Sananet reports the following results from its telemedicine in chronic care pilots:

• 30% reduction in hospitalization for heart failure patients in a telemedicine study from the University of Maastricht.
• Reduction in length of hospital stay for COPD patients from 13 days to 9 days on average in a telemedicine study from the University of Utrecht.
• In diabetes patients with an HbA1c of 8% or higher, a reduction in HbA1c of 1.5% compared to 0.6% in the control group in a study in Almere.

Although many think of telemedicine and telehealth as the remote collection of data from blood pressure monitors, digital weight scales, blood glucose monitors, and respiratory monitoring devices, Sananet achieved all of these results using a telemedicine system focused on educating and supporting patients at home in a simple daily text-message health dialogue about symptoms, behavior and knowledge.

Related posts:

Dutch Ministry of Health Recognizes Health Buddy for Best Practice in Telemedicine

Telebegeleiding met Health Buddy

Partners in Health has been improving chronic care in rural communities in Rwanda through an innovative model of care inspired by Paul Farmer. The regional hospital sees its mission as training community members to extend care into the community and monitor patients at home in order to prevent disease complications and the need for hospitalization. The hospital tracks symptoms and medications using electronic medical record (EMR) systems based on open source technologies. Meanwhile, the United States continues to neglect reforming our crisis-oriented health system because “we can’t afford it”, and the cost of chronic care continues to explode as the population ages. With far fewer resources, but with more creativity and courage, innovative leaders in Rwanda are creating new models of care based on prevention because they can’t afford not to. Maybe we can learn something from Rwanda.

In the most innovative models of care on both continents, health care providers have discovered that delivering better care with fewer resources can be possible with a proactive approach to supporting and monitoring patients at home rather than waiting for the inevitable complications of neglect. On both continents, healthcare providers have discovered that technology can be a useful tool to improve the effectiveness of care providers and to increase rather than replace personal touch.

In the United States, our healthcare system too often still penalizes rather than rewards prevention, especially in the largest fee-for-service system, Medicare. When it comes to innovation in disease management and prevention, we claim that we “can’t afford it,” while in a much poorer country in the heart of Africa, the government and the health system are working together to embrace innovation in home and community-based care because they can’t afford not to do it.

We have something to learn from innovations arising in places like Rwanda, where necessity truly is the mother of invention. Learning from such innovations can help us expose some of our own false dichotomies that too often have become an excuse to stifle innovation.

On Lok High Tech Chronic Care Transcript

• Slide 1: High Tech and Personal Touch: Case Studies in Chronic Care from United States and Africa Steve Brown, Founder and Former CEO, Health Hero Network On Lok Lifeways Conference, October 22, 2008 Sustainable Long Term Care: Ethics, Technology and International Perspectives
• Slide 2: Agenda   Background – Health Hero Network   Chronic Care Models   Example from US   Example from Africa   False Dichotomies in Chronic Care   A Better Mental Model
• Slide 3: Background: Health Hero Network We recognized a problem Too much effort spent treating the complications of chronic disease, and not enough on preventing them We had an idea A technology platform to enable a better model of care based on identifying problems early and changing behavior
• Slide 4: Health Buddy in 2008: Patients receive better support and monitoring at home   Daily check-in starts with “how are you feeling today”   Reporting symptoms and device readings like glucose and weight   Receiving supportive feedback and education
• Slide 5: Health Buddy 2008: Nurses can identify problems early and prevent complications   Dashboard to see how all patients are doing today.   Patients needs are triaged using red, yellow, green coding   Full picture includes symptoms, behavior and knowledge
• Slide 6: Why is innovation addressing the chronic care problem so painfully slow?   It is well known that monitoring high risk patients at home can improve care and reduce hospitalizations.   ABC World News Tonight featured Health Buddy way back in 1999 and predicted a new model of care for the 21st century.   The business of healthcare – especially in Medicare – still rewards treating complications far more than preventing them
• Slide 7: Meanwhile in Rwanda Africa, necessity is the mother of invention   Community health workers support and monitor at-risk patients at home   Focus on the simple things that have the biggest impact   Everything starts with “how are you feeling today”
• Slide 8: Partners in Health is a community-based model focused on prevention and education   The regional hospital sees its mission as preventing hospital admissions   Training community health workers to extend care into the community   Keeping organized and tracking patients with an open source electronic medical record system
• Slide 9: False Dichotomies in Chronic Care   High Tech versus Personal Touch   Improving Care versus Saving Money   Information Technology versus Simplicity
• Slide 10: False Dichotomy: Tech versus Touch. Explain the growth in social media! Life can be richer when we share more of it. 10 Lifeways Conference – Steve Brown 10/22/08
  Slide 11: False Dichotomy: Improving Care versus Saving Money
• Slide 12: False Dichotomy: Hi Tech versus Simplicity How About a Better Mental Model! Value Potential Value Cost Opportunity Realized Value Complexity
• Slide 13: Content can change the shape of the Potential Value Curve   Example: congestive heart failure, the leading hospital admission in Medicare   Focus on areas where you can make a difference.   Start with the simple things first
• Slide 14: Design can change the shape of the Realized Value Curve   Simplicity must be a strength
• Slide 15: Disruptive technology has radically changed the shape of the Price Curve   Cloud computing and resources   Open source tools for everything   Consumer electronics with open APIs   Result: 100x or greater capital efficiency
• Slide 16: Conclusions   High Tech can increase Personal Touch   Technology is just a tool, not a transformation   Apply the mental model to choose wisely   We can gain insights and inspiration in how to improve care and leverage technology from innovative models of care in highly resource constrained environments

“Telebegeleiding thuis geeft mensen met chronische ziekte meer veiligheid en zelfvertrouwen.”

It is not just the fact that Bill Clinton and The Clinton Foundation negotiated a deal on antiretroviral (ARV) drugs. It’s not just the fact that the once complex cocktail regimen of pills can be combined into one generic pill. It is because an army of community health workers visit patients in their villages every day, checking in to make sure everything is OK, and to make sure that everyone is taking their medicine.

Daily support and monitoring at home, working with informal caregivers in the community to surface problems early so that bigger problems can be prevented: That is the key to improving quality of care with limited resources.

Dr. Paul Farmer, as chronicled in the book “Mountains Beyond Mountains” by Tracy Kidder, realized this in Haiti a decade ago, and now the Partners in Health “accompagnateur” system is being rolled out in developing countries around the world. Is there something we might learn from Rwanda?

