Digital Health and Care Solutions Rachelle Kaye, PhD. March 2016 - - PowerPoint PPT Presentation

Rachelle Kaye, PhD. March 2016

Strategic Use of Mobile and Digital Health and Care Solutions

The Israeli Health Care System

National Health Insurance Law of 1995

• Universal compulsory statutory health insurance
• Financed by earmarked and general taxation
• Coverage for health care services is provided by 4 competing

nationwide health plans (HMOs)

• Every citizen must join a health plan but are free to choose and move

from one to another

• Public and private providers of services including physicians, hospitals,

pharmacies and other health care professionals

• Health Plans must provide a defined public basket of services to all its

members

• First Ambulatory Electronic Medical Record installed at Maccabi

Healthcare Services in 1991. Clalit Health Services followed in 1993.

• Today, all physicians working with health funds have electronic

medical records with electronic referrals, prescribing and comprehensive clinical data exchange

• Other health professionals also have EMRs (their own or shared)
• In the two largest Health Funds there is essentially a central

computerized medical record containing all interactions of the patient with services paid for by the Health Fund

Health ICT in Israel

• All hospitals have EMR systems, ATD, ward management and billing

system

• Many are completely paperless
• A new system “Eitan” has been implemented for the exchange of

clinical and healthcare data between community clinicians working with the health funds and hospitals.

Health ICT in Israel

Managers Physicians Nurses, Healthcare Professionals Hospitals Clinics Researchers and Analysts

Focused Information and Operational support for all players

Patients

Integrated Care for Prevention and Management of Chronic Disease

Access of Clinicians and Patients to all necessary information Defined responsibility for care coordination Decision support – alerts and reminders Timely Access to services “Seamless” transition between all points of care Care that is guided by the “big picture” –holistic view of patient problems and needs The patient receives the care he needs, when and where he needs it, and up-to-date information on his condition is available in real time to the care providers and the patient

Maccabi’s system is fully digitalized -the Cornerstone- Clinical Information System

Every transaction with the patient is computerized Shared EMR and Central Medical Record E-Laboratory E- Prescription E- Consultation Alerts and Reminders Physician Portal Member Portal (PHR)

Central Medical Record

Hospital Diagnoses Treatment Medicines & Drugs Lab Results Imaging Tests Pathology Tests Medical Visits

Patient Details Problem List and current Drugs Prescribing Medication An Alert on drug to drug interaction

Hello, Yael Nor

Pharmacy| Information | Appointments | Communication with the Doctor | PHR

Travel insurance Notification Drugs Approval Test Results Appointments

Leaving the Flu

• utside

Go to your doctor today for a flu shot

Pre Authorization Request from Doctor

Healthcare Recommendations

Here you can receive personal reminders on test or treatments recommended in accordance with your age, sex, and health status 4 personal recommendations are waiting / click here to see them

My medical home Recent visits, hospitalizations, test and treatments Recent drugs purchased Recent debits and credits

Maccabi Online - PHR – Access to Medical Information and Online Services

Main

App enabled doctors to view patients records and respond to immediate issues Launched: December 2011 Platforms:iPhone, Android Patient test results Medication Visits Medical Knowledgebase

Doctor Portal - Patient EMR

Mobile Patients Portal

#1 Pregnancy App

in the world

Find a service

Find a doctor

Urgent Care Centers Pharmacy Branch Labs and Clinics Maccabi “N`atural” Maccabi “ First look”

• Referring doctor
• Date

Laboratory Results Mobile Pregnancy Follow up

Request Prescription Renewal

Dr Ido Jacobs Family Physician Phone : Prescription? Choose from your list

• f drugs

Send request

MY DRUGS

• k

cance l

New Request

Member;Israel israel ID 123456789 Member;Israel israel ID 123456789

View of the Request With Response

Requests to doctor Prescription Valid My request

Renew Request

Dear Israel, Attached are the 3 prescriptions you requested. Sincerely, Dr. Gidi Lorben

Response from Dr Gidi Lorben Prescription: Valid 13.5.13-13.6.13 Prescription – Not Valid Member;Israel israel ID 123456789

Telemedicine Services

Tele-Diagnosis

Tele-radiology Tele- ECG/Holter monitoring Tele-mammography: mobile unit Tele- ophthalmology Tele-dermatology: skin ulcers

Tele-Treatment/ Consultation

Video Conference – care giver–patient Video Conference- home care Video Conference- service station Video Conference-Specialist-Primary Care

Service from a Distance (cost, time) Need for 24/7 response

Telemedicine Services

Call Centers

Multidisciplinary Telecenter for Chronically Ill Patients Maccabi Pharm Nurses Call Center - Triage Smoking Cessation Interpreter Services

On line services

Website Patient health Record Mobile Phone Applications

Service from a Distance (cost, time) Need for 24/7 response

Acute Care Preventi

• n

Chronic Care

Tele-Health Center

A complementary hospital & community based healthcare system

Triage:

Emergency nurse center; Home doctor

Prevention:

Smoking Cessation; Post-partum health

Chronic Care Rehabilita tion Caregiv er Support

The MOMA Center

Innovative platform for chronic care management Multi-disciplinary center Tele-health solutions for chronic conditions Fully coordinated with patients Primary physician Nationwide support network for remote care management Over 7,000 current subscribers 15,000 patients treated to date

Technolo logy gy

Computerized Medical Protocol System MOMA Nurse System BI Control Management Panel Video Consultation Medical Transmitting Sensors

Medical Transmitting Sensors

Blood glucose Electronic medical box Pulse (wearable)

Electronic medical box

Pulse (wearable)

Remote cardiac rehabilitation

Based on:

• Secondary

prevention

• Patient empowerment
• Individual training

plan

Assuta Ashdod Public Hospital – May 2017

The hospital will be full service hospital with all departments and medical specialties. It will open with 300 beds (planned for 650 in the future). Centers of excellence:

• Heart Disease
• Oncology
• Pediatrics
• Women’s Healthcare
• Ambulatory and Endoscopic

(minimally invasive) Procedures

“A Community that has a hospital”

Vision for Integrated Care Assuta Ashdod Hospital

• Innovative, advanced general public hospital, affiliated to a

medical school

• Full integration with the community's medical services, meeting

the special needs of the patients and their families, both within the hospital and at home

• Integration with Social Services and other support services in the

municipality

• All 4 HMOs in Israel have agreed to participate in this model
• The municipality and the department of social services are

committed to this vision

“A Community that has a hospital”

Integrated care solution

Nurse

PC

Specialist Nurse

Rehabilitation

Specialist Social care Nurse

Municipality

ICS

Hospital Primary Care Municipality

Social Care

EMR Hospital EMR Community

System for Insuring Seamless Information Exchange Between the Hospital and the Community

EHR INTEROPERABILITY

System for data exchange Between EMRs

HOSPITAL COMMUNITY

Video Consulting Patient PHR

Coordinate Discharge

Social Services

Clinics

Technology and Information Exchange Is NOT ENOUGH

• We need to break down traditional organizational barriers –

between the hospital and the community – between health care and social care

• We need to change attitudes of clinicians
• We need to build multidisciplinary teams
• We need to make the patient and his family fully functioning

members of the care team

Thank You