Styringsgruppemøte 28.august 2019 · 2019-11-01 · EMPATHIZE DEFINE IDEATE PROTOTYPE TEST Engage...
Transcript of Styringsgruppemøte 28.august 2019 · 2019-11-01 · EMPATHIZE DEFINE IDEATE PROTOTYPE TEST Engage...
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Velkommen!Presentasjoner fra møte om utvikling av pasientorienterte rehabiliteringsforløp 17.oktober 2019
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Velkommen v/Frode Jahren,
Generalsekretær LHL
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Agenda
• Velkommen v/Frode Jahren, Generalsekretær LHL
• Inspirasjonsforedrag om bruk av teknologi i helsetjenesten v/Iver Olav Sunnset, Forretningsutvikling Digitale Gardermoen
• Brukerrepresentanter LHL – erfaringer som bruker av rehabiliteringstjenestene v/Inger Lise Bråthen
• Workshop del 1
• Tjenestedesign søvn v/Laila Steen, PhD stipendiat OsloMet
• Hvordan ønsker brukere teknologi i oppfølging av behandling og livsstil etter PCI (utblokking av kransarterier). v/ Heidi Lunde Elstad. Sykepleier og PhD-stipendiat LHL
• Siemens Healthineers – erfaring fra implementering, ved Ingvar Sørlien
• Workshop del 2
• Inspirasjon om utvikling av rehabiliteringsområdet – Mari Klokkerud, Regional Kompetansetjenste for Rehabilitering HSØ (RKR)
• Oppsummering i plenum og veien videre
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Inspirasjonsforedrag om bruk av teknologi i helsetjenesten
v/Iver Olav Sunnset, Forretningsutvikling DGI
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HURDAL KOMMUNE STATUS 2.TERTIAL 2019
Tall i 1000 kr Regnskap
hittil i år
Justert
budsjett
hittil i år
Avvik i
kr
Justert
budsjett
totalt i år
Prognose
avvik
1.tertial
Prognose
avvik
2.tertial
Prognose i
% av justert
budsjett
Skatt, ramme og finans -107 720 -104 966 2 268 -165 720 0 %
herav finans 6 340 6 629 -196 9 550
herav frie inntekter (skatt og rammetilskudd) -114 126 -112 236 1 890 -181 460
Sentrale avsetninger 0 0 0 5 940 0 %
Tjenester
HA 1 - Sentraladministrasjon 7 211 6 098 - 1 113 9 668 0 %
HA 2 - Oppvekst 40 808 37 068 - 3 740 52 599 - 4 200 - 6 200 -8 %
HA 3 - Helse, omsorg og sosial 58 201 49 492 - 8 710 71 994 - 3 600 - 6 900 -5 %
HA 5 - Eiendomsforvaltning og prosjekt 6 279 6 420 141 11 732 0 %
HA 6 - Plan og miljø 2 396 2 582 186 4 071 0 %
HA 7 - Innbyggerservice og samfunnsutvikling 11 064 12 082 1 018 15 200 0 %
HA 9 - Sentrale reserver 162 162 455 2 500 2 500
125 960 113 903 -12 056 165 720 -5 300 -10 600 -3 %
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DEN OFFENTLIGA VÅRDEN MÅSTE KUNNA DRIVA INNOVATION
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HIT 2019 Utstyr, pasient og personell
Elektronisk dokumentasjon
Tilgang og oversiktFaktisk hendelser
Måle, rapportere, observere, tiltak,
behandling
Behov – ytelse – resultat?Hvor er effektiviseringsgevinstene?Hvorfor er integrasjon effektivt?
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4 Billion New Minds Online: The Coming Era of Connectivity
Jul 27, 201810,754
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ARENDALSUKA 2019. PASIENTENS DIGITALE HVERDAG - NÅR
HELSETJENESTEN FLYTTER INN I HJEMMET.
JEG TROR AT FOR Å KUNNE LYKKES MED
DETTE, VIL KVALITATIVE INTEGRASJONER
VÆRE AVGJØRENDE, OG IKKE RIGIDE
HELSEPLATTFORMER!
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https://www2.deloitte.com/no/no/pages/imagine/public-
health.html#
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A UNIVERSAL TRUTH – ALSO FOR IT ORGANIZATIONAL DESIGN
"People don't want a quarter-inch drill, they want a quarter-inch hole."