Conference Programme

Tuesday 28 November 2006
20.00 – 22.00	Welcome Reception – Registration
Wednesday 29 November 2006
08.00 – 09.30	Registration with Coffee and Tea
	Plenary Session 1
09.30 – 09.40	Opening Jack van Gelder • Chairman of the day Well known Dutch TV Journalist, Announcer
09.40 – 09.55	Welcome address Martin Eurlings • Minister Economic Affairs Province of Limburg
09.55 – 10.15	Strengthening the regional silver economy Marion Gierden-Jülich • Secretary of State for Generations, Family, Women and Integration, North-Rhine Westphalia
	Trends 1
10.15 – 10.45	Turn Silver into Gold – creative entrepreneurship Mary Furlong • Professor Entrepreneurship, Santa Clara University California (USA) Mary Furlong was founder of Seniornet (1986), ThirdAge Media (1996) and Mary Furlong and Associates (2002). The 45- to 64-year-olds are among the fastest-growing population of Internet users, and they spend more time on the web than their college-aged kids. Marketers who want to reach this group have to learn the right code. Download presentation (Powerpoint)
10.45 – 11.15	Coffee break
	Plenary Session 2
11.15 – 12.45	Towards a longer working life – ageing and the quality of work life Juhani Ilmarinen • Professor For Age Management and Work Ability Finnish, Institute of Occupational Health Thanks to the pioneering work of Juhani Ilmarinen Finland has won the Bertelsmann Prize this year for outstanding performance in the field of Active Ageing in the Economy and Society. Investments in the Work Ability of workers lead to a return of 12 to 30 times the original investment. Download presentation (Powerpoint) Remote health monitoring and management Stephen Brown • President, Health Hero Network (USA) Stephen Brown is the founder of Health Hero Network, a company now recognized as an industry leading innovator and solution provider for remote health monitoring and management in the USA with cost effectiveness for major healthcare institutions Download presentation (Powerpoint)Chances and choices in an ageing society Dolf van den Brink • former Member of the Board, ABN/AMRO Bank Co-author of the book ‘Vergrijzing Leeft’ on Ageing in The Netherlands – The ABN AMRO Bank is on the forefront of banks who invest in strong relationships with older clients by adapting and developing services. Download presentation (Powerpoint)Bayard: a winning publisher’s strategy targeted to the mature people Maxime de Jenlis • General Manager, Bayard Group Benelux De Jenlis developed six magazines for seniors in European countries, one of which is Plus Magazine in the Netherlands with a total circulation of nearly 1 million and a turnover of approx. 50 million Euros, including brand extension activities. Download presentation (Powerpoint)
12.45 – 14.00	Lunch at Rodahal
	Break Out Sessions 1
14.00 – 15.15	Health and Lifestyle
	Trends in prevention Chairman • Onno van Schayck, Professor Preventive Medicine, co-Director Research Institute CAPHRI Personalized Nutrition – Relevant for the silver generation Rob Beudeker • Business Unit Director/VP Personalized Nutrition, DSM Rob joined Gist-brocades in 1984 and has held various management positions at Gist-brocades and DSM Food Specialties since. At present he is responsible for New Business Development at DSM Food Specialties and acts ad interim as VP Personalized Nutrition at the DSM Innovation Center. Download presentation (Powerpoint) Health creates wealth – meeting the legitimate demands of an ageing population for innovative and high quality health care Rory O’ Connor • Vice President Medical Affairs, Pfizer, Europe/Canada Pfizer is one of the world’s largest enterprises; with 100,000 employees and 12,000 medical researchers. Pfizer manufactures pharmaceuticals for 38 million patients worldwide. Motto: “Adding years to life, and life to years.” Download presentation (Powerpoint) Valueing the 50 plus consumer Klaus Ruhnau • Vice President Marketing Solution Management, Hartmann AG Hartmann AG (yearly turnover 1.2 billion) is known for its variety of products for wound treatment management and skin treatment continence management and for succesful communication with 50 plus consumers. Stay in touch with the older consumer or you will have to learn it the hard way. Download presentation (Powerpoint) Prevention as a challenge for the health care sector Guus Broos • Member of the Board of Orbis Medical and Healthcare Group of Companies Orbis is active in cure, care, independent and assisting living and homecare services. Orbis operates a hospital (Maaslandhospital), 10 independent and assisting living homes, homecareorganisation and a hospice in the region of Limburg. Real estate development for older people. Download presentation (Powerpoint)
14.00 – 15.15	Living and Home Environment
	Living and Home Environment Chairman • Alex Sievers, Senior Consultant, INBO Advisors Real Estate Senior communities: are they the future? Sun City – recreation in the adult community Don Schordje • President, Recreation Centres of Sun City (RCSC) The RCSC manages the seven recreation centres in the first active adult community in the world: Sun City. RCSC is a non-profit organization that operates the Sun City recreational facilities for the benefit of its members. To develop and build for seniors – challenge of the century Rob de Jong • Director, TCN Property Projects TCN Property Projects is one of the Netherlands’ top project developers, distinguishing itself through innovative concepts and creativity in design, management and financing. TCN is involved in the initiative ‘Senior City’. Builders and developers have to acknowledge the preferences and wishes of older people. Download presentation (Powerpoint) Living together – intergenerational living forms Thomas Möller • Manager, Freie Scholle The Freie Scholle is housing corporation, which distinguishes itself in the debate about new living arrangements for seniors with a preference for intergenerational living arrangements. Villages and, cities should offer people of all ages a variety of choice, so that people of all ages can meet, talk, support and serve each other in daily life.
14.00 – 15.15	Work and Income
	Chairman • Paul Staal, Arbo Unie, vice chairman BOA, chairman STECR, platform ReintegrationAge management and return on investment in older workers Juhani Ilmarinen • Professor For Age Management and Work Ability, Finnish Institute of Occupational Health Thanks to the pioneering work of Juhani Ilmarinen Finland has won the Bertelsmann Prize this year for outstanding performance in the field of Active Ageing in the Economy and Society (‘Towards a longer Worklife!’). Investments in the Work Ability of workers lead to a return of approx. 12 to 30 times the original investment. Download presentation 1(Powerpoint) Download presentation 2 (Powerpoint)
14.00 – 15.15	Tourism and Culture
	Travelling Chairman • Dick Knook, Professor of gerontology emeritus, University of Leiden and ‘Senior’ Consultant The future (of tourism) belongs to the seniors: Challenges of a fast growing market Dick Knook • Professor of gerontology emeritus, University of Leiden and ‘Senior’ Consultant Dick Knook published the book Seniors & Tourism. Tourism will become one of the world’s main economic sectors in this century, which will also see a strong ageing of the population in many countries. The confluence of these two trends is opening up numerous opportunities. Download presentation (Powerpoint) A world to win Richard Smits • Director Tour Operator Maaskant Reizen Maaskant Reizen is active in the market for Third Agers in the Netherlands, organising round trips ans excursions throughout Europe. Download presentation (Word) Travelling with a handicap Fini de Paauw • Publisher Blauwe Gids (Accommodation Guide for persons with a handicap) and Vice President of the National Council for the Handicapped and Chronically Ill Handicapped people face numerous barriers in accommodations and transport. They represent a fast growing market segment, also because of the ageing of the population. A chance for entrepreneurs.
