Joining forces supports hospitals in moving care towards the home
Luscii, the e-health application for remote monitoring once developed as part of FocusCura, continues as an independent company. Healthcare entrepreneur and FocusCura founder Daan Dohmen, has acquired the majority of the shares and formed a strategic partnership with Omron Healthcare, known among other things, as the largest manufacturer of blood pressure monitors in the world. Part of this cooperation includes an investment, with which Luscii can accelerate its development further in the coming years. Omron will also support launches in more European countries, as the two companies announced today.
In European countries, efforts have been made for some time to make e-health available for chronic patients in order to prevent hospital visits and admissions. Despite that, a breakthrough is yet to be achieved. However, Luscii is one of the first digital healthcare concepts capable of bridging the important barriers in implementation. For example, Luscii successfully managed to integrate with large electronic patient records and secured reimbursement from insurers for their concept. Scientific research showed that using Luscii for specific target groups, such as patients with COPD, heart failure and resistant hypertension, can reduce hospital costs significantly and make patients feel safer.
FocusCura will continu its activities in home care under CEO Raoul Zaal. Dohmen handed over the CEO’s baton to the former Booking.com and Essent director a year ago. Under Zaal’s management, the number of users of FocusCura innovations continued to grow and 2018 ended with a strong operating result. Dohmen remains involved as a consultant and shareholder of FocusCura. Just like Medux, known for it’s brands Medipoint and Harting-bank.
Imagine no longer having to go to the hospital, but simply having a conversation at home with your lung nurse about how you feel. From February 2019, this will become a reality for 25 Treant patients with the chronic disorder COPD (lung disease). During this month, the healthcare group will begin a trial in which patients receive a tablet, on loan, through which they can transfer their medical information to the hospital. If this information requires further discussion, the lung nurse will contact the patient via ‘video calling’.
Treant, in collaboration with the healthcare innovation company Luscii, is starting this pilot to gain experience in monitoring COPD patients from a distance. Lung specialist, Steven Rutgers, is pleased with the new scheme: “For patients who already have less energy because of their illness, it is of course fantastic that they will no longer have to come to the clinic every time. This pilot also strengthens our vision to concentrate care as close to the patient as possible. It is great that we can experiment with this possibility.”
How does it work?
Every week, patients use the tablet to fill in their information, such as blood pressure, weight and physical activity. They also report how they are feeling. They then send this information to the hospital. A specialist nurse will take a look at the data and, if necessary, will contact the patient. Through the use of ‘video calling’, healthcare professionals can see how the patient is doing and, in consultation with the pulmonologist, can adjust the medication if necessary.
COPD is a lung disease in which the lungs are damaged. The lungs cannot absorb sufficient oxygen, leaving the patient with shortness of breath and less energy. COPD is characterised by lung attacks that often lead to hospitalisation. Rutgers: “As we receive information about the condition of the patient more often during this pilot, we hope to prevent such lung attacks and subsequent hospital admissions”.
The pilot was made possible by healthcare insurer Zilveren Kruis and will last for six months. The pilot reinforces the agreement that Treant holds with the healthcare insurer to develop initiatives that bring care closer to the patient. A good example of the right care in the right place. In collaboration with the healthcare innovation company Luscii, scientific research will also be conducted into the results of remote monitoring. To start with, remote monitoring will be available to just 25 COPD patients treated at Scheper in Emmen. If the pilot proves successful, in the future, more patients will be able to pass on information to the hospital via video calling.
This press release was published by Treant ziekenhuis on 4 December 2018 (https://bit.ly/2RhyywZ)
When keeping an eye on your health, you do not always have to go to the hospital. The home measurement of, for example, heart rate, blood pressure and weight, is on the rise. And that is a positive development; as it gives people more control over their health. The Jeroen Bosch Hospital is therefore starting a trial of home measuring for people with heart failure and patients with the chronic lung disease COPD. The trial will run for six months and is a collaboration between the Jeroen Bosch Hospital and Luscii, the hospital branch of FocusCura.