— Theodore Levitt, 1960
The value is in the hole …
… not the drill!
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HJEMMETJENESTENE GARDERMOREGIOEN
• 1500 mobile digitale trygghetslarmer.• 1300 elektroniske dørlåser• 57924 trygghetsalarmer per år. (siden 2017)
• Løst direkte som oppdrag fordelt mellom alle operative ansatte i tjenesten!• Integrert med Elektronisk pasientjournal.
• 337 utløste trygghetsalarmer Ullensaker Mai 2018.• Ca. 30 ansatte i tjenesten på dagtid. =>• 337 / 30 dager / 30 ansatte = 0.37 alarmer pr. ansatt pr. dag• Responstjeneste direkte til ansatte er effektivt.
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DET ER JO BARE Å KJØPE ETT SYSTEM?
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«GIVE ME MY OWN DAMN DATA» (NELSON, 2016)
Illustration: pixabay.com
ePatientsEquipped - Enabled
Engaged - Empowered (Doc Tom, 2004, e-Patient Dave, 2016)
annemoen/2018
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EN UBEHAGELIG APPLE-TESTKOMMENTAR: Å VÆRE EN AV DE FÅ I VERDEN SOM HAR FÅTT GJØRE EN REALISTISK TEST AV FALLREGISTRERING MED NYESTE APPLE WATCH, HØRES BESNÆRENDE UT. MEN JEG SKULLE
GJERNE VÆRT OPPLEVELSEN FORUTEN.
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HEALTH SYSTEMS OFFER APPLE HEALTH RECORDS
FOR PATIENT DATA ACCESSAPPLE HEALTH RECORDS'
RAPID GROWTH IS EXPANDING PATIENT DATA
ACCESS ACROSS THE COUNTRY.
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LIVSFORSIKRINGSKUNDER I USA MÅ RAPPORTERE OM EGEN
HELSE OG TRENING
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7 HEALTHCARE INDUSTRIES READY
TO BE DISRUPTED BY AI IN 2022
IT’S NOT SCIENCE FICTIONANYMORE! ARTIFICIAL
INTELLIGENCE IS TRANSFORMING
HEALTHCARE BEYOND OURIMAGINATION. THE POWER
OF AI IS ECHOINGACROSS HEALTHCARE
SUBINDUSTRIES, AND IT IS
TRULY LIFE-CHANGING.
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UTFORDRE DEG SELV OG ORGANISASJONEN DIN
• DET VIKTIGSTE ER Å TØRRE Å TESTE NYE TING.
• DU MÅ TØRRE Å UTFORDRE DEG SELV OG ORGANISASJONEN DIN, UTEN Å VITE HVA SOM KOMMER UT I
ANDRE ENDEN.
• NÅR DU TESTER NOE HELT NYTT BEVEGER DU DEG UT I DET UKJENTE, OG DU KAN IKKE REGNE ALT HJEM – SLIK
DU ER VANT TIL.
• DETTE ER OFTE DET VANSKELIGSTE.
• DET ER LOV Å GJØRE FEIL.
• DET ER OGSÅ LOV Å GJØRE DET SOM NYTTER!
• LOJALITET TIL OPPDRAGET/GAVEN!
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Erfaringer som bruker av rehabiliteringstjenestene
v/Inger Lise Bråthen
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Workshop del 1
Ansvar for egen helse – Hvordan kan nye tjenester og teknologi gi pasienten bedre mulighet til å styre sitt rehabiliteringsforløp
Ambisjon: diskutere drivere og barrierer for at pasienten bedre kan ta eierskap og styre sitt eget rehabiliteringsforløp. Dette gjør helsetjenesten til en støttespiller som på best mulig måte skal legge til rette for at den enkelte pasient klarer å oppnå sitt potensiale både mentalt og fysisk.
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Tjenestedesign søvn v/Laila Steen,
PhD stipendiat OsloMet
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CO-DESIGN in clinical care
Laila Steen | Workshop 17.10.2019| LHL-sykehuset Gardermoen
DELTAGENDE DESIGN I KLINISK HELSETJENESTE
How can we design user-centered health services for peoplewith obstructive sleep apnea?