14.00 – 15.15	Communication and Networking
	Media and Communication Chairman • Jack van Gelder, Journalist, Announcer Effective communication – how to do it? Maxime de Jenlis • General Manager, Bayard Group Benelux De Jenlis developed six magazines for seniors in European countries (one of which is Plus Magazine in the Netherlands) with a total circulation of nearly 1 million and a turnover of approx. 50 million Euros. Download presentation (Powerpoint) Innovation in the media: the advance of seniors Jan Slagter • Director and Chairman, Max Broadcasting In only a few month’s time, Max´s programmes became the best watched programmes in the Netherlands. The ‘50PlusBeurs’ (50PlusFair): the world’s largest communication platform and market place Alexander van de Kerkhof • Director, 50PlusBeurs With 560 exhibitors and 100,000 visitors the 50PlusFair is THE annual event for 50+ people in the Netherlands. Download presentation (Powerpoint)
15.15 – 15.45	Coffee Break
	Break Out Sessions 2
15.45 – 17.00	Health and Lifestyle
	Chairman • Onno van Schayck, Professor Preventive Medicine, co-Director Research Institute CAPHRICare technology for the silver century Maarten Janknegt • Member of the Board of Directors, Siemens Netherlands NV Arthur de Bos • Project Development, Siemens Siemens´ Medical Solutions division is one of the world’s largest suppliers of the health care industry. The company is reknown for linking innovative medical technology, health care information systems, management consulting, and support services to help customers achieve tangible, sustainable, clinical, and financial outcomes. Download presentation (Powerpoint)Technology as condition and driver for economic participation of senior citizens. Lessons from European comparative studies Lutz Kubitschke • Researcher, Empirica Ingo Meyer • Empirica Empirica is one of Europe’s leading research institutes in the field of technology and ageing. Lutz Kubitschke led programmes such as SeniorWatch which is at the base of many new developments. Scenarios for future independent living Josephine Dries • Researcher TNO Information and Communication, the Netherlands Organisation for Applied Technological Research Josephine Dries has over nine years experience in researching the relationship between ICT and older people and new design concepts of ICT applications (user centered design) involving older persons. Download presentation (Powerpoint)
15.45 – 17.00	Business development
	Master class Entrepreneurship Reaching out successfully to baby boomer and senior consumers Mary Furlong • Professor Entrepreneurship, Santa Clara University California Mary Furlong was founder of Seniornet (1986), ThirdAge Media (1996) and Mary Furlong and Associates (2002). The 45- to 64-year-olds are among the fastest-growing population of Internet users, and they spend more time on the Web than their college-aged kids. Those who want to reach this group have to learn the right code. Download presentation (Powerpoint)
15.45 – 17.00	Work and Income
	Workplace Innovation Chairman • Paul Staal, Arbo Unie, vice chairman BOA, chairman STECR, platform Reintegration Ireland’s National Workplace Strategy – supporting older workers Cathal O’ Regan • Head of Workplace Strategy at Ireland’s National Centre for Partnership and Performance Recent policy developments in Ireland reflect a commitment by Government and the Social Partners to supporting older workers and recognising their vital role in Ireland’s growing knowledge economy. These developments are outlined by Cathal O’ Regan of the NCPP, which acts to support such policy developments. Download presentation (Powerpoint) Age as a part of diversity management: A business case Mike Sharrock • Managing Director, BP Netherlands Demographic change as one real challenge for BP, one of the largest energy suppliers in the world… Download presentation (Powerpoint) Life course policies in organisations: a quick scan Dorinde Brands • Advisor, Expertise Centrum Leeftijd (Expertise Centre on Age and Life course) The Expertise Centre has more than ten years experience of successfully influencing national and European legislation and the legal infrastructure against age discrimination and for the equal treatment of people of all ages. It supports employers and employees in redesigning age strategies and investments following a life course perspective. Download presentation (Powerpoint)
15.45 – 17.00	Tourism and Culture
	Cultural Entrepreneurship Chairman • Conny Groot, Director of Catharsis Producties Amsterdam The silver economy from a film producers view San Fu Maltha • Film Producer San Fu Maltha, one of the Netherland’s key producers, produced a.o. the highly successful features ‘Phileine says sorry’ and ‘In Orange’. Recently he released the biggest Dutch language film ever. Paul Verhoeven’s epic war thriller BLACK BOOK. Download presentation (Powerpoint) Cultural entrepreneurs – exploring the silver market Hans Jörg Schütz • Film-Kommunikation – Agentur für Filmmarketing Weimar The world of the cinema sometimes seems an exclusive world of popcorn chewing youngsters who watch the latest movies. Film Kommunikation developed new marketing concepts to attract older audiences to see high quality film. Download presentation (Powerpoint) Bealtaine Festival Ireland: Celebrating creativity at an older age Sue Russel • Director, Bealtaine Festival This annual event in May involves all of the main Irish cultural and artistic institutions, attracts 35,000 older visitors in hundreds of events and has become one of the largest Irish festivals. Download presentation (Powerpoint)
15.45 – 17.00	Communication and Networking
	Older consumers in focus Chairman • Jack van Gelder, Journalist, Announcer Adapting marketing and product strategies to the untapped silver potential Pieter Paul Verheggen • Trend Watcher, Motivaction A Motivaction survey showed that the web and computer industry left a silver market of 500 million Euros untouched. Download presentation (Powerpoint) Supermarket for all generations Ulrike Stöcker • Manager press and communications, EDEKA Unternehmensgruppe Nordbayern-Sachsen-Thüringen Edeka developed a successful, award-winning supermarket concept aiming at all generations and taking into account the ageing consumer. Download presentation (Powerpoint) Matching staff and consumers: a winning team B&Q (to be confirmed) The most well-known and successful age diversity story is the story of B&Q, warehouse for home and garden. Optimising the match between customers and staff in terms of age leads to a considerable increase of consumer satisfaction and 20% increase of turnover.
19.00 – 22.00	Dine Around Tour, Maastricht
Thursday 30 November 2006
08.00 – 09.00	Registration with Coffee and Tea
	Plenary Session 3
09.00 – 09.05	Opening Jack van Gelder • Chairman of the day Well-known Dutch TV Journalist, Announcer
	Trends 2
09.05 – 09.45	Longevity and pension reform – the silver economic perspective Dick Sluimers • acting chairman of the Board of Directors of ABP ABP: the pension fund for employers and employees in service of the Dutch government and the educational sector. With an invested capital of EUR 160 billion and 2.4 million customers ABP is Europe’s largest and the world’s second largest pension fund. Download presentation (Powerpoint)
09.45 – 10.30	Do’s and dont’s in communicating to aging boomers and seniors – illustrated by TV campaigns from the world Jean-Paul Tréguer • CEO of Senioragency International, the 1st international advertising network dedicated to 50+ consumers, based in 12 countries. Jean-Paul Tréguer is one of the world’s top silver marketers and author of ‘50+ Marketing’ (Palgrave Publisher).
