tools for regions managing digital transformation · 2017-09-11 · tools for regions managing...
TRANSCRIPT
1
@ehtel_ehealth EHTEL Summer 2017
Tools for regions managing
digital transformation: examples and illustrations
Marc Lange, Secretary General
@ehtel_ehealth@ehtel_ehealth
EHTEL Summer 2017 2
Authorities and Payers
UsersIndustry
2
@ehtel_ehealth@ehtel_ehealth
People with a different viewpoints
50+ corporate members
• with 300+ staff
• from 20+ countries
4 000+ followers
75% of members involved
in EU-funded projects
10+ EU events every year
EHTEL Summer 2017 3
@ehtel_ehealth@ehtel_ehealth
WHAT’S WRONG WITH THE
IMPLEMENTATION OF
DIGITAL HEALTH?
EHTEL Summer 2017 4
3
@ehtel_ehealth@ehtel_ehealth
The challenge of
telehealth and telecare implementation
75% of projects
fail during the operational stage
5
Chen, S., Cheng, A., & Mehta, K. (2013). A review of telemedicine business models.
Telemedicine and e-Health, 19(4), 287-297.
EHTEL Summer 2017
The challenge: NT+OS=NOS
New Technology + Old System =
New Old System
EHTEL Summer 20176
4
EHTEL Summer 2017
Scaling-up?From pilot to routine care …
7
Telemedicine
service
Run
Plan
People
Context
IT & eHealth
infrastructure
16Legal & sec.
guidelines
13
Legal & sec.
conditions
11
Legal & sec.
experts
14
Market
procurement
18
Service
monitoring
17
Change
management
10
Cultural
readiness
1
Leadership
3
Compelling
need
2
User
friendliness
6
Potential
to scale-up
12
Primary
client
8
Business
plan
9
Privacy
awareness
15Patient
centeredness
5
Stakeholder
involvement
4
Resource
aggregation
7
Strategy and management
Organisation and management
Legal and security
Technology and market
Enabling service deployment:
18 Critical success factors
EHTEL Summer 2017 8
5
EHTEL Summer 2017
With TREAT (Telemedicine REadiness Assessment Tool)
Doers working on a deployment plan
for a particular telehealth service
Will use these 18 Critical Success Factors to assess
their plan – collectively – against a set of indicators
CSF 1. Assure that there is cultural readiness for the telemedicine service
In my organisation/region, • doctors and other healthcare professionals are ready to share clinical
information with each other and with the patient• financial and other incentives are aligned with the service to be deployed• an underpinning culture embraces technology• an underpinning culture welcomes and even promotes change
9
Use cases
EHTEL Summer 201710
www.ehtelconnect.eu
6
JIT
EHTEL Summer 201711
25
15
1 1
0
In Scotland, there is a compelling case for the use of technology-enabled care across our health and social care services.
Strongly Agree (59.5%)
Agree (35.7%)
Don't Know (2.4%)
Disagree (2.4%)
Strongly Disagree (0.0%)
Self-assessment of the Critical
Success Factors for
Mainstream Adoption of
« Technology Enabled Care »
Strong points
Cultural readiness to change
Consensus on the advantage
of telemedicine in meeting
compelling need(s)
Leadership
Resources availability for
scaling-up
12
16
2
9
3
There are financial resources available for development and embedding of technology-enabled care.
Strongly Agree (28.6%)
Agree (38.1%)
Don't Know (4.8%)
Disagree (21.4%)
Strongly Disagree (7.1%)
JIT
EHTEL Summer 201712
0
7
7
27
1
Citizens who will benefit from technology-enabled care are sufficiently involved in developing services.
Strongly Agree (0.0%)
Agree (16.7%)
Don't Know (16.7%)
Disagree (64.3%)
Strongly Disagree (2.4%)
2
7
720
4
There is a level of trust such that medical professionals (including doctors), and other healthcare professionals, are ready to share clinical
information with each other and with their patients.
Strongly Agree (5.0%)
Agree (17.5%)
Don't Know (17.5%)
Disagree (50.0%)
Strongly Disagree (10.0%)
Challenges (1)
Capacities, skills and
engagement of
Citizens
Health professionals
Senior managers
7
JIT
EHTEL Summer 201713
0
13
13
12
2
There is appropriate alignment between the large-scale deployment of technology-enabled care and financial (and other) incentives.
