Innovative eHealth Solutions in Mental HealthNils Kolstrup, Researcher and Medical Advisor, MD, PhD, MPH, GP, National Center for Integrated Care and Telemedicine, Norway

Jarle Strømmen, Advisor, Haukeland University Hospital, Norway

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Overview• We present two Norwegian approaches to get a

comprehensive system of eHealth psychological care

• Psychological problems major causes for ill health and death • The heath care systems cannot cope • eHealth works and is cost efficient

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Norwegian Centre for Integrated Care and Telemedicine in Tromsø• Start 1992 • World leading centre in telemedicine, • eHealth, and integrated care• 200 employees• Interdisciplinary• Numerous projects

– Diabetes– Communication– Video– Acute medicine– Infections– Skin– Journal systems– Psychiatry

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Mental and substance disorders

• Responsible for most years of life lost • Depression is:– highest burden of disease in industrial countries – third-highest burden of disease in low-income countries– suicide deaths are 2x higher than death by traffic accidents

in Norway

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Conventional treatment• Antidepressants cost 2.5% of the GNP in USA• 11 % of Americans + 12 years on antidepressant

medication• Psychotherapy works • Comparable to pharmacological treatment • Huge capacity problems

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IT • Self-help• Remote areas• Large scale • Cheap• Use in primary care• Anonymous, free of stigma • Always accessible

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It works

• Several internet-based programs in use • MoodGYM, Beating the Blues and Colour Your Life works

equally well• Therapist support increase the effect • The more you work with the programs the better

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Cost efficiency

• Cost-effective compared with face-to-face treatment • As cost effective as drugs for

HIV/AIDS

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Our experience

• EBUP – video conference policlinic – young patient at home• VIDEO CARE and DE VA VI – video conference between specialists• VAKe – Video use in emergency medicine• VIRTUAL HOME – video transmission directly from patient to home care• MoodGYM – psychologist supporting patient (GP follow up or

recommending the program) • Coping programs, integration in health care systems

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The funnel

GP and patient Mood Gym

Self helpMood Gym

GP Specia-list and patient(video)

Specialist patient

Self help without support

General practitioner (GP) follow up plus self help

GP assisted by specialist

Specialist patient policlinic or admittanceAcute cases,

not only depressed

Policlinic, video

Admittance

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Conclusion

• The health care systems cannot meet the need for treatment • Internet based therapy is cost efficient • We need a comprehensive system using the internet and

videoconferencing • This year we at the National Centre for Integrated Care and

Telemedicine will use our prior knowledge to do just that in a EU program (CIP MASTERMIND)

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Haukeland university hospital

• Second largest in Norway• #2 on medical research• App. 11 500 employees• Aims to be in front in

innovation in healthcare services

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Self help

Communication

Treatment

Examples in three areas

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The helping handTool for handling challenges

• A self help tool that help you deal with challenging situations

• Can be used by yourself or together with your family, teacher or health personell.

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The helping handTool for handling challenges

• Is based on the award winning Psylogical first-aid kit developed by a psychologist at Haukeland University Hospital.

• Was digitialized during a innovation weekend arranged by Haukeland.

• Was made available on Appstore in under 3 months.

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DigidagDigital Diary for Users with Psychological Disorders

• Give the patients the possibility to monitor their condition and communicate with the hospital

• Catch up early warning signs to avoid serios situations.

• Create a more closer relationship between hospital and patient.

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eMeistringAssisted online treatment system

R&D project supported by:- Haukeland University hospital- The western Norway Health Authority - The Norwegian Directorate of Health

Research is an integrated part of the clinic

Treatment developed by professor Gerhard Andersson, Linköping University, professor Per Carlbring, Stockholm University.

Developed in Checkware

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eMeistringAssisted online treatment system

1st prize eHealth award 2013 (Healtworld)

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eMeistringAssisted online treatment system

• Starts with a face-to-face consultation.

• Last from 9 to 14 weeks

• Consist of 9 modules.

• Weekly followups by your therapist.

Reading

ExcersisesChallenges

Rapport

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Service design

User experienceCo-creation

Innovative methods New partnerships

Other hospitals

Patient organisations

The start-up society

Other industry sectors

Future

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A simulation of future solutions:«How can we create the best online treatment for young people?»

• Patients• Service designers• UX designers• Game designers• Psychologists• Other hospital personell

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ExcersiseLearn to speak in front of a crowd

1. Click on the excersise2. Read/hear the instructions3. Choose difficulty level4. Do the exercise and save your

results

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ExcersiseLearn to speak in front of a crowd

1. Click on the excersise2. Read/hear the instructions3. Choose difficulty level4. Do the exercise and save your

results

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ExcersiseLearn to speak in front of a crowd

1. Click on the excersise2. Read/hear the instructions3. Choose difficulty level4. Do the exercise and save your

results

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ExcersiseLearn to speak in front of a crowd

1. Click on the excersise2. Read/hear the instructions3. Choose difficulty level4. Do the exercise and save your

results

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ExcersiseLearn to speak in front of a crowd

1. Click on the excersise2. Read/hear the instructions3. Choose difficulty level4. Do the exercise and save your

results

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Thank you for your attention!

Jarle StrømmenAdvisorR&D DepartmentHaukeland university hospital

Nils Kolstrup, Researcher and Medical Advisor, MD, PhD, MPH, GPNational Center for Telemedicine