10.30 – 11.00	Coffee Break
	Plenary Session 4
11.00 – 12.45	The AARP global network on business development Ladan Manteghi • AARP (50 plus member organisation USA) AARP has 36 million 50 plus members, issues ‘AARP The Magazine’ with a circulation of 22 million households, offers its members numerous services. AARP launched the AARP Global Network this year as a business to business association aiming at ensuring the needs of the ever growing global ageing population. Download presentation (Powerpoint)Living in Sun City keeps you alive Don Schordje • President, Recreation Centres of Sun City (RCSC) The RCSC manages the seven recreation centres in the first active adult community in the world: Sun City. RCSC is a non-profit organization that operates the Sun City recreational facilities for the benefit of its members.Ageing Society: New Opportunities? Peter van Leeuwen • Managing director, ING Bank, the Netherlands Are we to face a collapse of publicly financed pensions, or will a whole range of new arrangements arise to mitigate these financial problems and give way to new ventures? As Managing Director Institutions at ING Peter is responsible for service and product development for the public health sector and the public sector. Peter van Leeuwen also is Managing Director of ING Medinet, the centre of expertise for public health care. ING Medinet regulary publishes (sector related) research and organises events on various health care topics. Download presentation (Powerpoint) Care technology for the silver century Maarten Janknegt • Member of the Board of Directors, Siemens Netherlands NV Arthur de Bos • Project Development, Siemens Siemens´ Medical Solutions division is one of the world’s largest suppliers of the health care industry. The company is reknown for linking innovative medical technology, health care information systems, management consulting, and support services to help customers achieve tangible, sustainable, clinical, and financial outcomes. Download presentation (Powerpoint)
12.45 – 14.00	Lunch Rodahal
	Break Out Sessions 3
14.00 – 15.15	Health and Lifestyle
	Health Chairman • Paul Staal, Arbo Unie, vice chairman BOA, chairman STECR, platform Reintegration Healthy ageing – a consumers perspective Frans van der Ouderaa • Researcher, Unilever Corporate Research UK As one of the largest food businesses in the world Unilever makes a big impact on people’s health. Its mission is to add vitality to life. Frans van der Ouderaa is a specialist on the impact of food on older persons. Download presentation (Powerpoint) The Funding factor: Vitality & Insurances Alexander Korbee • Business Development Manager Prevention, Achmea Social Security Achmea is one of the largest insurance companies of the Netherlands, investing heavily in health and prevention related services. The core of these services is “The “Vitaliteitshuis” concept. The person responsible for these services and this concept as part of the business development activities of Achmea, is Alexander Kobree. Download presentation (Powerpoint) Technology supporting Health & Lifestyle Jeannette de Noord • Senior Director New Business Creation in the Business Unit Consumer Health & Wellness of Philips Electronics Jeannette’s work has a strong focus on the senior consumer. Royal Philips Electronics (headquartered in the Netherlands; 126.000 employees worldwide) is a global leader in healthcare, lifestyle and technology, delivering products, services and solutions through the brand promise of “sense and simplicity”.
14.00 – 15.15	Living and Home Environment
	Chairman • Alex Sievers, Senior Consultant, INBO Advisors Real EstateKey values and senior living, silver power – stimulation program Kees Penninx • Senior Policy Officer, Netherlands Institute Care and Welfare Zilveren Kracht (Silver Power) is a national stimulation program on civil society and living environment. It supports organisations and persons in staying productive and use their skills, knowledge and experience of seniors for the benefit of the community.Regional planning and development Alex Sievers • Senior Consultant, INBO Advisors Real Estate Walter Brouwers • Province of Gelderland INBO is an independent agency for regional planning and development, future vision development for neighbourhood and local community strategies. Sievers took the initiative for the project Senior City.
14.00 – 15.15	Work and Income
	Financial Services Chairman • Wil Foppen, Director of the Universiteit Maastricht Business School and Associate Dean of the Faculty of Economics & Business Administration of Universiteit Maastricht. Serving the silver economy Norbert Wahl • Director, Sparkassen- und Giroverband Rheinland-Pfalz The savings bank is a major player in the regional economy and takes an active role in developing silver economy strategies. Some building blocs for a sustainable solution of ageing in Belgium Frank Lierman • Chief Economist Dexia Bank, Belgium New financial arrangements for seniors Peter van Leeuwen • Member of the Board of Directors, ING Group, the Netherlands Download presentation (Powerpoint)
14.00 – 15.15	Tourism and Culture
	Health Tourism Chairman • Josef Hilbert, Director health Industries – Institute Work and Technology, Gelsenkirchen Creating a European network on health tourism Josef Hilbert • Research Director Health Industries, Institut Work and Technology, Gelsenkirchen. Josef Hilbert is responsible for development and initiatives on health tourism und “Kurorte” in German regions North Rhine Westphalia and Mecklenburg Vorpommern. Download presentation (Powerpoint) Health and prevention – a new role for spa’s Eberhard Volger • Doctor for Sebastian Kneipp Institut – Europäisches Centrum für Naturheilverfahren Demographic change urges us all to concentrate at prevention. Create better conditions for productive ageing in the future. Health Institutions such as ‘Kurorte’(spa’s) may have a new and important role to play. Download presentation (Powerpoint) Dutch market for spa’s – a work in progress Sjef van der Linden • professor rheumatology Maastricht Long term effects of spa therapy Marlies Sobczak-Boumans • spa expert A future full of chances Download presentation (Powerpoint)
14.00 – 15.15	Communication and Networking
	Doing business through seniors organisations Chairman • Jack van Gelder, Journalist, Announcer The AARP global network on business development Ladan Manteghi • AARP – 50 plus member organisation USA AARP has 36 million 50 plus members, issues ‘AARP The Magazine’ with a circulation of 22 million households, offers its members numerous services. AARP launched the AARP Global Network this year as a business to business association aiming at ensuring the needs of the ever growing global ageing population. Download presentation (Powerpoint) The big deal Arno Heltzel • Seniors Association Unie KBO Paul Mulder • Achmea Insurances The seniors association with 300,000 members and Achmea Insurances provide health insurance for older persons. A success story. Download presentation (Powerpoint) Supporting the silver economy – not just for profit Daniël de Levita • adjunct Director, Seniorweb Raquel Wanrooij • Rabobank – Case Study Seniorweb is a website and computer learning community in The Netherlands with 60,000 members in the 50 plus age groups. Teaching older persons to use the computers and use internet banking is certainly serving the development of the silver economy. Download presentation (Powerpoint)
	Plenary Session 5
15.30 – 16.00	Closing Session Announcement of next conference Award: Winner of the Best Practice Competition Final Conclusions