A total of fifty people will take part. One participant is Mrs. Liefmans*, who lives with COPD. Twice a week, she will measure her heart rate and saturation (amount of oxygen in the body) from the comfort of her easy chair. In addition, she will complete a digital questionnaire; has she had any difficulty breathing in the past few days? How much has she moved? All the information that helps indicate the status of her health.
All data is sent digitally to her lung nurse, Joke Spierings, in the Jeroen Bosch Hospital. Has something deteriorated? Then she can contact Mrs. Liefmans immediately via video calling on a tablet. “By monitoring more often, we can spot a potential lung attack earlier. This way we can take action together and prevent any hospitalisation”, says Spierings.
“Thanks to home measurement, I know exactly how I am doing”
Previously, Mrs. Liefmans did not have such a precise insight into her health. She went to her GP and visited the pulmonary doctor for a check-up once a year. She only saw her lung nurse in the hospital after a lung attack.
“If I did not feel well, I often thought: it’s not too bad, I’ll see how it goes and then visit the doctor”, says Mrs. Liefmans. “But, by that time it was too late, and before you know it, you’re in hospital”. She was still there three months ago. Thanks to home measuring, she expects that this will no longer happen so quickly. “I want to be able to take steps earlier, so that my health does not deteriorate further. Thanks to home measurement, I know exactly how I am doing. That gives me peace of mind. And because I can always consult with my nurse if things get worse, I feel that I really have control”.
Spierings is also enthusiastic: “This program supports self-management of people. Thanks to the information provided by home measurements, and advice from our side, patients are able to make the right choices. Taking control of your health despite being ill; that is our goal.”.
* Mrs. Liefmans is a fictitious name.
This press release was published by Jeroen Bosch Hospital in Dutch on 29 November 2018 (https://bit.ly/2RhyywZ)
Healthcare organisations join forces for people with COPD
Starting today, residents of the Kennermerland region with the pulmonary disease COPD can now use the network ‘COPD in the neighbourhood’. Thanks to the dedicated App, they can monitor the course of their illness and contact healthcare professionals remotely via video calling. The advantages for people with COPD include reducing the need for hospital visits, gaining more control over their lives and improving that feeling of safety, as specialised nurses are available for contact day and night. COPD in the neighbourhood is made unique through the intensive cooperation between healthcare providers in the neighbourhood, the hospital and innovative partners that make remote care possible.
“COPD in the neighbourhood”
‘COPD in the neighbourhood’ is a collaboration between healthcare organisations that want to improve care for people with COPD. One of the initiators is Peter Paardekooper, from Huisartsen Centrum Zandvoort. “For people with COPD, hospital visits are strenuous because of their limited lung capacity. In addition, the checks are arranged at fixed times, meaning we are not always there when the care is really needed. Thanks to our new remote monitoring service, that is now possible; patients can securely exchange information with doctors and nurses, and make video calls on a tablet via the dedicated Luscii app. In this way, patients gain insight into their lifestyle and its influence upon their health. Then, we only need to make appointments in the hospital if it is necessary”.
What makes the project special is that all parties involved in the care for people with COPD have joined forces: general practitioners cooperative Zuid-Kennemerland, network of physiotherapists FysiQ, healthcare organisations Kennemerhart and Zorgbalans, the Spaarne Gasthuis, health insurer Zilveren Kruis and innovative partners that make ‘remote care’ a reality. In an initial pilot scheme, the idea of ‘COPD in the neighbourhood’ proved to be successful: now the time has come for the next step. Paardekooper: “What’s new is that we can now offer 24/7 care through video calling and use of the Compaan, a user-friendly tablet. With remote monitoring, we bring second-line care to the ‘zero-line’, at home with the patient. That gives him or her much more freedom”.
