Mobile Health & Telemonitoring
in today's and future pharmacies
MedTech week Symposium: Innovative digital Health
June 14th 2016
be
MedTech
Mobile Health & Telemonitoring
in today's and future pharmacies
MedTech week Symposium: Innovative digital Health
June 14th 2016
Roadmap
/
20 points of action for
the development of eHealth in Belgium
–
–
–
–
Round Table in may & june 2015
Timing: Q4 2015 - Q4 2018
Data sharing, mobile health, patient involvement, …
www.plan-egezondheid.be
“eGezondheid is vertrokken
als een hogesnelheidstrein.
Het gebruik van digitale technologieën
binnen de gezondheidszorg
hou je niet meer tegen.”
Maggie De Block, 14/10/2015
Goals
• Coordination of mHealth policies
• Better health and comfort for civilians
(patients & users alike) in Belgian health care through
effective and efficient mHealth applications
• Integrate mHealth in health care system
legally, financially and with regard to organisation of care
• Make eHealth services mobile
• Quality & accessibility of mHealth
• The user in the driving seat…
Actions
• Q1 2016: create a general framework
regarding privacy and accountibility
• Q4 2016: create a legal framework
including conditions for reimbursement
• Accessibility of health data
– Q3 2016: Mobile access for health care professionals
– 2016: Access for patients and users too…
– 2018: Access for patients to Personal Health Record
• 5 use cases:
stroke, cardiovascular disease, diabetes, mental health
& chronic pain
Press communication (june 8th)
“Maggie De Block invests 3.25 million
in pilot projects with health apps”
• Call by the end of june
• Heart rate monitor & smartphone
• Digital Health Valley
• 5 domains
• Self management, telemonitoring, the
use of wearables, teleconsults, …
“Digital applications will allow patiënts to
become copilots of their health.
Through apps patiënts will for instance be able to
monitor their heart rate and blood pressure.”
Criteria for digital applications
• Privacy & data security
• Interoperability with each other and
current eHealth services
• European CE-label
• Scientifically funded & evidence based
• 3.25 milion euro, among others to
reimburse the use of health apps by
health care professionals
Long live Maggie! Or not?
• There are 19 more actions in the plan…
• eHealth is up and running, but…
– Implementation and acceptance is growing,
actual uptake is low and slow
– Performance and legal issues to be tackled
– Standardisation and interoperability required
– When will we reach tresholds & critical mass?
• Who will pay for all this?
– € 3.25 million won’t do at all!
Today’s pharmacy (AD 2016)
• 4929 pharmacies
– Decreasing numbers!
– 85% is privately owned
– Uneven dispersion compared with population
density, due to history and funny legislation…
• Prices & budget for medicines in
ambulatory care are going down!
– For health insurance as well as for patients
– Despite increased medication use!
Some numbers…
CP = cost for
patients
CI = cost for
health insurance
PP = public price
DDD = Defined
Daily Dose
RPH = pharmacy
remuneration
NB = number of
« boxes »
Some numbers…
RI = reimbursed
Rx, not RI =
prescribed, but
not reimbursed
not Rx = OTC
NOT = para,
supplements &
medical devices
eHealth @ pharmacies
• Health insurance data
– Insurabilaty complete roll out
– Chapter IV complete roll out
• Electronic prescriptions
– 97% availability
– About 1/3rd uptake
• Shared Pharmaceutical File
– 70% of pharmacies applied for connection
– Data of 6 million patients available
• Shared Medication Scheme
mHealth @ pharmacies?
• Consumables are available and
reimbursed in pharmacy
• Modest reminder tools (e.g. Posomind®)
• Limited number of apps (e.g. OnePharma®)
Future pharmacies (AD 2020?)
Patiënt
Apotheker
Arts
3 ways to go for the
development of our profession
1. Pharmaceutical care
– Legal responsability in Belgium of
community pharmacists since 2006
– Determined outcomes in Quality of Life
2. Orientation of patients
– Accessible and nearby
– Many patients are ignorant about their health
state (e.g. diabetes, hypertension, …)
3. Prevention
– Only 2% of the health budget is spent to
promote healthy life style!
SPEC
HON 5%
2010
MEC
20%
HONBAS
75%
2015
2020?
HON VFZ = fee for
pharmaceutical care
services
HONBAS = fee at delivery
MEC = economical margin
SPEC HON = specific fees
18
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MedTech
Chronic care reform
an inconvenient truth…
Demographics in Belgium
Source: FOD Economie (2006)
Chronic disease by age
Health care expenditure
in Belgium
Source: L. Annemans
“De prijs van uw
gezondheid”, Lanoo
Campus (2014)
“If you do not change direction,
you may end up
where you are heading.”
(Lao Tzu)
What changes are needed?
•
•
•
•
Planned care instead of reactive care
A health model for integrated care
Actual interdisciplinary collaboration
Patient centered care:
– Health literacy
– Empowerment
– Responsibilisation
• New remuneration systems
What tools do we need to get
there?
• Data sharing and eHealth
• Electronic health records
• Common care plans
– For all patients in self care and disease
management
– With shared decisions and common goals
– Patients in the driving seat…
– A reliable health care team for every patient
– Case management for complex care
mHealth and telemonitoring
@ future pharmacies
• Validated and connected health apps
– Available for patients
– Reimbursed or (why not?) for free
– Connected to patient health records
• Self tests and health risk profiling
– Not diagnostics, only early detection
– Guided by a trusted health care professional
– Connected consumables, wearables,…
• A virtual mobile personal health coach!
A dashboard showing all your
critical health parameters
Who is going to fix all that?
• You are!
– Entrepreneurs and industry will continue to
provide technical solutions if it’s economically
profitable
– If you aren’t, someone else will
• We are!
– Health care professionals will have to get out
of their cocoons, get connected and invest
• They are!
– All 9 health care ministers of this country
– Health insurance providers
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MedTech
Thank you and good luck!
MedTech week Symposium: Innovative digital Health
June 14th 2016