Transcript

Slide 1: Caring for People with Chronic Illness: The Role of Telehealth Technology Steve Brown CEO, Health Hero Network 29 November 2006

Slide 2: Our Shared Vision A better model of care serving people who struggle with chronic conditions.

Slide 3: What the world is thinking about right now:

Slide 4: What the world is thinking about right now:

Slide 5: What the world is thinking about right now:

Slide 6: What the world is thinking about right now:

Slide 7: What the world is thinking about right now:

Slide 8: What do we want?

Slide 9: What’s Telehealth Got To Do With It? A Better Model of Care = Change Behavior and Moving Care to the Home

Slide 10: How to Change Behavior and Move Care to the Home • Personal Coaches for Everyone? • Nurses with Phones? • Nurses with Cars? • Doctors with Phones and Cars? Remote Health Management Technology! What Gets Measured Gets Done!

Slide 11: The Market Has Arrived “ r. B ohana, an 82-year-ol W orl W arII M d d vet , has been abl t m ove from l vi i eran eo i ng n hospi underround-t -cl m edi ce he ock cal supervi on t a B rookl st o apart entw i h si o yn udi m t t hel ofa rel i y si pl m oni ori he p at vel m e t ng syst from H eal h H ero N et ork. em t w The hand-hel H eal h B uddy consol , w hi d t e ch pl i o hi phone, del vers hi bl ugs nt s i s ood pressure erans A ffai nurse. and w ei ghtreadi t a V et ngs o rs Ital prom pt hi t answ era seri of so smo es qual t i quest ons abouthi l i at ve i s ung and ci at ai m ent , l ke w het rcul ory l si herhi breat ng s hi i bet erorw orse t t day before. st han he “ s i so si pl a 2-year-ol coul do i , Thi s me d d t” M r. B ohana sai .” d

Slide 12: Success Story: Veterans Administration February 2006 Today • 16,000+ patients enrolled in daily home telehealth with Health Buddy • Deployed in 120+ clinical sites • Over 100 programs for 30+ chronic conditions

Slide 13: Care Management Process with the Health Buddy System Scripted messaging, monitoring and reporting platform Education, monitoring Personalized, remote care and feedback at home management and support.

Slide 14: Technology Enabled Model of Care The Health Buddy System Technology Provider Patient Enabled Directed Centric

Slide 15: Expanding the Reach of the Health Buddy System The Next Step: Platform Independent Content Delivery Solutions

Slide 16: Health Buddy Teleguidance Health Buddy Teleguidance Project Contributors: Health Hero Network • Delivery of Health Buddy Meavita Program content through the Sananet B.V. television with IPTV Impact Media • Pilot Program – Available for Meavita customers in the Netherlands – Initial program for diabetes patients – Health Buddy Teleguidance will Launch in 2007

Slide 17: Care Management Process: Technology-enabled, Provider-directed Model Health Buddy Desktop • Keeps care provider “in touch” with patient – Monitor patient daily – Assess patient risk – Identify change in patient’s health – Intervene before crisis occurs • Improves productivity • EMR Integration • Secure web application

Slide 18: Health Buddy Desktop: Tools to Enable Management by Exception

Slide 19: Health Buddy Programs  Adult Asthma 2  Hyperlipidemia • Library of 100+ programs  Advanced Illness /  Hypertension 1 • Over 30 health conditions  Med. Compliance Palliative Care  Anticoagulation  Myocardial Infarc. • English & Spanish  Bipolar Disorder  Pain Mgt 2 •  Cancer 2  Pediatric Asthma 2 Ready to deploy  Caregiver  Polypharmacy • Customizable  COPD 1  PTSD  Coronary Artery 2  Pre-Diabetes  Cystic Fibrosis  Schizophrenia  Depression 2  Sr. Wellness – Evidence based practice  Diabetes 1  Substance Abuse guidelines  Functional ADLs  Smoking Cessation – Patient education  Heart Failure 1  Spinal Cord Injury – Care management  Hepatitis C  Weight Mgt  HIV

Slide 20: Care Management Process: Personalized Coaching and Monitoring • Dynamic branching logic collects information on: – Symptoms – Behavior – Knowledge • Delivers unique reply to each patient response in the form of – Call to action – Information / education – Further assessment – Reinforcement / reminder – Acknowledgement

Slide 21: Care Management Process: Creating Feedback Loops Knowledge • Identify high risks & potential problems Behavior • Address needs through dynamic content Symptoms H M L Knowledge • Move risks to lower levels Behavior • Stabilize health status Symptoms H M L • Identify changes in status Knowledge early on Behavior • Manage by exception Symptoms H M L Stabilize Patients Over Time

Slide 22: VA Outcomes 2002: Telehealth Reduces Inpatient Utilization* • 40% reduction in ER visits • 63% reduction in hospital admissions • 63% reduction in hospital bed days of care • 64% reduction in nursing home admissions • 88% reduction in nursing home bed days 1-Year Telemedicine Care Coordination • Significantly improved Quality of Life SF36V Demonstration * Published in Disease Management Volume 5, Number 2, 2002.

