Closed-Loop Healthcare Monitoring in a Collaborative Heart Failure Network

Transkript

1 Closed-Loop Healthcare Monitoring in a Collaborative Heart Failure Network Graduelle Anpassung der Versorgungsstruktur R. Modre-Osprian 1,*, G. Pölzl 2, A. VonDerHeidt 2, P. Kastner 1 1 AIT Austrian Institute of Technology GmbH, Safety & Security Department, Assistive Healthcare Information Technology, Graz, Austria 2 Medizinische Universität Innsbruck, Univ.-Klinik für Innere Medizin III, Kardiologie und Angiologie, Innsbruck, Austria Kontakt: robert.modre@ait.ac.at

2 Hospitalisierung bei Herzinsuffizienz 18% 6% 7% Kostenverteilung Hospitalisation Medikamente Hausarzt 69% Ambulanzen 2 4 % Gesundheitsbudget > 350 Mill. EUR pro Jahr 2

3 Der natürliche Verlauf der Herzinsuffizienz Allen LA, Circulation

4 Welche Parameter sollen gemessen werden? 4

5 Modelle zur Verhinderung von Rehospitalisierungen Disease Management Program Telephonebased Telemonitoring Home-care Unterschiedliche Ergebnisse aus HI- Telemonitoring-Studien Patientenkollektiv Kontrollgruppe Compliance Methodik Prozessunterstützung Medikamentenmanagement Therapieoptimierung Schulung Persönlicher Kontakt Erfahrungen aus HerzMobil Tirol Ärzte sehen medizinischen Nutzen QoL & Selbstvertrauen

6 Offene Fragen Disease Management Program Welche Methode für wie lange für welches Patientenkollektiv? Home-care Effiziente, zeitnahe Kommunikation zwischen Patient - Arzt? Kollaboration des Betreuungspersonals continuity of care? Telephonebased Telemonitoring Individueller, anpassbarer Betreuungsgrad notwendig mhealth Apps / Telemonitoring Lösungen / Disease Management Programme

7 Closed Loop Heart Failure Management motivate patients to be compliant to treatment regimens monitor and manage patients at home better control the progress of the therapy react in time with personalized adjustments enhance patient adherence to medical treatment efficiently close the heart failure management loop detect upcoming adverse events early filtering the relevant signals from the noise of physiological data provided by remote monitoring platforms A.S. Desai and L. W. Stevenson. N Engl J Med. 2010;363:

8 Closed Loop Heart Failure Management mhealth home monitoring motivate patients to be compliant to treatment regimens monitor and manage patients at home better control the progress of the therapy react in time with personalized adjustments enhance patient adherence to medical treatment efficiently close the heart failure management loop detect upcoming adverse events early filtering the relevant signals from the noise of physiological data provided by remote monitoring platforms 8

9 Closed Mobile Health Loop Heart Keep Failure in Touch Management Technology based on NFC mhealth home monitoring motivate patients to be compliant to treatment regimens monitor and manage patients at home better control the progress of the therapy react in time with personalized adjustments enhance patient adherence to medical treatment efficiently close the heart failure management loop detect upcoming adverse events early Easy to use and easy to learn data acquisition procedure by simply touching one object after another filtering the relevant signals from the noise of physiological data provided by remote monitoring platforms Physical action of touching makes the patient actively taking part in his treatment process 9

10 Closed Loop Heart Failure Management mhealth home monitoring motivate patients to be compliant to treatment regimens monitor and manage patients at home better control the progress of the therapy react in time with personalized adjustments enhance patient adherence to medical treatment efficiently close the heart failure management loop detect upcoming adverse events early filtering the relevant signals from the noise of physiological data provided by remote monitoring platforms signal processing & analyzing 10

11 Closed Loop Heart Failure Management mhealth home monitoring motivate patients to be compliant to treatment regimens monitor and manage patients at home better control the progress of the therapy react in time with personalized adjustments enhance patient adherence to medical treatment efficiently close the heart failure management loop detect upcoming adverse events early filtering the relevant signals from the noise of physiological data provided by remote monitoring platforms signal processing & analyzing 11

12 Closed Loop Heart Failure Management motivate patients to be compliant to treatment regimens mhealth home monitoring monitor and manage patients at home integrated care better control the progress of the therapy react in time with personalized adjustments enhance patient adherence to medical treatment efficiently close the heart failure management loop detect upcoming adverse events early filtering the relevant signals from the noise of physiological data provided by remote monitoring platforms signal processing & analyzing 12

13 Closed Herzinsuffizienz Loop Heart Versorgungsnetz Failure Management motivate patients to be compliant to treatment regimens mhealth home monitoring monitor and manage patients at home integrated care better control the progress of the therapy react in time with personalized adjustments enhance patient adherence to medical treatment efficiently close the heart failure management loop detect upcoming adverse events early filtering the relevant signals from the noise of physiological data provided by remote monitoring platforms signal processing & analyzing 13

14 Vermeidbare Re-Hospitalisierung Green: Unavoidable Readmissions Rehospitalization for Heart Failure: Predict or Prevent? Akshay S. Desai and Lynne W. Stevenson. Circulation. 2012;126:

15 Betreuungsgrad 15

16 Betreuungsgrad 16

17 Betreuungsgrad 17

18 Betreuungsgrad 18

19 Graduelle Anpassung der Versorgungsstruktur Integriertes telemedizinisches Versorgungsnetzwerk mhealth App 19

20 Diskussion Verteilte Entscheidungsfindung Rechte, Pflichten, Haftung, Verantwortlichkeiten Klare Definition des Risikoprofils Einschluss-, Ausschluss-, Übergangskriterien Finanzierungsmodelle Öffentlich / Privat Ausblick mhealth basiertes Telemonitoring eingebettet in ein integriertes Versorgungsmodell schafft eine Möglichkeit zu einer angepassten und optimierten Betreuung chronischkranker Patienten 20

21 AIT Austrian Institute of Technology your ingenious partner Robert Modre-Osprian AIT Austrian Institute of Technology GmbH Assistive Healthcare Information Technology Safety & Security Department Reininghausstraße 13/1, 8020 Graz Thanks to Kardiologie Innsbruck Qualitätszirkel Herzinsuffizienz Herzmobil TILAK Tiroler Landeskrankenanstalten GmbH UMIT Land Tirol AIT - AHIT