Strongly Agree (0.0%)
Agree (32.5%)
Don't Know (32.5%)
Disagree (30.0%)
Strongly Disagree (5.0%)
0
11
11
15
3
Time and capacity to achieve implementation at scale is factored into action planning.
Strongly Agree (0.0%)
Agree (27.5%)
Don't Know (27.5%)
Disagree (37.5%)
Strongly Disagree (7.5%)
Challenges (2)
Change management
Commitment of managers
to lead change
Alignment between
incentives and
objectives
Management of the change
process
Interoperability
JIT
EHTEL Summer 201714
2
13
15
8
2
Transparent frameworks are in place for arrangements (e.g. contracts and Service Level Agreements) setting out expectations, rights and
responsibilities between providers and commissioners.
Strongly Agree (5.0%)
Agree (32.5%)
Don't Know (37.5%)
Disagree (20.0%)
Strongly Disagree (5.0%)
1
15
15
9
0
There is clear guidance on any legal, ethical and confidentiality issues relating to the deployment of technology-enabled care.
Strongly Agree (2.5%)
Agree (37.5%)
Don't Know (37.5%)
Disagree (22.5%)
Strongly Disagree (0.0%)
Challenges (3)
Governance and
infrastructure
Guidance needed on legal
and cyber-security issues
Service Level
Agreements …
8
JIT
Conclusions of the
workshop
Developing an action plan with key priorities and
timelines at both local levels and the national level
Obtaining the necessary skills to develop sound
business models to ensure sustainability
Benchmarking the new Telehealth & Telecare Delivery
Plan – that will take Scotland up to 2020 – through an
international Peer Review process
EHTEL Summer 201715
@ehtel_ehealth@ehtel_ehealth
DO WE HAVE ALL THE
ANSWERS FOR SCALING-UP?
EHTEL Summer 2017 16
9
@ehtel_ehealth@ehtel_ehealth
Service Innovation
≠ Product Innovation
R&D strengths are more important for new product
development than they are for service development
A company's willingness to cannibalize
organizational routines and prior investments is
more important in the case of new service
development than new product development
EHTEL Summer 2017 17
Edwin J. Nijssen, Bas Hillebrand, V, K (2006). Exploring product and service innovation similarities
and differences.(Elsevier, 241 - 251
@ehtel_ehealth@ehtel_ehealth
Technology versus Service Readiness
EHTEL Summer 2017 18
•Actual system proven in operational environment
TRL9
•System complete and qualified
TRL8
•System prototype demonstration in operational environment
TRL7
•Technology demonstrated in relevant environment
TRL6
•Technology validated in relevant environment
TRL5
•Technology validated in lab
TRL4
•Experimental proof of concept
TRL3
•Technology concept formulated
TRL2
•Basic principles observed
TRL1
•The service has been rolled out to its target population
SRL8
•The organisation supporting the services has been adapted as appropriate.
SRL7
•Wide-scale adoption: The service (with its technology solution) is adopted by its users and non-users
SRL6
•Evidence of the benefits of the service has been assessed with a statistically significant
SRL5
•Service prototype developed, tested and validated in lab
SRL4
•Technology identified as an enabler for the desired change
SRL3
•User readiness to change a process or create a new one
SRL2
•Capturing drivers and scoping area for change
SRL1
10
@ehtel_ehealth@ehtel_ehealth
Scaling-up: tools and methods
EHTEL Summer 2017 19
Environmental
conditions
SCIROCCO Maturity Model
Business
Model Canvas
Impact
assessment
MAST, HTA …
MAFEIP Decision Support
ASSIST Cost & Benefit
Scaling-up
management
Service
Readiness
Level model
MOMENTUM Critical Success
Factors
Testing facilities, living labs,
co-production labs, citizen
science …
@ehtel_ehealth@ehtel_ehealth
Scaling-up: tools and methods
EHTEL Summer 2017 20
Environmental
conditions
SCIROCCO Maturity Model
Business
Model Canvas
Impact
assessment
MAST, HTA …
MAFEIP Decision Support
ASSIST Cost & Benefit
Scaling-up
management
Service
Readiness
Level model
MOMENTUM Critical Success
Factors
Testing facilities, living labs,
co-production labs, citizen
science …
11
@ehtel_ehealth@ehtel_ehealth
Early Impact Assessment
EHTEL Summer 2017 21
Monitoring and Assessment Framework
for the EIP on Active and Healthy Ageing
An on-line analysis tool which
• Provides an early assessment of the likelihood that
interventions will achieve the anticipated impact,
• Helps to identify what drives interventions’ effectiveness or
efficiency
A use case in Cataluña
• Elderly patients, living at home, with a history of heart failure or
stroke and an additional chronic disease.