Slide 23: VA Outcomes 2005: Telehealth Improves Clinical Outcomes* • Hospitalizations declined from 630 inpatient days pre to 122 during intervention period • Bed Days Of Care fell from 8.63 to 1.65 (p < 0.001) • Blood Pressure: 129/73 to 119/69 (p < 0.05) • Weight: 196 to 192 (p < 0.01) • Shortness of Breath 0-10 Scale: 4.0 to 2.7 (p = 0.02) 1-Year Telemedicine • ACE Inhibitor Avg Daily Dose: 24mg/d to 35 (p < 0.01) Care Coordination  -Blocker Avg Daily Dose: 84 mg/d to 94 (p = 0.05) Demonstration * Published in Telemedicine and e-Health Volume 11, Number 1, 2005.

Slide 24: SPAN-CHF II Study 2005: Telehealth Reduces Hospital Readmissions* All Cardiac 2.5 Heart Failure Hospitalizations Re-Hospitalizations 2.0 2.20 63% 1.82 Reduction 72% 1.5 (p=0.029) Reduction 1.0 (p=0.03) 3-Month CHF Study 0.81 0.5 0.51 Hospitalizations PPPY 0.0 Control Health Control Health Buddy Buddy * Presented at American Heart Association Annual Meeting, Scientific Sessions, 2005.

Slide 25: Mercy Study: Compliance Drives Outcomes Medication Compliance as Hospitalization Costs for CHF Measured by Pharmacy Claims patients decreased 52% PPPY and Patient Self-reporting 100% $25 80% $20 $25,013 94% 1-Year Diabetes & 60% $15 HF Study 40% $10 $11,854 34% 20% $5 0% $0 Before Health Buddy Standard Health Buddy

Slide 26: Patient Acceptance Patients enjoy significant improvements in quality of life1 • 95% patient satisfaction2 • 86% better understand their treatment and are better able to manage their health condition • Patients feel more connected to their care provider2 1 Diabetes Technology & Therapeutics, Volume 4, Number 6, 2002. 2. Henry Ford Medical Center, CAD Study, 2004. (n=602)

Slide 27: The People We Serve “Health Buddy is the best thing to come down the pike. When I get up in the morning, I feel confident I am good for another day.” Wally Browning 1941-2006

Slide 28: Contact Information: Steve Brown, CEO Health Hero Network, Inc. 2000 Seaport Blvd. Fourth Floor Redwood City, CA 94063 stevebrown@healthhero.com 650-779-9101

Mountain View, CA – May 23, 2005 – Health Hero Network’s Dutch partner Sananet B.V., an eHealth company offering information and communication technology products and services to improve the quality of health and social services in the Netherlands was selected by the Dutch Ministry of Health, Welfare and Sport (VWS) for a best practice project in telemedicine. Sananet was invited to demonstrate their project using Health Hero Network technology at the Ministerial Conference and Exhibition e-health 2005, May 23 and 24 in Tromso, Norway. The Ministerial Conference is a high-level conference and exhibition sponsored by the European Commission to promote advances in health care enabled by information and communications technology (ICT).

Representatives from Sananet will present their experiences and results with remote health monitoring for heart failure patients in Limburg to public health experts and decision makers from the entire European Union. Sananet will demonstrate the Health Buddy® system used in their telemedicine program sponsored by the Dutch Ministry of Economic Affairs and the Provincie Limburg which covers Heart Failure patients at the Academic Hospital Maastricht, the Atrium medical center in Heerlen and the Orbis medical and care group in Sittard/Geleen. The technology presented in Tromso will include the Health Buddy® appliance for monitoring and coaching patients with chronic illnesses and web-based decision support tools providing health data and services for care providers.

“In the Netherlands we showed that patients feel more safe and their self efficacy improves significantly after 6 weeks using the Health Buddy ® appliance at their home. The results are very promising for the near future and we expect that more patients with chronic illnesses will receive a Health Buddy ® appliance. In the Utrecht region we developed a telemedicine program which covers COPD sponsored by the Asthma foundation, and there we expect the same results. The selection as a Dutch Best Practice by the Ministry of Health for this Telehealth solution will accelerate the structural embedding of telemedicine programs in the Dutch Healthcare System, “ noted Jan Ramaekers, Sananet CEO. “Sananet is honored to have Health Hero Network as a strategic partner.”

“Around the world, people with chronic conditions have similar needs for coaching and monitoring at home in order to prevent hospitalization and improve the quality of care,” noted Steve Brown, Health Hero Network CEO. “Health Hero Network is honored to partner with leading innovators in Europe to advance chronic care, which is a critical necessity given the growing health needs of an aging population.”

About Sananet
Sananet B.V. offers products and services to enable professionals and patients to use sophisticated information and communication technology (ICT) for eHealth. Sananet enables healthcare professionals to link care providers with each other and patient data regardless of time or place, helping to provide efficient relations between different care partners and patients. The simplified communication facilitated by Sananet results in increased quality of care. Sananet’s services include consultancy, network capacity, training and solutions support. http://www.sananet.nl/

About Health Hero Network
Health Hero Network develops and markets the Health Buddy® system for health improvement. The Health Buddy system serves as the interface between patients at home and care providers, facilitating patient education and monitoring of chronic conditions. The system includes monitoring technologies, clinical information databases, Internet-enabled decision support tools, health management programs and content development tools. Through increased communication, behavior modification, and prevention, the Health Buddy system improves the quality of care. Based in Mountain View, California, Health Hero Network’s systems are protected by over 55 issued US patents. http://www.healthhero.com.