The 24/7 remote care is carried out by the nurses of Medisch Service Centrum NAAST. If necessary, they can call in one of the other healthcare professionals, for example, for a home visit. René Baljon, director of NAAST: “Our years of experience with remote care for hospitals can now benefit general practitioners. We stand beside the healthcare professional and the patient, and that gives them a safe feeling. With remote care, the actual care becomes a less prominent part of your life and that makes it incredibly valuable”.Fast information exchangeAll healthcare providers, such as the district nurse, practice assistant, lung nurse and the physiotherapist, remain informed over the course of the disease via the communication platform OZOverbindzorg.
Paardekooper: “Together, we give the patient control, he or she determines which care providers receive access. They can exchange information as quickly as possible and take action when necessary”. COPD in the neighbourhood will begin, in this new set-up, with 50 patients. Paardekooper: “In 2019, we wish to expand this further and make remote monitoring possible for all people with COPD in the Kennemerland region”.
Baljon supports that ambition. “It has recently been agreed in Parliament that remote care is to be made available for everyone with COPD and heart failure, across the Netherlands, within the next three years. That is where the collaboration in Kennemerland fits in seamlessly. We are ready to scale up together”.
Made possible by
The project “COPD in the neighbourhood” is made possible by the uniting parties: GPs Cooperative Zuid Kennemerland, Spaarne Gasthuis, FysiQ network, Luscii, Kennemerhart, Medisch Service Centrum NAAST, Compaan, Zorgbalans, OZOverbindzorg and Zilveren Kruis.
The role of Luscii in “COPD in the neighbourhoud”:
Luscii provides software and patient support in the remote monitoring service in Kennemerland. Therefore, Luscii contact (secure video calling) and Luscii vitals (remote monitoring) was integrated into “Uw Compaan” (senior friendly tablet, www.uwcompaan.nl) and connected to the nurses of the medical service centre NAAST (24/7 medical service centre, www.naast.je), the care professionals in the neighbourhood (GPs, homecare, physiotherapists) and the Spaarne Gasthuis Hospital. Patients can send their values using Luscii on the Compaan-tablet, which will be diagnosed in Luscii’s platform by the nurses at the medical service centre NAAST. In case of deterioration, NAAST or one of the local care professionals will directly contact the patient via videocall. If needed, home care nurses will visit the patient at home or the patient will be asked to visit the GP or hospital.
This press release was published by NAAST on 11 November 2018 in Dutch (https://www.icthealth.nl/nieuws/zorgorganisaties-bundelen-krachten-voor-mensen-met-copd/)
Noordwest Ziekenhuisgroep and Luscii start Telemonitoring pilot
The Heart-Lung Centre of the Noordwest Ziekenhuisgroep (Northwest Hospital Group) starts its Telemonitoring pilot with Luscii. With Telemonitoring, patients are followed remotely by a medical specialist and/or nurse specialist while carrying out medical check-ups from home. This means they won’t have to visit the outpatient clinic every time.
During the pilot phase, Noordwest Ziekenhuisgroep will ask 25 heart failure patients and 25 COPD patients to participate for a period of 6 months. The project is a collaboration between Noordwest Ziekenhuisgroep and Luscii.
Today Floor Haak, member of the Board of Directors of the Noordwest Ziekenhuisgroep and Daan Dohmen, founder of Luscii, signed the collaboration agreement for Telemonitoring using Luscii. “This project is great because it is a way to deliver care in a very patient centred and future proof manner. Care of high quality, delivered at the right place”, said Floor Haak.
The signing itself was also completed in an innovative way, using the video communication to practice what we preach. On the photo (from left to right): Jan van Ramshorts (cardiologist), Victor Umans (cardiologist), Daan Dohmen (on the screen), Floor Haak (member of the Board of Directors) and Wendy Burgersdijk (pulmonologist).