• MAFEIP showed that the intervention is better (more effective)
than the standard care, but that it is also more expensive!
www.mafeip.eu
Willingness to
Pay?
@ehtel_ehealth@ehtel_ehealth
Data Collection and
Impact Assessment
Model for Assessment of Telemedicine (MAST)
www.united4health.eu/overview/project-evaluation/
Based on the EUnetHTA model, and adjusted to
telemedicine
Objectives
• Guiding research teams in structuring their data collection
• Improving the scientific level of data collection and reporting
Towards a predictive modelling tool
EHTEL Summer 2017 22
12
@ehtel_ehealth@ehtel_ehealth
MAST use cases
EHTEL Summer 2017 23
© HIM s.a.
@ehtel_ehealth@ehtel_ehealth
ONCE AGAIN, DO WE HAVE
ALL THE APPROPRIATE
ANSWERS FOR SCALING-UP?
EHTEL Summer 2017 24
13
@ehtel_ehealth@ehtel_ehealth
Scaling-up: tools and methods
EHTEL Summer 2017 25
Environmental
conditions
SCIROCCO Maturity Model
Business
Model Canvas
Impact
assessment
MAST, HTA …
MAFEIP Decision Support
ASSIST Cost & Benefit
Scaling-up
management
Service
Readiness
Level model
MOMENTUM Critical Success
Factors
Testing facilities, living labs,
co-production labs, citizen
science …
@ SCIROCCO_EU
► From pilot to routine care …
◼ Technology
◼ Change Management
Scaling-up Innovative Services
for Integrated Care
EHTEL SUMMER 2017
► But
◼ People need to be ready for change
◼ A structure is needed to finance innovative services and manage their deployment
◼ An eHealth infrastructure is needed to support and ease their deployment
◼ Transition funding is needed to deploy the new model of care and decommission the older one
◼ Plans and means are needed to deal with inhibitors in place
14
@ SCIROCCO_EU
EHTEL SUMMER 2017
Maturity Model for
Integrated Care:
- 12 dimensions
(with an explanatory
narrative)
- each with a rating scale (0-5)
www.scirocco-project.eu
@ SCIROCCO_EU
Self-Assessment Conversations:
an On-Line Tool
EHTEL SUMMER 2017
Yes, but getting thedevices to
interoperate is anightmare!
We are all using HL7 FHIR
as standard for electronic data exchange
This will all be resolvedsoon, as we are joining an
international standardsgroup for devices
15
@ehtel_ehealth@ehtel_ehealth
Sustainability business modelling
To understand and create value for
• The organisation
• The patient
To expand practices in an economically
sustainable way
To increase the probability of success
To compare and contrast experiences
29EHTEL Summer 2017
@ehtel_ehealth@ehtel_ehealth
The Business Model Canvas
https://strategyzer.com/
http://www.businessmodelgeneration.com/canvas/bmc
30EHTEL Summer 2017
16
@ehtel_ehealth@ehtel_ehealth
Business modelling
in health and social care
Business Model for delivering care
• Despite it is an unusual term in the public sector,
all health and social services have an implicit business model.