HEALTH HERO NETWORK CEO STEVE BROWN TO ADDRESS
ASIA-EUROPE MEETING IN LONDON
Home Health Monitoring Pioneer to Demonstrate how the Health Buddy® System
Is Being Globally Adopted to Improve Chronic Care

London – February 22, 2005 – Nations around the world can use similar approaches – including deploying home health monitoring technologies for people with chronic illness – in dealing with the challenge of aging populations, Health Hero Network CEO Steve Brown will tell an audience of European and Asian government and business leaders today.

Brown will deliver his address, “Advancing Chronic Care with eHealth Technologies in Japan: Proving Global Solutions for an Aging Population” at the annual Asia-Europe Meeting (ASEM) Conference on eCommerce in London. Health Hero Network markets the Health Buddy® system, a comprehensive technology solution for home health monitoring of people with chronic illness. In his speech, Brown will compare the implementation of home health monitoring in Japan in partnership with Yamatake and the deployment of the Health Buddy system in the Netherlands in partnership with Sananet.

“The need to improve chronic care for aging populations is driving very different health care systems to adopt very similar technology solutions,” Brown will say in his speech. “The Health Buddy system has led to dramatic improvements in the health of chronically ill patients in the U.S. and reductions in cost, and our partners are starting to experience similar successes in their initial efforts in their countries.”

ASEM is a multilateral forum for action-orientated debate between the EU Member States and Asian partner countries: Brunei, Burma, Cambodia, China, Indonesia, Japan, Korea, Laos, Malaysia, the Philippines, Singapore, Thailand, and Vietnam. The objective of this conference is to identify ways of increasing trade and investment through the use of online technologies.

About Health Hero Network
Health Hero Network develops and markets the Health Buddy® system for health improvement. The Health Buddy system serves as the interface between patients at home and care providers, facilitating patient education and monitoring of chronic conditions. The system includes monitoring technologies, clinical information databases, Internet-enabled decision support tools, health management programs and content development tools. Through increased communication, behavior modification, and prevention, the Health Buddy system improves the quality of care. Based in Mountain View, California, Health Hero Network’s systems are protected by over 55 issued US patents. http://www.healthhero.com

eHealth Programme

Monday 21 February 2005

08.30 Arrival and Registration

09.30 Plenary Session. Oficial Opening & Introduction
Conference Chairperson: Prof. John OÕReilly, CEO, Engineering and Physical Sciences Research Council

Keynote Speakers:
The Hon. Mike O’Brien, the UK Minister for eCommerce
Sir Richard Sykes, Rector Imperial College, London
Mr Takeshi Natsuno, Managing Director of Planning, i-mode Business Division, NTT DoCoMo Inc. Japan

Summary & Information on Streams

11.00 Coffee Break

11.30 eHealth Stream Session 1
Theme: Medical & Technology Future Convergence.
Chairperson: Professor Ricky Richardson: Vice President, ISFT, Chairman, UK eHealth Association

11.35 AneHealth, Anywhere. Professor Ricky Richardson, Chairman, UK eHealth Association

11.55 The Biological Continuum. Professor Richard Kitney, OBE, Professor of Biomedical Systems Engineering, Imperial College

12.15 The Impact of Molecular Biology on the Practice of Medicine.
Professor Stephen Smith, Dean of Medicine, Imperial College, London

12.35 Interactive Discussion. Chairperson: Professor Ricky Richardson, Vice President, ISFT, Chairman, UK eHealth Association

Professor Ricky Richardson
Professor Richard Kitney, OBE
Professor Stephen Smith

13.00 Lunch – Buffet in Conference Centre

14.00 eHealth Stream: Session 2
Theme: Telemedicine and International Outcomes.
Chairperson: Dr Niels Rossing, Danish Society of Clinical Telemedicine, Hon. Fellow of the European Federation for Medical Informatics

14.05 A European Perspective on eHealth as an agent for reform
Mats Larson; President European Health Telematics Association

14.20 Asian Perspectives on eHealth as an agent for reform
Ki-Chan Ahn, Korean eHealth Association
Tan Sri Dató Dr Abu Bakar bin Suleiman, President, International Medical University, Malaysia
Dr Sablee Aspar – Brunei
Prof. Wang Cai-you, Deputy Director of the Centre for Health Statistics and Information, Department of Health, The Peoples Republic of China

15.30 Interactive Discussion

15.45 Afternoon Tea

16.00 eHealth Stream: Session 3
Theme: Global Applications for eHealth.
Chairperson: Professor Ricky Richardson: Vice President, ISFT, Chairman, UK eHealth Association

Professor Jean-Claude Healy; World Health Organisation
WHO eHealth Strategy
The WHO Health Academy
eHealth for Crisis Management

16.30 Interactive Discussion

17.00 Streams Close. Exhibition and Networking.

17.30 Close of day 1

18.30 Meet and Travel to Dinner

19.30 Conference Reception & Dinner; The Royal Naval College, Greenwich

23.00 End

Tuesday 22 February 2005

08.30 Arrival, coffee, exhibitions

09.00 eHealth Stream Session 4
Theme: Putting eHealth Into Practice.
Chairperson: Professor Richard Kitney (OBE), Professor of Biomedical Systems Engineering, Imperial College

09.05 The National Programme for Information Technology (NPfIT):
Implementation and beyond. Richard Granger, Director General of IT for the NHS

09.20 NPfIT Local Service Providers: Perspectives on Achieving Successful Implementation.
Tim Smart – President, Consulting & Systems Integration, British Telecomm
Ken Lacey – Global Managing Partner Health & Life Sciences, Accenture
David Baker – NHS Account Director, CSC Alliance
Peter Hutchinson – Managing Director, UK Public Sector, Fujitsu Alliance

10.20 Interactive Discussion
Richard Granger
Tim Smart
Ken Lacey
David Baker
Peter Hutchinson

Conor Ward – Partner, Lovells Solicitors

10.40 Morning Coffee

11.00 eHealth Stream: Session 5
Theme: Realising Benefits from eHealth – Europe.
Chairperson: Mats Larson, President, European Health Telematics Association

