NCD 4.0: Telehealth & eHealth

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NCD 4.0: Telehealth & eHealthนพ.นวนรรน ธระอมพรพนธ

คณะแพทยศาสตรโรงพยาบาลรามาธบด29 ม.ค. 2560

SlideShare.net/Nawanan

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Outline

• Thailand 4.0

• Healthcare 4.0

• NCD 4.0 & The Way Forward

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Thailand 4.0

Image Source: คณะท างานเพอสรางความตระหนกและการรบรเพอสงเสรมรฐวสาหกจเรมตน กระทรวงพาณชย https://www.youtube.com/watch?v=OEfY3rQZpNo

https://www.youtube.com/watch?v=OEfY3rQZpNo

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Thailand 1.0



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Thailand 2.0



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Thailand 3.0



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Thailand 3.0



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Thailand’s Middle Income Trap



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Thailand 4.0



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Thailand 4.0



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Thailand 4.0



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Thailand 4.0



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Thailand 4.0



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Healthcare 4.0?

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Healthcare 1.0• การแพทยแผนโบราณ

Healthcare 1.0 - 4.0 เปนความเหนสวนตวของวทยากรImage & Caption Source: http://kanchanapisek.or.th/kp6/sub/book/book.php?book=33&chap=8&page=t33-8-detail.htmlhttp://kanchanapisek.or.th/kp6/sub/book/book.php?book=33&chap=8&page=t33-8-infodetail02.html

การยอยขนาดตวยาสมนไพร โดยใชครกต าและหนบดยาของโรงศรราชพยาบาล (ปจจบนคอ โรงพยาบาลศรราช)

คนไทยสมยกอนมกใหบคคลในครอบครวบบนวดได

http://kanchanapisek.or.th/kp6/sub/book/book.php?book=33&chap=8&page=t33-8-detail.html

http://kanchanapisek.or.th/kp6/sub/book/book.php?book=33&chap=8&page=t33-8-infodetail02.html

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Healthcare 2.0• การแพทยแผนปจจบน

Healthcare 1.0 - 4.0 เปนความเหนสวนตวของวทยากรImage Source: http://www.mcot.net/site/content?id=51065d70150ba027570000a6#.V5k98vl96Hs

http://www.mcot.net/site/content?id=51065d70150ba027570000a6#.V5k98vl96Hs

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Healthcare 3.0• การแพทยยคมงสคณภาพ

Healthcare 1.0 - 4.0 เปนความเหนสวนตวของวทยากรImage Source: http://e-learning.ha.or.th/moodle/webha/index.php/newsth/news-releases-th/item/426-2559

http://e-learning.ha.or.th/moodle/webha/index.php/newsth/news-releases-th/item/426-2559

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Healthcare 4.0• Value-based Healthcare

• Smart Healthcare & Smart Hospital

Healthcare 1.0 - 4.0 เปนความเหนสวนตวของวทยากรImage Source: Nawanan Theera-Ampornpunt, PowerPoint slide template from SmileTemplates.com

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อะไรคอ Smart Healthcare?

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Smart Healthcare For Policymakers?

Image Source: http://healthdata.moph.go.th/kpi/2557/ProvinceKpiTopicListAll.php?provincecode=99

http://healthdata.moph.go.th/kpi/2557/ProvinceKpiTopicListAll.php?provincecode=99

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Smart Healthcare For Clinicians?

Image Source: http://www.medscape.com/viewarticle/780298

http://www.medscape.com/viewarticle/780298

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Smart Healthcare For Patients & Consumers?

Image Source: Agence France-Presse/Getty Images

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Digitizing Healthcare นหรอคอสงทเราตองการ?

Image Source: http://www.bloomberg.com/bw/stories/2005-03-27/cover-image-the-digital-hospital

http://www.bloomberg.com/bw/stories/2005-03-27/cover-image-the-digital-hospital

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• “Don’t implement technology just for technology’s sake.”