• Deploying telehealth/telecare creates disruption and requires the
business model to be made explicit and adapted
Resources
• Telehealth/telecare to improve economic effectiveness
• To do more with less or
• More with the same overall budget
Reimbursement
• “Patient – health professional – payer” triangle
31EHTEL Summer 2017
@ehtel_ehealth@ehtel_ehealth
The Business Model Canvas
in health and social care
People
Professionals
Organizations
32EHTEL Summer 2017
17
@ehtel_ehealth@ehtel_ehealth
CASE STUDY
33EHTEL Summer 2017
www.ehtelconnect.eu
www.united4health.euU4H_EC
General Practitioner
CHF telehealth configuration& key interactions: Scotland
STH Florence / Medvivo / SPS Web Portal
Practice nurse
Data Transmission Information Exchange Optional Contact (direct/indirect)Triggered ALERT
Patient Telehealth IT-Infrastructure Care Team
STH Simple Telehealth /Medvivo / SPS Server
Health Coaching Messages:via Tabletand Mobile
Cardiology home-visiting specialist nurse
Florence / Homepod/ SPS Tablet
Family
Connected Devices
Cardiologists at hospital or
local healthdistrict
Please enter
Pulse & Blood Pressure
Cardiology home-visiting specialist nurse
EHTEL Summer 2017 34
18
@ehtel_ehealth@ehtel_ehealth
FLORENCE
Self-management
Improving health
outcomes
Quality of life
Pre-diagnosis
Care at home
Targeted care
Quality reputation
and compliance of
targets
(accommodating
evolution of
demand)
Cost reduction
Complex COPD
patients
Health
professionals
Hospital
Health system
Respiratory nurse
Referring clinician
GP
Hospital
Florence (IT co)
NHS
Strategic planners
Data governance
Personalization
Supported self-
management
Anticipatory care
Mobile (SMS)
Customer
documentation
Information
booklet
Enrolling
(stratification)
Early discharge
Monitoring
Alert management
Data Protection
Protocol
customization
Pulse-oximeter
SMS system
Smart phones
Investment: kit, smart phones
Recurring: communication cost
(SMS), annual license
Explicit: From TEC fund to
healthcare budget
Implicit: Efficiency gain
EHTEL Summer 2017 35
@ehtel_ehealth@ehtel_ehealth
Scaling-up: tools and methods
EHTEL Summer 2017 36
Environmental
conditions
SCIROCCO Maturity Model
Business
Model Canvas
Impact
assessment
MAST, HTA …
MAFEIP Decision Support
ASSIST Cost & Benefit
Scaling-up
management
Service
Readiness
Level model
MOMENTUM Critical Success
Factors
Testing facilities, living labs,
co-production labs, citizen
science …
19
@ehtel_ehealth@ehtel_ehealth
A service package which
Brings Europe direct to your desk
Facilitates for you
• A multi-stakeholder understanding of
implementation projects
• A self-assessment of implementation
successes and challenges
Is tailored to your needs
• By using well established methodologies
EHTEL Summer 2017 37
@ehtel_ehealth@ehtel_ehealth
EHTEL Summer
201738
Päivi Hämäläinen
“Doing a business modelling exercise with EHTEL really
fitted with the Scottish digital health and social care
context. It has really helped us to ‘future-proof’ the
directions we aim to take, and to inform our next step
digital health and social care plans.”
Margaret Whoriskey
“The project group became aware of the Critical Success Factors for
a successful roll out. The results have been presented to the
strategic leader group in the hospital and all the municipalities.
The project plan for 2015 had been revised, addressing two main
tasks: preparing and implementing a business plan and a change
management plan.”
Wenche Tangene
“In Finland, the policy makers needed to have a trusted review of our
eHealth achievements and our chosen strategic approach.
The review gave us the opportunity to reflect on our work to date. It meant
we could be positive about our investments. We could also move forward
with confidence as a country with our eHealth work”
20
@ehtel_ehealth@ehtel_ehealth
Sail with the European Union
- ride the wave with EHTEL!
EHTEL Summer 2017 39
www.ehtelconnect.eu
@ehtel_ehealth@ehtel_ehealth
Contact details
40
Marc Lange
Secretary general
EHTEL Association168, avenue de Tervuren, bte 2
B-1150 Brussels Belgium
Tel: +32 (0)2 230 15 34
Fax: +32 (0)2 230 84 40
Mobile: +32 (0)475 27 71 45
www.ehtel.eu
www.ehtel.eu
www.ehtelconnect.eu
EHTEL Summer 2017