Selected Case Studies:
The Danish eHealth Experience – Dr Arne Kverneland, Head of Department of Health Informatics, National Board of Health in Denmark.
Telemedicine Clinic, Barcelona – Dr Henrik Agrell, Vice President, European Telemedicine Clinic,
Current Finnish eHealth experiences and International Society for Telemedicine update – Dr Jarmo Reponen, President, Finnish Society of Telemedicine
Provision of regional cross-border eHealth programmes in Europe – Mark Simon, Chief Executive, ComMedica
NHS Direct New Media – Prof. Bob Gann, Director, NHS Direct New Media
HINE European eHospital Survey – Murray Bywater, Silicon Bridge Research

12.45 Lunch – Buffet in Conference Centre

14.00 eHealth Stream Session 6
Theme: Realising Benefits from eHealth – Asia
Chairperson: Tan Sri Dató Dr Abu Bakar bin Suleiman, President, International Medical University, Malaysia

Selected Case Studies:
The Ministry of Health hospital IT project, Malaysia – Dató Dr A Jai Mohan, Vice-President, Malaysian Health Informatics Association
Longitudinal population health records on a single platform in Hong Kong – Dr Chun Por Wong, Immediate past President of the Asia Pacific Association for Medical Informatics
An eHealth solution in Japan – Steve Brown, President and CEO, Health Hero Network Ltd

15.00 eHealth Stream Session 7
Theme: Looking To The Future; eHealth Innovation
Chairperson: Professor Ricky Richardson, Chairman, UK eHealth Association

Microwave Endometrial Ablation To Treat Heavy Menstrual Bleeding – Mr Ellis Downes MRCOG, Consultant Gynaecologist & Obstetrician, Chase Farm Hospital, North London UK
Technology & The Patient – Jo Wright, Managing Director of Global Health Business, British Telecom & Dr William Rutter, Chairman, iMetrikus
DVD-based training in the recognition of autism and Asperger syndrome
Prof. David Skuse; Institute of Child Health, Great Ormond Street Hospital for Children

16.00 Afternoon Tea

16.30 Plenary

Keynote Speakers:
European Commission: tbc
Mr Wang Zhong Min, Vice Administrator of the Standards Administration of China

Conference Chairman’s Summary:
Prof. John O’Reilly, CEO, Engineering and Physical Sciences Research Council

18.00 Official Close of Conference

18.30 Reception at ExCel, Exhibition and Conference Centre

20.30 End

Transcript

Slide 1: Mainstreaming eHealth

Slide 2: Advancing Chronic Care with eHealth Technologies in Japan: Proving Global Solutions for an Aging Population Steve Brown CEO Health Hero Network Ltd Mainstreaming eHealth

Slide 3: The Aging Population Challenge in Japan • Total population drops from 120M (2000) to 100M (2050) • Population over 65 rises from 18% (2000) to 37% (2050) • Traditional familial care of elderly declining rapidly • • New solutions needed for chronic care Mainstreaming eHealth

Slide 4: What can eHealth do? • Tools to support and educate patients to improve self- care, wellness, and health behavior • Tools to support caregivers in the monitoring and management of patients with chronic disease • Value to patients, caregivers, and society: Prevent the worsening of chronic disease Increase access to chronic care Lower the burden and cost of chronic care Mainstreaming eHealth

Slide 5: Tools to support and educate patients • Easy-to-use interactive countertop device • Daily personalized dialogue and guidance • Communication hub for home medical devices Behavior modification Mainstreaming eHealth

Slide 6: Personalized daily guidance and feedback • Congestive Heart Failure • Chronic Obstructive Pulmonary Disease • Coronary Artery Disease • Diabetes • Hypertension • Asthma • Depression • Senior Wellness (diet, activity, medications) Development tools and platform approach enables adaptation to local needs Mainstreaming eHealth

Slide 7: Fully customizable dialogue content • Example from Dutch COPD program operated by Sananet BV in Netherlands Mainstreaming eHealth

Slide 8: Communication hub for home medical devices * Subject to appropriate regulatory approvals Open system can serve devices from many different vendors Mainstreaming eHealth

Slide 9: Tools to support caregivers • Web-based application services for caregivers • Daily patient status and needs stratification • Symptoms, behavior, knowledge Monitor everyone but manage by exception Mainstreaming eHealth

Slide 10: Systems approach Enabling an improved model of chronic care Mainstreaming eHealth

Slide 11: Yamatake Corporation – Pioneer of chronic care improvement in Japan • Over 90 years experience in innovating in process automation and factory automation • Develops new business in the fields of health care, energy conservation and food safety and agriculture • 7,100 employees, over 1.4 billion (USD) in sales – 2003 • Created the Safety Service Centre which runs a personal emergency response service • Developed chronic care improvement system and service based on Health Buddy® system in partnership with Health Hero Network • Chronic care improvement services through Safety Service Centre Mainstreaming eHealth

Slide 12: Obstacles to improving chronic care in Japan • Insufficient economic incentives for healthcare providers to focus on prevention • Entrenched healthcare interests and institutions are slow to change • Population health factors are moving in the wrong direction (obesity, diabetes, lung disease all rising) Does this sound familiar? Mainstreaming eHealth

Slide 13: Situation in Japan is model for global needs to improve chronic care for aging population • Very different healthcare systems in Japan, Europe, USA • Very similar needs to improve chronic care for aging populations Leading toward similar eHealth solutions Mainstreaming eHealth

Slide 14: Video example is from Health Buddy® program in Netherlands operated by Sananet BV Mainstreaming eHealth

Slide 15: Similar chronic care improvement programsand pilots underway in 2005 • Japan (Yamatake) • Netherlands (Health Ministry, hospital pilots with Sananet) • USA (Veterans Affairs national program, Medicare pilots) Opportunity to learn from examples around the world New body of evidence being generated to support systems approach to improving chronic care for aging patients Based on eHealth enabling tools Mainstreaming eHealth

Slide 16: Future developments will further increase capabilities applications globally Health Buddy® 2 Processor: Samsung ARM 2410 Memory: 64MB Persistent Storage: 32 MB Operating System: Linux Screen: 640 x 240 Color LCD Ports: 4 USB, 1 RJ45 Serial Modem: 33.6 kbs Multiple languages Remote configuration 45 health applications Mainstreaming eHealth

Slide 17: Contact Information Steve Brown CEO Health Hero Network Ltd 40 Abbey Road Monkstown, Co. Dublin Ireland Tel: 00353 1 280 3997 Fax: 00353 1 280 9806 stevebrown@healthhero.com Mainstreaming eHealth