• “Don’t make use of excellent technology. Make excellent use of technology.”(Tangwongsan, Supachai. Personal communication, 2005.)

• “Health care IT is not a panacea for all that ails medicine.” (Hersh, 2004)

Some “Smart” Quotes

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“Smart Hospital”

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แลว “Smart Hospital” ตางจาก Digital หรอ

Paperless Hospital ตรงไหน?

27 https://www.youtube.com/watch?v=gxz9ZVvduGc

Connecting People to a Healthy Future With Personalized Care – Kaiser Permanente

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Back to something simple...

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To treat & to care for their patients to their best abilities, given limited time & resources

Image Source: http://en.wikipedia.org/wiki/File:Newborn_Examination_1967.jpg (Nevit Dilmen)

What Clinicians Want

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High-quality and timely information meaningful for monitoring & evaluation of health systems and policymaking

What Policymakers Want

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A safe, effective care that focus on us, the patients, and our needsAnd something that helps us take care of ourselves...

What Patients Want

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• Safe (ปลอดภย)

• Timely (ทนเวลา)

• Effective (มประสทธผล)

• Patient-Centered(ยดผปวยเปนศนยกลาง)

• Efficient (มประสทธภาพ)

• Equitable (เปนธรรม)Institute of Medicine, Committee on Quality of Health Care in America. Crossing the quality chasm:

a new health system for the 21st century. Washington, DC: National Academy Press; 2001. 337 p.

Quality of Care

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• Safe–Drug allergies, drug interactions

–Medication Reconciliation

• Timely–Complete information at point of care

• Effective–Guideline adherence (alerts & reminders)

Being “Smart” in NCD Care

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• Patient-Centered

–Empowerment & better self-care by m-Health & Personal Health Records

• Efficient

–Faster care, time & cost savings

–Reducing unnecessary tests

• Equitable

–Access to providers & knowledge

Being “Smart” in NCD Care

35Image Source: (Left) http://docwhisperer.wordpress.com/2007/05/31/sleepy-heads/

(Right) http://graphics8.nytimes.com/images/2008/12/05/health/chen_600.jpg

To Err is Human 1: Attention

36 Image Source: Suthan Srisangkaew, Department of Pathology, Facutly of Medicine Ramathibodi Hospital

To Err is Human 2: Memory

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Health

Information

Technology

Goal

Value-Add

Tools

Health IT: ชอนส าคญไฉน?

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• Guideline adherence• Better documentation• Practitioner decision making or

process of care• Medication safety• Patient surveillance & monitoring• Patient education/reminder

Documented Values of Health IT

39 Dorsey & Topol (2015)

Telehealth


State of Telehealth• Current Trends

– Change from using telehealth to increase access to health care to providing convenience and reducing cost

– Expansion of telehealth to chronic conditions

–Migration of telehealth from hospitals and clinics to home and mobile devices


State of Telehealth• Limitations of Telehealth

– Reimbursement• Limited & fragmented insurance coverage of

telehealth

• Potential for excess health care utilization

– Clinical issues• Patient-physician relationship

• Quality of physical examination

• Quality of care with remote visits than with in-person visits


State of Telehealth• Limitations of Telehealth

– Clinical issues (continued)• Potential for abuse (e.g. overprescribing of

narcotics)

• Fragmentation of care among multiple providers

– Legal issues (e.g., state licensure, liability)

– Social issues (digital divide)

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Hospital A Hospital B

Clinic C

Government

Lab Patient at Home

Health Information Exchange (HIE)

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Source: Courtesy of นพ.พลวรรธน วทรกลชต ผอ านวยการศนยเทคโนโลยสารสนเทศและการสอสาร ส านกงานปลดกระทรวงสาธารณสข

Health 4.0 as eHealth Vision

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Health 4.0 & Digital Economy (DE) Roadmap

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DE, MoPH’s 4 Excellence & eHealth

NCD 4.0: Telehealth & eHealth

Healthcare

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