A European Perspective on Patient Directed Healthcare, Health 2.0 and Lean Healthcare

I was made aware of this from a colleague in the US. For groups or organisations who are doing research into capturing information from the Patient journey this could be a worthwhile organisation to look to for monetary support to get your project off the ground.

The possibilities are endless with this. Been excited about Surface since it first came out and nice to see an example for use in Healthcare.

If you want to keep track of this follow @proxense on Twitter

I attended this conference last Thursday in Tralee. Having attended another event last year hosted by Tralee last year I was looking forward to this one. The emphasis was slightly different than previously which had a large amount of content in Supply Chain Management systems.

This year the theme of event was varied and was untimately centred around pulling latest and greatest developments in Sensor Networks, Bio Technology and Medicine to form a vision of how they can work together.

The main attraction of the event was Professor Andrew Fire who gave two talks. Andrew Fire shared the Nobel Prize for discovering how double-stranded RNA can switch off genes. From my own point of view whilst by no means an expert in the field I was still very interested having worked in the Biotech Industry for a few years and having some knowledge of the area.

Firstly he gave a talk on “Where will biology and medicine be in 30 years and who will get it there?”
One of the key challenges is to make clinical information more readily available and also available in a more structured manner rather than simply google searches. He also reflected on the degree of altruism that is oing to be necessary on the part of innovators and entrepreneurs in the field to share knowledge, in some cases not necessarily getting for their work.

The most interesting idea postulated by Prof Fire was the idea of Governments approaching research institutions with “Applied Problems” which could form research challenges and form the basis of academic and/or commercial research.

Next up was Dr. Sokwoo Rhee from Co-Founder and Chief Technology Officer with Millennial Net. His company specialises in multi hopping/wireless sensor/mesh network technology. This was really interesting stuff since I was familiar with the Medical Ring Sensor he developed for Nursing home patients as part of his MIT studies and which is mentioned in Shoumen Dattas paper Will Nano Butlers accept Micro-Payments.
One of the biggest challenges in Mesh Networks is scalibility (scalibility in mesh networks is measures in number of hops, not size). There are currently only around 2 mesh network technologies that can scale above 10, an average building requires well above 10 hops which poses a significant problem.

Sokwoo also talked about some other projects his company is involved in HVAC Monitoring and Control application in a large German supermarket retail chain.

Next Andrew Fire talked about his work on RNA-Triggered Gene Silencing.

Finally Dr. Shoumen Datta talked briefly about his paper which incorporated elements from all the previous speakers and synthesized the various strands into a vision for patient centric healthcare.

All in all a fascinating day. Thanks to Dr. Pat Doory, Brita Lyons and all the other IT Tralee people for putting on the event.

This is a great conference coming up for anyone interested in Healthcare. It’s being hosted by the Centre for Distributed Systems in Tralee IT.

The timetable for the event including speakers is here

I attended the Inaugural event earlier this year and really learned alot from it.

Just back from a very interesting conference in London on outcome measurement in healthcare services from the patient’s perspective. As longtime proponents of the value of outcome feedback from patients/clients of healthcare services we were heartened by the increased emphasis on this area within the UK DOH and NHS.

The term Patient Reported Outcome Measures (PROMS) is the designated term in healthcare services to describe this approach. Guidelines on using PROMS, based on the results of of research and piloting of PROMs in the NHS have recently been published.

This PROMS conference was in conjunction with the Institute of Healthcare Management and featured some very interesting presentations on the application of PROMS in healthcare provision in the UK. The event was absolutely packed out (estimate 250 attendees), mostly NHS healthcare managers and senior medical consultants in attendance. The organisers had clearly underestimated the interest in this subject.

What has prompted the growing interest in this event is the new Standard NHS Contract for Acute Services, introduced in April 2008 by the UK DOH. This includes a requirement in Schedule 5 to report from April 2009 on patient-reported outcome measures (PROMs) in a number of clincal specialities, hence the rush to understand PROMS and how to implement them by clinicians and healthcare managers.

