TCares Final Meeting Dorking June 16 th 2011

TCares Final Meeting Dorking June 16 th 2011 Dorking, UK Eric Schlangen, Project leader TCares Pantein, NL Presentation Businesscase Pantein

Overview Approach NHS 8 steps Business case Pantein Telecare implementation review

Business Case Business case for Dutch pilots is accepted by board Part of the pilots will be writing a business case for large scale implementation The importance of having a good BC was part of our telecare review, identified as an important success factor BC is a working document, it should be refreshed from time to time

Business Case Looking for a good approach: Telecare BC are difficult to write because of the many variables in the process: • Many stakeholders • Technology evolves quickly • Integrating and thus changing more services • Financial insecurities: write off, revenues, many claims but little proof Document NHS provides good information on writing a BC.

Business Case NHS states 8 steps to follow to create a BC • Identifying the needs • Establishing buy-in (involving stakeholders) • Considering technology • Workforce requirements (change management) • Designing the evaluation • Planning the implementation • Stating the business case • Sharing best practice

Dutch Pilots (not People funded) Project 1 (July/August 2011) Pantein community (Pantein Home Care 50 clients) Information, news, health, wellbeing, activities, neighbourhood. Project 2 (September 2011) Independent Living (Pantein residential Care 25+10 clients) Project 1 plus: video contact, home automation/surveillance Project 3 (September 2011) Telemonitoring Heartfailure (Pantein Hospital 20 clients)

Nature of telecare is changing Started out as personal alarm unit More functions surveillance added (movement, fire) Controlling house electronics (light, power, climate, RTV) Video contact with doctor or nurse Video contact friends and relatives Games, information In NL the social aspect of telecare is becoming the key feature for independent living

Social media and telecare Passive websites Interactive websites and webshops Social media and web communities Create new opportunities for communication based on shared interests, free from boundries of location Facebook 700 M members 10% of the world population Linked. In 100 M members (professionals) Dutch community Hyves 11 M, 66% of all Dutch We want a platform to combine telecare and Social Media

PAL 4: Personal Assistant for Life Founded in 2006 as reaction to technology driven telecare Lots of possibilities the users didn't want Caregivers wanted communication tool to prevent housecalls Clients want safety, interaction, games and most of all: simplicity '09: PAL 4 awarded best practice by Dutch ministry of health PAL 4 is an open platform that provides all this and can develop and add new functionalities

Background and trends Development of supply and demand of care Growing expenditure from 4000 to 6300 Euro pppy in 2020 Shift from hospital to care-home to home care Social and cultural changes in clients (& in finance, knowledge) Growing number of chronically ill to 2020: Diabetes / COPD / Heart failure > 36 -43% Dementia > 41% More complex technology: biotech, nanotech, smart drugs Market dynamics: quality and service become important

Importance innovative ICT New forms of supply for professional and informal carers • Reducing workload • Increasing efficiency • Substituting labor with technology Government: telecare policies: AWBZ, ZVW, DBC’s Municipalities (informal care: WMO) lagging behind Health information now in top 10 internet activities in NL

Chances for Pantein Service and information · extra revenues Telecare · supporting CRM · new product & revenues Welfare support · improving efficiency · substituting care with wellbeing Informal carer support · prevention · customer satisfaction Binding strategic partners · improving efficiency · strengthening market position · more services for clients

PAL 4 background Founded in 2006 with 4 healthcare providers Now recognised for upscaling by ministry Currently joint venture with 35 care providers Co creation: content group every three months Personal content: news, activities, games (editorial desk) Secure HQ video technology (German police) Open technology with webinterface to other applications (patient files) Integrating physical and virtual reality

PAL 4 connected: menu card Choice for user: start with base kit Ususally followed by alarms (KIWA Quality Mark) Automatic locks (Police Quality Mark) Sensors Extra: Video surveillance (walking digital rounds) For the Hospital pilot: COPD & Heartfailure • Information and clarification materials • Video support (consultation hours) • Telemonitoring or coaching with daily risk profiles

Pantein proposition Planning: 1. Businesscase and investmentplan 2. Application Healthcare Infrastructure Policy (AWBZ clients) 3. On approval of application pilot will start 4. Paralel application for the Care Innovation Policy for screen to screen care 5. 24 months two fased upscaling • 2011: 35+20 • 2012 another 45 6. All get base kit, 50 get extra sensors from the menu 7. Leasing with option to buy

Pantein proposition The cost include: o Subscription and licensing fees o Equipment (Touchscreen, Alarm, + av. 1 extra sensor per user) o 1 Video-control room station (to be placed on location of choice) o 2 Video-team posts o 1 Medical-team post (in the hospital) o Internet connections with 50% of the users o Installation and instruction in users homes o Editorial services incl. help desk and “virtual activities” (*e. g. bingo) o Project consultancy by project leader PAL 4 (besides internal project leader Pantein)

Summary Cost for Pantein (100 clients) Subtotal net investment 24 months Subtotal net operating cost clients 24 months Total cost video and content network Financing for Pantein Healthcare infrastructure policy: investment Healthcare infrastructure policy: clients operations Healthcare infrastructure policy: carers operations Care production AWBZ (4 hrs/conn. /month) Care innovation policy (indic. time) Total financing from policies Euro 83. 122 434. 713 35. 557 553. 410 83. 122 434. 713 35. 557 reminder 553. 410

Potential Other possible revenues (100 clients) Euro Care production under AWBZ performance contract 4 hrs per 468. 000 per connection Acceptance care innovation p[olicy or Screen to screen policy 5 minutes tele 43. 333 Extra income Pantein web-community (payment by third parties, municipali pm Total result Pantein before deducting personel cost Result per year before deducting personel cost 511. 333 255. 667

Preferred partnership In the defined region where Pantein works New developments New content Marketing tools PR and communications from PAL 4 Will be made first available to Pantein. If people want to subscribe to PAL 4 through the national PAL 4 website they will be referred to Pantein

Telecare implementation review Success and failure factors identified Implementation Project management Business model

Telecare implementation review Implementation: success factors Users like the social aspects of video communication Users see privacy as a medium of exchange for safety Users ask more during e-consults Users will use services they didn't expect to use at the start Users are prepared to pay after they have experienced added value Safety features are most wanted, convenience remote 2 nd Showing benefits are greater than costs

Telecare implementation review Implementation: failure factors Regulations are not compatible with innovation of technology Users are not being involved: est. needs, designing, etc. Care workers see it as threat to and impoverishment of care Technology often not reliable No continuation plan: after pilot it falls apart

Telecare implementation review Project management: failure factors Projects are complicated to oversee / manage No clear allocation of responsibilities between parties No chain responsibility (“my part is OK”) Project management: success factors Enlarging the scale through cooperation

Telecare implementation review Business model: failure factors Not investing enough to make it work No structural funding or profitmodel No transparent cost overview for user Products are reliant on single/few supplier Business model: success factors Saving cost with open source software Standing out as care organization by providing e-health

Eric Schlangen habipro E: ericschlangen@habipro. nl T: +3150254686