates of GM’s HEIs

• Removing gaps in critical pathway from invention to successful

commercialisation is crucial - bridging ‘valley of death’

• Throughout the UK there is an evidenced lack of investment in early forms of

support for scientific businesses in the UK

• Activity will centre on growing GM’s science and technology business

base linked to our key areas of excellence.

• Supporting companies to innovate, exploit commercialisation

opportunities and leverage GM’s key assets is key.

• This includes driving closer linkages between HEIs, the NHS and the

commercial sector.

• We expect to see specialist support to bring new products and processes

to market including;

– Industrial Research & Development Projects

– Early stage investment in scientific discoveries

– Knowledge Transfer

– Commercial exploitation of new scientific developments arising from the HEI

knowledge base

Objectives: science commercialisation call

For Discussion: indicative actions (GM call)

Industrial Research & Development Projects

• Support SMEs to research and develop technologically innovative products

• Collaborative / applied research projects linked to GM’s smart specialisation strengths

• Programmes for current and future technologies and support to develop prototypes

Early stage investment in scientific discoveries

• Investing in proof of principle and pathfinder projects in GM’s areas of scientific strength

• Stimulating and de-risking graduate start-ups and spin-outs

Knowledge Transfer

• Knowledge transfer programmes – particularly linked to key growth areas / technology

development

• Particularly interested in approaches that bring teams together from across disciplines to

solve business issues

Exploiting new scientific developments arising from the HEI knowledge base

• Outreach to help companies / entrepreneurs think about how developments in HEIs might help

them to innovate including support to exploit commercial potential of new scientific

developments

Questions?

Helen.Wilding@neweconomymanchester.com

0161 237 4122

Panel Q & A

@Man_Inf #McrEcosystem

Thanks for attending the October 2015 Ecosystem- GM AHSN Meeting.

Next Meeting: 14th January 2016