opentele presentation - silverbullet
DESCRIPTION
Study trip to Denmark – succesfull integration of eHealthTRANSCRIPT
Home Health Monitoring Market
4 Business opportunities
2
• Open Source/license free
• Initial budget $1,5 mio USD
• Large scale focus
• Complete coverage
OpenTele -‐ overview
2 Silverbullet
3 OpenTele
4 Business opportunities
Denmark - the danish healthcare strategy1
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Portable devices for measurements and end user interaction
Clinicians view designed to handle large scale remote monitoring
Monitoring data
Feedback from clinicians
Remote monitoring issues
Existing problems: (solved by Open Tele)
• Systems are too complex and ambitious (Keep it SIMPLE!)
• Not designed to be efficient or scalable (Design for scalability)
• Expensive by license fee’s, prohibitive pricing (Target <$35 pt/year)
• Proprietary hardware is complex and expensive (Use COTS)
• Systems are designed to specific diseases (All in 1 platform)
• Few and scattered references (Implement a whole nation)
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OpenTele approach
Doctor creates questionnaire with clinical pathway for <DISEASE> with schedule
At schedule the patient execute the workflow
Data send to theOpenTele DB
instructions to remain calm for 10 minutes
Data is obtained -
- using std. devices
Doctor reviews dataand takes action
Patient goes to hospital
Questionnaire is pushed to patienttablet, and activated when it’s time!
or perhaps.…
Patient has an online videoconference with the doctor
TIME!
Cloud based, simple and scalable6
Context, Data & Facts
Automatic or Manual input • Blood saturation/pulse • CTG • Blood pressure • Weight • Glucose in blood • Lung function (spirometer) • Continual glucose measurement
Manual input • Temperature • Glucose i urine • CRP • Hemoglobin • Protein i urine
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COPD Questionnaire/workflow
• COPD workflow • Patient follows clinical pathway
• Instructions -> Context + • Q&A -> Diagnostic data + • Measurements -> Facts
The workflows can be quite complex, and work as part of diagnostic efforts, for specific diseases - thus extending monitoring to also include fact-finding and document changes/development in the patient condition.
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=============Clinical Value
Scalability
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10% of users 20% of users85% of users
High Clinical qualityBluetooth/Manual
High Clinical qualityBluetooth/Manual
BYODManual
• Hospitals: massive cost reductions by allowing the patients to take measurements at home. Patients save time, are checked more often, and feel empowered.
• Hospitals: Much better resource utilization and huge savings on medico equipments, by utilizing empty beds for patients, equipped with a low cost tele kit instead of expensive fixed equipment
• Health insurance companies are able to systematically prevent people from hospitalization, because conditions are caught early and treated by GPs rather than at the Hospital.
• Large HealthIT provider benefit from cost effective cloud based platform, and provider can focus on rollout and logistics delivered.
• Pharma companies mandated to document adherence and compliance to maintain reimbursement. Support ambitions to value add to their products by providing IT support for home care and telemedicine.(Chronic diseases)
Potential utilization
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Potential utilization
• Industrial companies that need to monitor critical personnel on a daily basis for security reasons (Like off-shore, shipping, mining etc)
• Public administrations (Health) are able to launch regional projects for screening large groups of citizens, or even focus on home for elderly or schools. Preventional programs can be added.
• NGO’s can have access to remote monitoring and diagnostic equipment – increasing range, possibilities and efficiency of their healthcare efforts
• 3rd world governments seeking to stretch very few clinical resources over vast geographical areas, as well as utilizing overseas specialists and doctors.
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SMS Component - example mapping
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SMS TEXT RESPONSEWelcome -‐ sit down and relax
-‐
Wait 60 secs -‐
(60 sec pause) -‐
Do you feel well? Yes or No
Enter sat. value <saturation pct>
Enter pulse <pulse bpm>
Do you feel dizzy? Yes or No
Relax -‐ prepare for measurement…
-‐
Enter Blood pressure -‐ top value
<BP val 1>
Enter Blood pressure Bottom value
<BP val 2>
Enter Pulse <Pulse bpm>
Do you want to submit data
Yes or No
Data registered -‐
The ability to utilize ALL mobile and medical devices, ensures total coverage….but measurement data must be entered manually. Interesting concept for screening large populations for Pre-diabetes, obesity, Hypertension etc.
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Different clinicians - one platform
Cardio Diabetes COPD Nursing pers.
https://www.youtube.com/watch?v=WkzJYaRxp3I
Patient can review the data on the tablet
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Architecture overview
Clinician
Patient
Continua Health Alliance
medical devices
Very simple Android App GUI (Support BYOD)
Presentation server
• Secure cloud infrastructure • Based on VM’s
OpenTele server
System Integrations HL7/PHMR
Database And IHE XDS document
repository
Adaptable Clinical user
interface (Web portal)
Prop. System 3
Prop. System 2
Prop. System 1
An OpenTele installation Central Data repository
OpenTele -‐ overview
2 Silverbullet
3 OpenTele
4 Business opportunities
1
OpenTele Enterprise Architecture!
External EHR/EMR Systems!
Multiple OpenTele installations in a scalable private cloud.!
Central XDS and DB XDS repository, HL7/PHMR
Consolidates data from multiple OpenTele installations
Virtually limitless capacity scalability, but….. Challenges to scalability are organizational !
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OpenTele points of excellence
• Concept of workflow/questionnaires, with embedded clinical measurements.
• Graphical tool to design questionnaires
• Easy to use WEB portal
• APP for use with tablets and smartphones (IOS / Android)
• Standardized devices
• Only one platform needed for basic remote monitoring
• Open to infrastructures like Qualcomm life’s 2NET.
Automatic input • Blood saturation/pulse • Blood pressure • CTG • Weight • Glucose in blood • Lung function
(spirometer) • Continual glucose
measurement
Manual input • Temperature • Glucose i urine • CRP • Hemoglobin • Protein i urine
• Acquires ISO certificates ult. 2014 (ongoing) • Can deliver certified platform Q2 2015
• CE Marked medical device • Class I and Class II
• Cloud based delivery world wide (SaaS) • Extremely scalable
• Direct delivery or through partners (white label) • Partnering for local market • Logistics • Consulting/trainiing etc
• Unique knowledge of platform • Unique experience in delivery & maintenance • Value add to platform in terms of
• Components • New devices • Integration • Consulting • Implementation
• Danish nation as reference client
Company points of excellence
Status of OpenTele
Silverbullet has developed OpenTele has Open Source for Danish Government
Live version of OpenTele is maintained by Silverbullet Development, changes and support agreement with Danish Government
Live from 1/9 2013 - large scale
2000+ patients is using OpenTele as per 1/8 2014.
2nd version of OpenTele to be delivered before 1/1 2015.
CE mark Medical device class II by Q2 2015 - deliverable through cloud technology
SignOn in DK by 3 regions and 10+ municipalities including CPH Municipality. More to come.
Part of the governments national roll-out strategy
OpenTele hype
Thank you for your attention!