Photo by Noordwest Ziekenhuisgroep/Pierre Mettes
The role of Luscii at Noordwest Ziekenhuisgroep:
Luscii provides hardware, software and patient support in the Telemonitoring pilot at Noordwest Ziekenhuisgroep. Luscii will help the cardiology and pulmonology department at Noordwest Ziekenhuisgroep to start with the Luscii software. Patients will receive measurement devices and can download the Luscii Vitals and Luscii Contact apps to send in their measurements and have (video)-communication with their care team. Also, after enrolment, Luscii is responsible for all logistics (sending the measurement devices), service and (installation at home) support for patients joining the project.
This press release was published by Noordwest Ziekenhuisgroep on 6 November 2018 (https://www.nwz.nl/Nieuws-NWZ/ArtMID/6077/ArticleID/865/Noordwest-en-Luscii-starten-pilot-Telemonitoring)
Patients with COPD of the Medisch Spectrum Twente Hospital will now have the opportunity to receive Luscii telemonitoring to support their at-home care and reduce the risk of hospital readmissions. I was at the kick-off meeting with patients and talked to them and their doctors and nurses.
Last week, on Tuesday 11th September, the official Kick Off with COPD patients, their relatives and care professionals took place in Enschede. Patients were shown how to use the iPad with Luscii monitoring and Luscii videocare at home and are now familiar with the term ‘telemonitoring’.
MST – one of the biggest hospitals in the eastern part of the Netherlands – starts with an Experience phase first, where patients with a history of frequent hospitalisations will be monitored at home. To gain insight into the feasibility of telemonitoring for these patients, I will lead a study together with the care professionals in the hospital. Since this new way of providing care to patients is quite exciting to both patients and care providers, we expect to retrieve some initial answers on the added value of telemonitoring from this research.
Chantal van der Linde, pulmonary care nurse, explains that she “hopes to be able to intervene in case of deterioration much earlier”. And to “offer a better safety net to patients”.
Patients are looking forward to starting with home monitoring. When asked what they expect from telemonitoring, one patient explained that they hope for “less hospital admissions, I already had two in a row recently”. Another patient added: “I believe that this makes contact with the nurse much easier and quicker, now I often call when it’s already too late”.
“It is difficult to address the effect of telemonitoring within the first 25 patients we start with”, explains Dr. Hekelaar, pulmonologist. “But I’m curious to see to what extent we can keep patients out of the hospital”.
We are all very excited to start and are looking forward to experiencing the use of telemonitoring in practice!
The role of Luscii in Medisch Spectrum Twente Hospital:
Luscii provides hardware, software and patient support for COPD Monitoring in Medisch Spectrum Twente (MST). The Luscii platform is used by the care teams in the hospital to monitor their patients and get notifications in case of increased health risks. Patients who are enrolled can download the Luscii Vitals and Luscii Contact apps on their iPhone or iPad, send in their measurements and have (video)-communication with the nurses or cardiologists. Also, after enrolment, Luscii is responsible for all logistics (sending the measurement devices), service and (installation) support for patients within the MST-service.
At the start of the Dutch e-Health Week, RKZ-patients will receive their tablets with the Luscii Vitals (formerly cVitals) and Luscii Contact (formerly cContact) applications. They will use them to monitor their vital signs directly from home.
The Luscii Vitals app on the tablet will provide the patients with information about their disease, self-management tips and support when having health problems related to their COPD. Over the following months, they will fill out a questionnaire weekly and whenever Luscii detects deterioration of their health situation, Luscii will inform the pulmonary nurse of VIVA Homecare directly. The nurse will then visit the patients at home or use Luscii videocare for a virtual consultation. If needed, they can refer to the pulmonologist or pulmonary nurse directly at the Rode Kruis Hospital.
Pulmonologist Erik Kapteijns: “We are going to treat these patients much more intensively without them needing to visit the outpatient clinic. By acting earlier, patients will have less exacerbations and a more stable development of their disease”.