HVORDAN KAN VI UTVIKLE BRUKERSENTRERTE TJENESTER FOR PERSONER MED SØVNAPNÉ?
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Prevalence
16 % age 30 – 65 5
..of which only
15% diagnosed 6
.. gold standard:
CPAPtherapy 7
5 Hrubos-Strom H, Randby A, Namtvedt SK, Kristiansen HA, Einvik G, Benth J, et al. A Norwegian population-based study on the risk and prevalence of obstructive sleep apnea. The Akershus Sleep Apnea Project (ASAP). J Sleep Res. 2011; 20(1 Pt 2): 162 - 70.6 Tidsskrift for Den Norske Legeforening. 2014; 134: 1030 – 1.7 Holt, A, et al. Sleep Apnea, the Risk of Developing Heart Failure, and Potential Benefits of Continuous Positive Airway Pressure (CPAP) Therapy. J Am Heart Assoc. 2018;7:e008684. DOI: 10.1161/JAHA.118.008684.)
Laila Steen | Workshop 17.10.2019| LHL-sykehuset Gardermoen
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AHI > 15 =Loss of drivers
license
Annual clincalassement for professional
drivers
Laila Steen | Workshop 17.10.2019| LHL-sykehuset Gardermoen
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Assessment
2100/yrTreatment
900/yr
Laila Steen | Workshop 17.10.2019| LHL-sykehuset Gardermoen
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Designing from and for
experiences
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INFORM CONSULT INVOLVE COLLABORATE EMPOWER
*Adapted from IAP2 spectrum of public participation
HUMAN / USER CENTERED DESIGN / HEALTHCARE
CO-DESIGN
EMPOWER
Laila Steen | Workshop 17.10.2019| LHL-sykehuset Gardermoen
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EMPATHIZE
DEFINE
IDEATE
PROTOTYPE
TEST
Engage in a continous short-cycle innovation
process to continually
improve yourdesign
Design a prototype (or a
series ofprototypes) to test all or part
of your solition
Brainstormpotential
solutions; selectand develop
your solutions
Clearlyarticulate thechallenge youwant to solve
Develop a deepunderstanding
of the challenge
*Stanford d.school Design Thinking Process (Design Thinking)
Laila Steen | Workshop 17.10.2019| LHL-sykehuset Gardermoen
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Service design principles
1 User centered: Do not go straight to solution. Create meaningful services by systematically focusing on the needs of the users (residents and employees).
2 Co-creative: Involve all stakeholders in order to ensure the right competence, quality, commitment and ownership.
3 Holistic: Work with the entire user journey to create a good and coherent experience for those who use and deliver the service. Remember to think about what happens both before and after the service!
4 Visual: Visualize information and ideas to simplify complexity, create common understanding and good documentation.
5 Tested: Work exploratory and make prototypes continuously through the process of testing, validating and developing solutions. 8
8 Design for offentlige tjenester, 2014 i Følgeforskning: Veikart for tjenesteinnovasjon 2016, Arkitektur- og designhøgskolen (AHO) i Oslo.)
Laila Steen | Workshop 17.10.2019| LHL-sykehuset Gardermoen
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Hva er en god helsetjeneste?
→ Virkningsfull
→ Involverer bruker
→ Trygg og sikker
→ Samordnet og preget av kontinuitet
→ Utnytter ressurser
→ Tilgjengelig og rettferdig fordelt
Helse- og sosialdirektoratet, 2005
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System
Tjeneste
Individ
Laila Steen | Workshop 17.10.2019| LHL-sykehuset Gardermoen
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ReferralReferral assessed
Preparations for
assessment
Assessment and diagnosis
Start treatment
Follow-up via AirView
1-year follow up
BEFORE DURING AFTER
Laila Steen | Workshop 17.10.2019| LHL-sykehuset Gardermoen
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FOLLOW UP
Laila Steen | Workshop 17.10.2019| LHL-sykehuset Gardermoen
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Action groups
AirView / myAir
Laila Steen | Workshop 17.10.2019| LHL-sykehuset Gardermoen
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AirView / myAir
Shared understanding? Comfort? Better communication? Tool for shared decision making?
