ensuring patient safety and transparency of information
TRANSCRIPT
“Ensuring Patient Safety and Transparency of Information”
Javier Ferrero Álvarez-Rementería
20th January 2016
Unlocking the Potential of Mobile Health in Europe: Removing Barriers to the Empowerment of Citizens
Andalusian Public Health System
Andalusia
The andalusian public health service
Andalusia Surface: 87.597 Km2
Population: 8.302.323 hab. + 21 M tourists/year
Primary Care Centres Public Hospitals Healthcare Professionals Pharmacies
1.514 48
102.000 3.602
Andalusian Public Health System
95 M appointments/year 121 M e-prescriptions/year 8.24 M individual eHR
Professional competences
Process Management
Clinical Management
eHR
The andalusian public healthcare model
Patient-centered model
Fundación pública perteneciente a la Consejería de Salud encargada de promover y desarrollar políticas de calidad y seguridad en el Sistema sanitario público de Andalucía
www.juntadeandalucia.es/agenciadecalidadsanitaria
The Andalusian Agency for Healthcare Quality
The Andalusian Agency for Healthcare Quality
Luca Bruno /AP
mHealth: Introduction
Michael Sohn /AP
mHealth: Introduction
Gutenberg Moment
Eric Topol January 2016
Healthcare is having its ‘Gutenberg Moment’, right now. This is driven by the adoption of smartphones and is going to continue to disrupt the common paternalism in the doctor-patient relationship
mHealth: Benefits…
mHealth: Benetifs…
Huge benefits…
500 million people will use apps by 2015 100.000 m€ savings in European Budget by adoption of mHealth in 2017 (1) 18% Healthcare cost reduction per capita in Europe and up to 35% in chronic patients in 2017
(1) GSMA 2013. Socio-economic impact of mHealth: An assessment report for the European Union (2) Adam Cohen, Google european responsible for strategy and communitary services, press release 6/5/15
81% (2)
75%
Starting with appointments…
644.012 citizens 792.204 downloads
3.318.486 APPointments
Savings: 0,65 Eur/appointment*
* With respect to an appointment through phone call
Dec’13 – Jun’15:
mHealth: Benefits
Ensure that technology is safe and optimized to improve patient safety
“Optimizing the safety benefits and minimizing the unintended consequences of health IT is critical.” December 2015
Fifteen years after To err is human…
mHealth: Patient safety
Lewis T, Wyatt J “mHealth and Mobile Medical Apps: A Framework to Assess Risk and Promote Safer Use” J Med Internet Res 2014 Sep; 16 (9): e210
• Loss of privacy
• Poor quality patient data
• Inaccurate or out or date content
• Lack of feedback or failsafe mechanism
• Inappropiate app usage
• Poor clinical decision
• Inappropiate clinical action
•…
Different types or risk
mHealth: Risks…
3 out of 4 apps fail at detecting more than 30% of melanomas…
mHealth: Risks
mHealth: Risks
11600 downloads Cost 1,99$ Net income (detracting Apple’s fee) 16158$ Conciliation fine 14294$
mHealth: Risks
mHealth: Risks
mHealth: Regulation
The need for “regulation”
mHealth: Regulation
The need for “regulation”
Most commonly used criteria in International health Apps awards…
• Social impact and value for end users • Innovation, creativity and originality • Functional prototype to be tested. • Economical and finantial viability • Quality of content • Ease of use: navigation and orientation • Quality of design: stetic value of graphics, music and sounds • Functionalities • Technical quality: performance, stability, …
Jury usually composed by marketing, mobility, technology, business, consulting profiles… but…
mHealth: Quality acknowledgement
mHealth: Andalusian strategy for quality and safety in mobile health
Andalusian strategy in mHealth
2012
2013
www.calidadappsalud.com
https://ec.europa.eu/digital-agenda/en/news/journal-mhealth-available
mHealth: Andalusian strategy for quality and safety in mobile health
http://www.calidadappsalud.com/distintivo-appsaludable
- Free.
- For any health app: private and public, national or international.
- Self-assessment and Assessment methodology.
mHealth: Quality and safety certification
A labelling system for mobile health apps in order to promote a reliable and safe use, minimizing risks.
mHealth: Quality and Safety certification
mHealth: Quality and Safety certification
Recommendations aimed to: - Reinforce liability of app contents. - Inform about app responsibles. - Explain about sources of information and scientific evidence. - Declare sources of funding, as well as coflicts of interests. - Ask for a patient safefy risk management and notification methodology
www.calidadappsalud.com
Block 2: 11 recommendations Transparency of information and patient safety
mHealth: Quality and Safety certification
Only a few apps… but a strict and rigurous
schema
mHealth: Quality and Safety certification
(1) GSMA 2013. Socio-economic impact of mHealth: An assessment report for the European Union
research2guidance: Global Mobile Health Market Report 2010-2015
mHealth: Perspective of use within HCPs
2013 - 2014
mHealth: Piloting integration and personalisation
Andalusian mHealth Corporate Repository
Certification
Integration
Pertinence
Personalization
Commercialization
Clinical Process Optimization
3rd party apps
2014-2016
mHealth: Integration and personalisation
Open Data Model
Large scale deployment
mHealth Service hub for citizens
Currently 1.000.000 users
mHealth: Personalisation
Reimbursement models with up to 8,5 Millions users
A new (wider) integration model is needed…
• Currently, interoperability model is based on international standards (HL7, IHE, Dicom…)
• A very high specialisation level is required.
• Unreachable and unaffordable for mobile and R+D+i initiatives
mHealth: Open data model
Public Procurement: “Open data” model
Enterpreneurs
SMEs
mHealth: Open data model
Self-registry web portal API management
https://www.youtube.com/watch?v=Z1b8yGuZyk0
“…getting the most complete list of medicines … improving adherence and reducing mistakes…”
https://www.youtube.com/watch?v=dwkRCNauQQI
mHealth: Some examples (patient safety)
“…the more questions… the least risks…”
“…engaging patients…prechirurgical verification lists”
“…first… do not harm”
https://www.youtube.com/watch?v=iLEDQ4lKOos
mHealth: Open Innovation
Challenges… why not?
Challenges… why not?
mHealth: Open Innovation
Hackathon
http://www.juntadeandalucia.es/agenciadecalidadsanitaria/reto-msspa/
https://www.youtube.com/watch?v=JJjIN_GDfS0
…from a public HCP point of view… Urgent to raise awareness on quality and safety in mHealth More (interoperable) certification initiatives and not so many popular app
crowded directories
From a public HCP point of view, far from blocking, regulation is an innovation enabler
Easy to build up some mHealth services with a quick ROI
Necessary to connect - and optimise - clinical processes to mHealth services
Delicate to talk about clinical open data, but it is possibly the only way to catch up with citizen demands
mHealth: Some conclusions
www.calidadappsalud.com @CalidadAppSalud
facebook.com/CalidadAppSalud
Thank you very much!