Luscii will provide its digital health platform with apps for the patients and hospital users. Through this digital health platform, data will be managed and sent securely. The first step is to test and optimise the care pathway with a smaller group of patients. When successful, it will be scaled further.
The role of Luscii in Rode Kruis Hospital:
Luscii provides hardware, software and patient support for the Rode Kruis Hospital. The Luscii platform is used as a web portal. Patients download the Luscii Vitals and Luscii Contact apps on their iPhone or iPad to send in their measurements and have (video)-communication with the nurses or cardiologists. Also, after enrolment, Luscii is responsible for all logistics (sending the measurement devices), service and (installation) support for patients within the service.
Part of this article was published in Dutch on the website of RKZ in January 2017. A follow up article was published in print in May 2018.
The Martini Hospital starts, in collaboration with Luscii (previously ‘FocusCura’), two innovative projects to monitor patients with a chronic disease remotely and thereby prevent hospitalisation. Patients with COPD or heart failure receive a tablet at home, on which they transmit medical information about their condition to the hospital on a daily or weekly basis. If a patient exceeds their specific threshold value, the hospital will contact the patient via video calling. For example, medication can be adjusted at an early stage to ultimately prevent hospitalisation. In addition, it increases the degree of self-management, the feeling of safety and the quality of life of patients.
Hans Feenstra, the Martini Hospital’s chairman of the board: “These projects are a good example of ‘The right care in the right place’. We believe that, in principle, care should be organised as close to the patient as possible and we are therefore actively engaged in this”.
Patients who are already being treated by the hospital can participate in these projects. It is not the aim to relocate care to the general practitioner (substitution). This effective care is not only adding value for patients, it also reduces the costs of healthcare. Emergency admissions can be prevented and fewer outpatient visits are necessary. Feenstra: “The projects give substance to the long-term agreements that we have with healthcare insurers Menzis and Zilveren Kruis. We have committed to develop initiatives for care close to the patient.” Both projects start with a small group of patients in order to gain experience with this new way of working. Also, in collaboration with Luscii, scientific research into the results of telemonitoring is being conducted.
Prevent an exacerbation
COPD is a lung disease in which the lungs are damaged. The lungs fail to provide adequate breathing and the patient has less energy. COPD is characterised by lung attacks, in which the patient experiences more stuffiness, coughing and production of mucus, which often results in hospitalisation. We want to prevent these exacerbations by means of more frequent monitoring. Patients suffering from severe COPD fill in a validated questionnaire every week, containing questions about how the patient feels. A specialised nurse monitors the outcomes in the hospital. If these outcomes exceed certain threshold values, the nurse will contact the patient via a video consult. This way she can literally see how the patient is doing and can, for example, adjust the medication. This may possibly prevent an exacerbation. For patients with COPD, the trip to the hospital is very exhausting, as it often requires a great physical effort. Therefore this type of remote care is very suitable for them.
Titration of medication
Heart failure is a condition in which the pumping function of the heart decreases slowly or abruptly. As a result, patients get tired faster, develop fluid retention and experience shortness of breath in daily activities. Patients with heart failure transmit measurements of their weight, blood pressure and heart rate to the hospital daily, using the iPad. Therefore, these patients do not only receive an iPad, but also a weighing scale and a blood pressure meter at their disposal. Telemonitoring for heart failure is highly suitable for patients who have just been diagnosed with heart failure and for patients who are in an unstable phase of their condition. In both groups, the medication must be properly set or reset. And where that normally happens over a period of eight weeks through a series of visits to the outpatient clinic, it is expected that this can now be done in just a few visits and in just a few weeks. Adjusting the medication and explaining the condition and lifestyle will now take place via video contact, so that the patient does not have to visit the hospital. It is also expected that emergency admissions will be prevented. In addition, the patient is actively involved in his or her care process through this form of telemonitoring. Research shows that more control and self-management increases the patient’s quality of life.
