e Health Hanze UAS Hugo Velthuijsen professor

e. Health @ Hanze UAS Hugo Velthuijsen, professor New Business & IT

Health and IT: worlds apart? 19 -3 -2018 New Business & ICT 2

Societal issues in rural areas Demographic change necessitates new solutions § § Demand for and costs of healthcare increasing Supply of (potential) caretakers is decreasing shortage in skilled employees § Also, necessary shift from intramural to extramural ► maximize number of people that live in “regular” housing § North East Netherlands is at the front of this change in The Netherlands § Technology is considered to be instrumental in solving issues resulting from resource shortage: § Money § Personnel § Dedicated housing 19 -3 -2018 New Business & IT

Challenges Health & Techology Common analyses national ánd international Known bottlenecks: ■ Attitude and willingness to change patients and clients ■ Attitude and willingness to change healthcare professionals ■ Limited or missing ‘medical evidence’ ■ Lack of knowledge on available solutions and how to use them ■ Lack of standardisation ■ Lack of sustainable business case ■ Law & regulations, e. g. privacy Source: www. ehealthnu. nl/barrieres and Actionplan e. Health implementation research, Zon. Mw, april 2013 19 -3 -2018 New Business & ICT 4

Developments in Health & Technology Meanwhile…. But the good news is…. Developments in the Netherlands: § § Acknowledgment healthcare insurers Awareness in healthcare industry § Self management patients § Access to personal health records § Planning appointments with specialists § Growing need for synchronisation in care supply § Growing need for communication & interaction on patient level (health literacy) § Growing need for sharing with peers § Growing sense of urgency to resolve those bottlenecks 19 -3 -2018 New Business & IT

Health and IT: how to build a bridge “intercultural cooperation” • • • 19 -3 -2018 Create common language/common culture Co-makership Integral approach: strategy, organisation, finance, technology New Business & ICT 6

Benefits of IT Main benefits of IT • facilitating access to comprehensive and detailed patient data • supporting adherence to guideline-based care • improving the process of care • increasing independence for patients incl self management But IT is often associated with • Quality control • Distraction from caregiving 19 -3 -2018 New Business & ICT 7

Adherence to guideline-based care • Process steps • Standardisation • Options • Ease of use • Values • Collaboration 19 -3 -2018 New Business & ICT 8

The process of care Source: Ordening in de wereld van ehealth, Whitepaper, Nictiz, 24 augustus 2012 19 -3 -2018 New Business & ICT 9

The process of care Source: Ordening in de wereld van ehealth, Whitepaper, Nictiz, 24 augustus 2012 19 -3 -2018 New Business & ICT 10

The process of care Source: Ordening in de wereld van ehealth, Whitepaper, Nictiz, 24 augustus 2012 19 -3 -2018 New Business & ICT 11

Ehealth topics NB&ICT Alignment between healthcare and technology educations • Active and Healthy Lifestyle and IT (m. Health, blended treatment, serious gaming, biofeedback loops: Quantified Self). • Healthy Ageing @ Work (biofeedback loops: Quantified Self) • Independent living solutions • Dementia, Living lab, and e. Health • e. Health and organisational change 19 -3 -2018 New Business & ICT 12

Healthy@Work Biofeedback loops to improve “fitness for the job” sensors • A database that stores output of all the sensors in use by employees. database analytics • A tool that analyses the sensor output data to distil relevant information out of this data and to allocate relevant suggestions for employees and employers. • An interface for employees to view their own information and suggestions to improve working habits and/or lifestyle, typically made available via a smart phone or tablet and/or website • A web-based interface for employers to view aggregated information on employees’ overall fitness and to offer suggestions for possible HR interventions

Independent Living Interreg project i. Age defines needs-driven solutions Self actualisation Closing windows Info services Esteem schedule advanced audio system contact peeers traffic scheduling Love/belonging contact gen practitioner EMR door opener stove protection Physiological 1 sport / exercise contact clubs contact friends contact family Video communication door camera Safety Internet access Contact neighbours e-consult burglary alarm fire alarm button hotline carer fall detection online shopping groceries sleep monitor delivery groceries NB Maslow used for organising ideas, not as a preferred model needs 19 -3 -2018 New Business & ICT 14

Independent Living Intelligent monitoring of Mentally Handicapped People Development of a system of telemonitoring and automated interventions supporting independent living of mentally handicapped people. § System § Sensors and actors in homes § Expert system that initiates interventions given observed situations 19 -3 -2018 New Business & IT Mentally handicapped § IQ ca 50 -85 § Need for a regulated life without excesses § Poor sense of time, duration, location, distance, risks, good or evil § Poor sense of cause & effect, if-then, taking initiatives, planning, finishing § Current support § Human interventions: observation, signalling, intervention § Mostly reactive § Improvements: § Automatic observation, signalling , intervention § Improving independence of clients § Support more proactive than reactive § Support more tactical than operational § Decrease of incidents and escalations

Dementia Computer Aided Virtual Environment for patients with dementia CAVE project § Aimed at improving wellbeing of patients with dementia § Stimulating memories with images, sounds, smells § Generic and specific content § Living Lab: Research environment with sensors observing: § Reactions & interactions § Physical signs of well being § Mental states § Research questions: § Which interventions improve well being? § How can we measure well being? § What are potential benefits for the healthcare organisation 19 -3 -2018 New Business & IT 16

Ehealth and organisational change • Change management and co-creation (Agile) • Business modelling • IT maturity • Managing success and failure • Evolving standards of “evidence-based” 19 -3 -2018 New Business & ICT 17

Ehealth and organisational change Best practices during all steps of the development process STOF Business Model Framework MARKET DYNAMICS e. g. changing customer demands competition Requirements BUSINESS MODEL Service Domain Design Value Proposition Market Segment NETWORK VALUE e. g. revenues TECHNOLOGICAL ADVANCEMENTS Technology Domain Functionality required Experiments Financial Domain Cost structure Profit potential CUSTOMER VALUE Organisational Domain Pilot e. g. ease of use, costs, experience Structure of value network Implementation CHANGES IN LEGISLATION Source: ehix. nl 19 -3 -2018 e. g. antitrust and privacy legislation New Business & ICT 18

Thank you!