Attendees heard from a range of speakers about the applications of PROMS in health.  Stefan Cano a researcher with the Institute of Neurology and psychometrician, gave an excellent presentation on the psychometrics of PROMS and had some very critical things to say about many of the current PROMS in practice. A psychologist by profession, he is clearly an individual with an indepth knowledge of the area backed up by excelllent research data and great presentation skills in what is quite a technical area. I expect to be posting further blogs about his work in the future.

Next up was Mark Emerton, clearly an expert in his specialist field of urology, his overview of the development of PROMS in this field was illuminated by his extensive clinical experience in the field. He trained as a psychologist prior to his training as a surgeon specialising in urology and his interest in the patients perspective on outcomes was been a consistent themes in his work

Further posts to follow including details on other presenters, in the meantine thanks to the Institute of Healthcare Managers and Healthcare Events for a great conference.

I’m not long in the door from attending the Health Informatics Society of Ireland annual conference. The Keynote speakers today were very impressive and I met some great people.

At the moment I’m too tired to write an entire post. However I was Tweeting at the event, for those of you not following me on Twitter here are the Tweets during the Keynote speakers (my iPhone battery ran out at noon)

For those of you unfamiliar with Twitter it is a Micro Blogging tool. Entries must be 140 characters or less and are generally called Tweets. You can follow people on Twitter and their updates and they in turn can follow your updates on Twitter.

The hash # tag can be added to Tweets to give contextual information to your entries, such as your location or a particular conference, event or topic. In this case I used the #HISI tag to signify Health Informatics Society of Ireland. People who cannot attend the event or who wish to find out what people are “Tweeting” on a particular location, conference or topic can search for Tweets containing that hash tag.

To see my updates on Twitter and join go here.

During the Health 2.o conference a couple of things really crystallized in my head. I’ve been so busy since that this is the first opportunity I’ve had to get my throughts down.

One of the main motivations of FIT (Feedback Informed Treatment) in our opinion is that very often the patient is an expert in their particular condition. This is especially true in the case of people suffering from long term chronic illness’.

So what was the main thing that I took from Health 2.0? Many of the tools such as Long tail search, social networks and other types of knowledge sharing all contribute to making the individual even more of an expert in their particular condition.

This is invaluable for two of the areas we are looking at:
1) Patient Self Management of their chronic illness
2) The Patient giving their evaluation of progress in treatment during the actual meeting/session with their healthcare professional

In fact I would go so far as to say that one cannot succeed without the other. There is no point in a patient becoming an expert in their condition if there is no means for them to have meaningful input into the direction of treatment based on their evaluation of progress. Conversely this makes the advocacy aspect and disseminating knowledge even more critical.

High rates of non compliance, treatment drop out and poor outcomes characterise many chronic diseases treatment programmes. Proposed solutions feature the design and implementation of simple feedback tools that permit practitioners to obtain valid and reliable feedback from patients in a feasible manner on their evaluation of progress in treatment and their experience of the treatment process.

Such tools, generally self report questionnaires administered at every treatment session, have been around for at least a decade in the field of psychological therapies. Psychological therapies that features such measures have come to be know as the client directed outcome informed (CDOI). An orientation which has gained in prominence in recent years thanks to the pioneering work of Michael Lambert and his colleagues at the University of Utah and Scott Miller and Barry Duncan at the Institute for the Study of Therapeutic Change.

More recently in an online discussion on the CDOI listserv initiated by Eric Kuelker of Mental Health Pros the concept of feedback improved treatment (FIT) was debated. This concept essentially describes an approach to treatment, adaptable by any healthcare practitioner, in which feedback from the patient on progress in treatment is privileged and an appropriate response to such feedback is seen as an important factor that contributes to treatment compliance, retention and outcome.

Such orientations have gained significant ground in terms of practitoner acceptance in the field of psychological therapies. They are poised to play a key role in guiding treating planning and administration in the broader healthcare sector in the future.

I’m in San Francisco for three weeks until November 6th. Amongst other things I’ll be attending Health 2.0 Con.

I’ll be kept busy as  a volunteer at the event however I’ll be providing frequent updates on Twitter twitter.com/endamadden and following up with some blogs on my thoughts and highlights from the conference.