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Re-Health: Responsive e-Health for tackling the challenge of chronicity (Ricardo Devis)

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A brand new (tested) approach, a holistic digital strategy to tackle the challenge of chronicity, launched in the Basque Country for providing responsiveness and sustainability to the process of radically changing the current Health Model.

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Re-Health: Responsive e-Health for tackling the challenge of chronicity (Ricardo Devis)

  1. 1. Ricardo Devis<br /> • @ricardodevis<br />
  2. 2. A Responsive Digital Strategy fortackling the challenge of Chronicity<br />
  3. 3. 14 Strategic Projects on Chronicity<br />
  4. 4. …based on 5 Strategic Policies…<br />
  5. 5. …and a Chronicity Web site!<br /><br />
  6. 6. But we need a Digital Strategy!<br />
  7. 7. For Designing a Strategy we need…<br />A clear Direction<br />A solid Architecture for dealing properly with the relationship between the parts and the whole<br />A Response for everyone of the groups of actors involved in the Health System.<br />
  8. 8. Re-health aims<br />Responsiveness and Sustainability<br />
  9. 9. Towards a Definition (?!)<br />
  10. 10. What direction?<br />
  11. 11. The [assumed] e-Health Path<br />
  12. 12. The e-Health Simplistic Process<br />
  13. 13. e-Addition… Explained!<br />The same aim, but now with a plus: e-lectricity<br />
  14. 14. Bridging the gap!<br />
  15. 15. Responsive e-Health<br />
  16. 16. The e-Health Revised Process<br />
  17. 17. A Transitional Path<br />Discourse<br />Half-Duplex Dialogue<br />Dialogue<br />Conversation<br />
  18. 18. The Conversational Health System<br />
  19. 19. The Pivoting Aim: Chronicity<br />“In the Basque Country, chronic illnesses represent the dominant epidemiological situation of the country. It is estimated that they currently represent 80% of the interactions with the Basque Health System (BHS) and account for more than 77% of health expenditure”<br />Rafael Bengoa<br />
  20. 20. Re-Health is…<br />Conversational<br />Responsive<br />Adapted to HC actors<br />Integrated<br />Chronicity-aware<br />Sustainable<br />Supported by realcommunities of practice<br />
  21. 21. An integrated architecture<br />An Organically Ordered Web Architecture for HealthCare<br />
  22. 22. We need a sense of info-order<br />
  23. 23. A well balanced Architecture<br />“Organic Order: … The kind of order that is achieved when there is a perfect balance between the needs of the parts and the needs of the whole”<br />“The principle of organic order: Planning and construction will be guided by a process which allows the whole to emerge gradually from local acts”<br />Christopher Alexander, 1975<br />
  24. 24. Different Needs<br />
  25. 25. Does the Elastic User exist?<br />
  26. 26. A Common Solution?<br />
  27. 27. Real (different) Objectives<br />To flirt<br />For kids<br />To Work<br />
  28. 28. The Big Picture<br />
  29. 29. Architectural Drivers<br />
  30. 30. And Inside? The Integration Bus<br />e-HealthIntegration Bus<br />
  31. 31. The biggest Chronicity Living Lab<br />
  32. 32. Osakidetza orain<br />The Basque Health System’s Web Portal<br />
  33. 33. The Integrated Web Initiative<br />
  34. 34. Brand New Features<br />
  35. 35. Multimode Assistance<br />
  36. 36. A Multi-Channel Web Portal<br /><br />Integrates all previous portals<br />Virtual Web Assistant<br />Web Appointments<br />Instant Medical Assessment by Phone<br />iPhone, iPad, Android support<br />Integrated with a powerful Patient Relationship Management (PRM) infrastructure<br />902 20 30 20<br />Extended tosocial networks<br />
  37. 37. …fed with 14 Chronicity Projects<br />
  38. 38. Pro-sakidetza<br />An online network of real professional communities of practice<br />
  39. 39. Pro by Pros for Pros<br />
  40. 40. Unpredictable Master Plans<br />“Master plans have 2 unhealthy characteristics<br />Its existence alienates the users<br />…the members of the community can have little impact on the future shape of their community<br />Because most of the important decisions have already been made <br />…users live in a frozen future, able to affect only relatively trivial details<br />Neither the users nor the key decision makers can visualize the actual implications of the master plan.”<br />Extracted from Christopher Alexander, 1975<br />
  41. 41. Master Plans as… skyscrapers!<br />“A modern skyscraper has a fixed inflexible interior, which is secondary to the designed beauty of the exterior. Little attention is paid to the natural light, and often the interiors are constructed as “flexible office space,” which means cubicles. The flexibility is for management to set up offices for the company, not for the inhabitants –the employees- to taylor their own space. When you run out of space in the skyscraper, you build another; you don’t modify the existing one or add to it.”<br />Richard P. Gabriel, 1996 <br />
  42. 42. Habitability<br />Healthcare professionals are not mere users, but inhabitants of the Health System, and consequently they need a sense of…<br />Ownership<br />Professionals need to feel that they have some authority over what they are responsible for…<br />…and also a sense of ‘elitism’ that hold them together and makes each member of the team feel responsible for the others’ success (Richard P. Gabriel)<br />Professionals know what they need, and despite of the BHS master plans, they’re engaged with their own (usually modest) marginal communities, with their own look & feel and a consensus-based flexible structure.<br />…so they can comfortably inhabit them.<br />
  43. 43. A Network of Pro Communities<br />Pro Community #2<br />Pro Community #4<br />Agora<br />
  44. 44. Our First Pro Community<br />
  45. 45. A Pro Social Network<br />
  46. 46. Kronikoen sarea<br />A Community of Patients based on emotional elective affinities<br />
  47. 47. The Patients’ Associative Platform<br />
  48. 48. Identifying Moods as Objectives<br />Patient’s objectives use to be related to their moods and states-of-mind.<br />But it’s not always easy to recognize them!<br />We needed to use Interaction Design techniques for coming out with effective results<br />…that have being successfully validated by Chronic Patients<br />
  49. 49. Chronic Patients’ Emotional Cycle<br />
  50. 50. …mixing patients and carers!<br />
  51. 51. …promotinganEmotionalApproach<br />
  52. 52. …tothewayPatientswantto share!<br />
  53. 53. Patients… in their own way!<br />
  54. 54. Following the Patient’s State of Mind<br />
  55. 55. summary<br />Key Ideas: Drivers. Digital Architecture, Re-Health<br />
  56. 56. Different Needs, Different Drivers<br />
  57. 57. A Response for every BHS’ group<br />
  58. 58. Re…Re…Re…Re…Re…Re-Health<br />Re[sponsive]-Health is our way of saying that…<br />We need to react in front of the mere technology sublimation, reformulate our schemes in order to achieve a revolutionary road to an integrated health system, responding to its main actors, and reinserting all their values in it.<br />
  59. 59. Responsive e-Health!!!<br />
  60. 60. Eskerrik asko<br />Thank you very much… for your attention!<br />Muchísimas Gracias<br />
  61. 61. III Spanish conference on chronic care<br />Meet us at<br />Building capacity for progress: the role of clinicians<br />may, 19th/20th 2011 • Donostia – San SebastiánKursaal Congress Center<br />