The role of Luscii in the Martine Hospital:
Luscii provides hardware, software and patient support for the Martini Hospital. Luscii also helps the Hospital to implement Luscii the right way and to create the business case for insurers. Furthermore, when a patient is enrolled in telemonitoring, he/she will receive the Luscii Vitals and Luscii Contact apps to send in their measurements and have (video)-communication with the nurses or doctors. Also, after enrolment, Luscii is responsible for all logistics (sending the measurement devices), service and (installation) support for patients within the region of the Martini Hospital (Groningen). The PhD of Luscii (Martine Breteler) will be helping with the validation research.
This article was published in Dutch on the website of Martini Hospital in July 2018.
The Department of Pulmonary Diseases at the Isala Hospital started with digital homemonitoring for COPD patients via Luscii Apps in 2017. Patients in the project don’t have to come to the hospital as often and have a lower risk of hospital admissions as well. The check-ups of the patients are completed remotely, with home measurements taken twice a week using the Luscii Apps. If Luscii detects deterioration, the nurses at Isala will be informed and will reach out immediately. The project is accompanied by research carried out by Martine Breteler MSc, working together with different people at the Isala Hospital, including pulmonologist Jan Willen van den Berg MD, PhD.
The Dutch Ministry of Health made a video of this great project and showcased it as an example of the eHealth movement in the Netherlands during the eHealth Week:
The role of Luscii at Isala Hospital:
Luscii provides hardware, software and patient support for the COPD project at the Isala Hospital. Luscii helped the hospital to introduce telemonitoring into the outpatient clinic visit. Luscii worked together with the pulmonologists and specialised nurses in setting up the project. Furthermore, when a patient is enrolled into telemonitoring, they will receive the Luscii Vitals and Luscii Contact apps to send in their measurements and have (video)-communication with the nurses or pulmonologists. Also, after enrolment, Luscii is responsible for all logistics (sending the measurement devices), service and (installation) support for patients within the service.
Mr. Foederer suffers from heart failure, a serious condition in which the heart’s pumping function continues to decrease. As one of the first patients of the Haga Hospital’s Heart Centre and in the region in general, he is now under supervision at home via ‘Cardio@Home’. The doctor or nurse sees all measurement results and can intervene quickly if a situation changes.
In the Netherlands, about 150,000 patients are suffering from heart failure. There are many disorders that can cause heart failure: a heart attack, high blood pressure, cardiac arrhythmias, cardiomyopathy, valvular heart disease, inflammation of the heart muscle or a congenital heart defect. “Although the medication continues to improve, the condition is unfortunately as yet incurable”, explains cardiologist Ivo van der Bilt. “Half of these patients have a life expectancy of 5 years after the diagnosis, so it is a serious condition that calls for proper support of the patient and family. The Haga Heart Centre has an outpatient clinic with specialised nurses for heart failure. Here, we recently started the project Cardio@Home”.
More measurements, less hospital visits
“The patients that participate in the project Cardio@Home are now monitored more often, while they have to visit the hospital less often”, says heart failure nurse Arjan te Hoonte. “They receive an iPad, a wireless blood pressure monitor and a weighing scale for 6 months. The equipment is delivered and installed at the patient’s home by the supplier Luscii (previously ‘FocusCura’). At home, the patient measures his or her weight and blood pressure 2x a week. The results are sent to us via an app and we assess them immediately. We also ask the patient to fill in a questionnaire regularly, which contains questions about shortness of breath and fatigue during the measurements. This helps us in evaluating the measured values. In addition to the regular check-ups in the hospital, now we can also monitor and check on the patient remotely, adjust medication or give other advice, and if necessary, we can video call the patient via the iPad”.
Arjan is very enthusiastic about this development. It helps the patient to feel safer and to reduce the the hospital visits. “We also ask about the level of satisfaction, to make the quality of life visible. It provides us with a lot of information for scientific research, which helps us to adjust policies and to continue the use effectively”.
