e Health e Europe e Volution Dr Ricky

e. Health e. Europe e. Volution Dr Ricky J Richardson BSc MBBS MRCP(UK) FRCPCH DTM&H Chairman UK e. Health Association Chairman e. Health Working Group - EHTEL Board Member European Health Telematics Association – EHTEL Vice President International Society for Telemedicine Clinical Director Health. Systems Consultants Ltd Consultant Paediatrician Great Ormond Street Hospital for Children, London The Portland Hospital for Women & Children, London The Speech, Language and Hearing Centre, London

Health is far too important a subject to be left in the hands of the medical professionals !!!! Dr Halfdan Mahler - DG Emeritus - WHO after Oscar Wilde

The Bio. Intelligence Age BIOLOGIC Biosensors Biomaterials Biomimetic FUTURE PHYSICAL Cellular Genomics cyborg Robotics Bioinformatics HPCC/WWW MEMS/Nano Biocomputation INFORMATION

Who will be at the primary care interface of the future?

The e. Patient ! and the e. Nurse

The e. Patient is part of therapeutic team!!!!

What is e. Health?

The (e)ATM of Healthcare

e. Health • Clinical Applications Tele. Consultations (previously Telemedicine) Clinical Decision Making Support Software Vital Signs Monitoring Services Tele. Home. Care National e. Prescribing & e. Booking Services

Finance Departments Medical Devices Government Research and Development Patient Care Practitioners Transport Paramedics Insurance Companies Suppliers Human Resources Technical Support Personnel Patient Care Facilities Ambulances Medical Information Community Health Provision Professional Associations Medical Schools Alternative Medicine Patients e. Health Specialists: (Orthopaedics, Radiologists, Paediatrics Alternative Health Centres Information Technology Pharmaceuticals Quality Standards Strategy & Planning General Practitioners Clinics Surgeries Hospitals Specific Care Centres Hospices Primary Care Centres Home Monitoring Social Welfare

The Paradigm Shift The eight Drivers Forcing Change • Obligatory search for cost containment • • Changing demographics Peripheralisation of health care delivery Changing disease patterns Impact of information technology including IT support for clinical decisions - Telemedicine & e. Health • More informed and expectant patients C-Health • The well-being factor – responsibility shift into patients hands - The Wellness Paradigm • Knowledge Management – changing world

Integration of IT into Business Sectors Manufacturing Business Services (Banks) Public Services (Health…) Jean-Claude Healy 1990 2000 IT as a gadget 1980 May 2000 Trojan horse: networks, … Full Integration of IT into Business (Organisational, Legal) Re-engineering of the system

Traditional Healthcare Delivery Model Ph Mo ysi ve cal me nt Pa of tie nt s Teaching Hospitals 3° Health. Care 2° Health. Care 1° Health. Care Regional Hospitals District General Hospitals General Practitioners The Patient Community - Bottom of the pile!! Unchanged for 6000 years - circa 3000 BC!

The Informed Wired up Citizen Community The well-being factor WWW Freestanding Diagnostic Centres IDTV Direct Access to specialists Home Care Health Kiosks Day. Care Surgery IDTV C-Health WWW C-Health Community Acute Hospitals Trauma Maternity (Non-acute) (Acute) Allied Health. Care Professionals Primary Health. Care The ‘Super’ Primary Care Physician PRIMARY TELERADIOLOGY AND TELEPATHOLOGY ? Clusters of Specialists with Global Access ? e. Health & Telemedicine

The Impact of Globalisation on Healthcare delivery Healthcare Services move into the Retail Environment Shopping Mall medicine C-health: - Health-on-line Websites District General and Regional Hospitals become obsolete as a concept Emergence of Epicenters of Medical Excellence Managed Clinical Networks

The Impact of Globalisation on Healthcare delivery Hospitals………. . to e. Hospitals Old Markets Patients in the locality New Markets The Global Patient Community Shipping Mercantile Cruise ships (Sea. Med) Airline Industry Hotel Resorts Multinational Corporations (Shell /Amoco etc) The Military Space Travellers

The Paradigm Shift The Impact Healthcare Professionals • Healthcare practices - changing roles • Nurse Practitioners at Primary Care • Healthcare training • Financial remuneration/rewards • Healthcare vocation Patients Partners in the healthcare process

The Paradigm Shift Who will be the Primary Care Team of the Future? The e. Patient Family and friends Patient Web Communities e. Nurse Practitioners Pharmacists ? ? ? ? Will the family doctor become “The Wellness Guardian-Caretaker”?

ICT Solutions in Healthcare delivery Globalisation Healthcare Economists Patient Power The Medical Profession The World Wide Web New Technologies e. g. Mobile Videophones G 3 mobile networks 1980 Technology driven 1990 September 2003 Disappointment Healthcare Professionals: HELP!!!!! Sit on the fence or Resist “I told you so !” Accept the inevitable and want control

Telemedicine & e. Health The story so far • • Dr Kenneth Bird – Logan Airport – MGH – 1967 • Interactive Video Conferencing - 1980 • Tele-Radiology, USA - 1990 • International Telemedicine - 1994 • The Telemedicine Blueprint, Malaysia - 1997 • Telemedicine “Comes of Age” - 1998 Tele. Health ? Tele. Care ? Citizen-Health? • Telemedicine becomes “Medicine” - 1999 • e. Health : The Road Ahead - 2003