Laila Steen | Workshop 17.10.2019| LHL-sykehuset Gardermoen
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Erfaringer så langt• Brukernes følelse av økt oppfølging, trygghet og
kontroll over egen helse er markant bedret ved brukav avstandsoppfølging.
• Enkelte av brukerne fortalte at dialogen med helsepersonell ble bedre, og flere meldte at de ofteretok kontakt med fastlegen grunnet forståelse av egenforverring.
• Økt innsikt i egen helsetilstand er en sentral driver for å unngå forverring og oppnå ønsket helseeffekt, og et eksempel på mobilisering av pasientens egneressurser.
• Forbruk av helsetjenester viser både økning ogreduksjon. Oppmerksomhet på kostnadsvariablerved implementering viser seg å være av betydningfor kostnadseffektivitet.
Gode brukererfaringer med medisinsk avstandsoppfølging
Tips fra kommuner som har deltattKommunene peker på følgende områder å huske på:• Jobbe godt med prosjektledelse og endringsledelse.• Ikke undervurdere behovet for å forankre arbeidet
oppover og utover kontinuerlig.• Inkludere brukere, fastleger og sykehus i arbeidet fra
start, i utvikling av tjenesten.• Gjøre grundig innsiktsarbeid.• Sette mål for inkludering av pasienter, og visualiser;
Tegn opp et tydelig forløp med klare roller og ansvar.• Sørge for gode avtaler med leverandører om teknologisk
utstyr, opplæring av ansatte og pasienter.• Ha fokus på og konkretiser gevinster fra start, men ikke
forvent gevinster med en gang - det tar tid å endrearbeidsmåter.
22.01.2019 14:10 | https://helsedirektoratet.no/nyheter/gode-brukererfaringer-med-medisinsk-avstandsoppfolging
Nasjonalt velferdsteknologiprogram har oppsummert alle rapportene fra første utprøving av medisinsk avstandsoppfølging. For kommunersom bruker - eller vil ta i bruk - medisinsk avstandsoppfølging, peker oppsummeringen på områder å huske på.
Målgruppen for medisinsk avstandsoppfølging er kronisk syke pasienter med medium til høy risiko for forverring eller reinnleggelse på sykehus, eller økt behov for helse- og omsorgstjenester.
Laila Steen | Workshop 17.10.2019| LHL-sykehuset Gardermoen
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Laila Steen | Workshop 17.10.2019| LHL-sykehuset Gardermoen
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System
Tjeneste
Individ
Laila Steen | Workshop 17.10.2019| LHL-sykehuset Gardermoen
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Hvordan ønsker brukere teknologi i oppfølging av
behandling og livsstil etter PCI. v/ Heidi Lunde Elstad.
Sykepleier og PhD-stipendiat LHL
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Erfaring fra implementering Siemens Healthineers,
Ingvar Sørlien
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Restricted
Rehabilitering
MedisinskAvstandsoppfølging
Ingvar Sørlien, 17.9.2019
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Medisinsk avstandsoppfølging
• Løsning for å følge opp pasienter uten fysisk møte
• Dynamiske spørreskjemaer• Kan inkludere medisinske målinger • Saturasjon• Blodtrykk• Blodsukker • Etc
• Helsepersonell følger opp avvik• Rolle som coach
Bilder fra Telma
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“Ideas alone have little worth. The value of an innovation lies in its practical implementation”
Werner von Siemens, 1865
Author | Department
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Author | Department
Fagsystem foravstandsoppfølging
Samhandlingsløsning
Innovative Web-Portlets E.g. Patient Summary view
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Nasjonale referansearkitekturer
Author | DepartmentImportant Standards/frameworks and more...
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Hva mener dere er det viktigste vi kan gjøre for å
skape bedre samhandling?
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Workshop del 2
Hvordan kan bruk av teknologi bidra til tjenesteutvikling for bedre samhandling
Ambisjon: diskutere utfordringer og muligheter knyttet til bedre samhandling både faglig og for å sikre bedre overganger mellom helsetjenestene (Sykehus, kommune, fastlege, private avtalespesialister, ..)
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Inspirasjon om utvikling av rehabiliteringsområdet –
Mari Klokkerud, Regional Kompetansetjenstefor Rehabilitering HSØ (RKR)
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Takk for i dag!Gardermoen Campus – helserelatert innovasjonshub
innen forebygging og rehabilitering