Safe and secure
Mr. Foederer feels comfortable with monitoring at home. “I do not have to go to the hospital as often, and if there is something strange, I can take action immediately. I can have a call with the nurse through the iPad. The nurse also called me once when my weight suddenly went up. He wanted to know if I was also developing fluid retention around my ankles. Now I’m being watched closely, but remotely”.
E-health has become an integral part of healthcare
Ivo van der Bilt considers this form of e-health a valuable addition to healthcare. “Innovative e-health facilities are used increasingly as part of the care process in healthcare.Thanks to Cardio@Home, these vulnerable patients can live independently at home for as long as possible. We can reassure the patient remotely, but also intervene faster if the situation worsens. With medication adjustment, for example, we can prevent a visit to the Emergency Department and maybe even a hospital admission, which is a reassuring thought for the patient”.
The role of Luscii in Cardio@Home at Haga Hospital:
Luscii provides hardware, software and patient support for the Cardio@Home project at the Haga Hospital. Luscii helped Haga Hospital to introduce telemonitoring into the outpatient clinic visit. Luscii’s implementation specialists guided the cardiologists and specialised cardio nurses in setting up the project. Furthermore, when a patient is enrolled in telemonitoring, he/she willl receive the Luscii Vitals and Luscii Contact apps to send in measurements and have (video)-communication with the nurses or cardiologists. Also, after enrolment, Luscii is responsible for all logistics (sending the measurement devices), service and (installation) support for patients within Cardio@Home.
This article was published in Dutch on the website of Haga Hospital in December 2017.
“I can’t do it anymore. My husband has late-stage dementia and my children live far away. I just don’t know what to do anymore. Please help me”. Wow, that hit home. I looked up and saw an older woman sighing with frustration at the health-care counter. The woman at the desk was doing her best, but didn’t really know how to help. I was sitting in the waiting room, watching it all unfold. For some reason, I couldn’t stop thinking about it. Is this vulnerable group of people being left behind? Are we expecting them to be too self-sufficient? Are we doing enough to help them?
Technology back in the day
When I first started working with FocusCura in 2003 (the company which I founded and of which Luscii became a spin-out brand), the world was relatively simple. iPads and iPhones didn’t exist and technology was reserved for cool youngsters and nerds, not for senior citizens. That’s why a lot of people called me crazy when I came up with the idea of using technology to help older people maintain their independence. But I did it anyway. And the senior citizens loved it. You can see how it looked on the picture below (made in 2004).
Things are very different today. Technology plays a dominant role in the lives of young and old alike. We use computers, smartphones, and tablets for everything. In fact, our devices are the first thing we see when we wake up and the last thing we see when we go to bed.
Last year, 86% of Dutch people used a smartphone (source: Dutch Smartphone Users report by Telecompaper). The majority of this growth was found among older people, given that most young people already used smartphones. In fact, smartphone use among people in the 65-80 age bracket increased from 9% to 63% in 2016.
Self-sufficiency and technology
Technology is playing an increasingly important role in our lives and is therefore becoming a determining factor in our ability to remain self-sufficient. However, there are a lot of vulnerable people who don’t understand these advancements – like the woman in the story above – and are afraid to ask for help. They are limited in their ability to take care of themselves and manage their lives. In many cases, the children live far away or have no interest in caring for their parents. It’s important that we don’t forget these people. And we aren’t: ten thousand nurses, caregivers, and volunteers are committed to helping this vulnerable group every day.
At home with dementia
I recently had the opportunity to shadow a dementia nurse at a healthcare organisation we work with. Dementia nurses help old people with dementia and their relatives, such as husbands, wives, and close family members, the entire time that person lives at home. During my work, I try to have this kind of ‘days in the life of’ with the users of our products once in a while (see also our way of working in the keynote below).
Together, we biked around visiting several clients. One of those clients was a couple and the wife had severe dementia. The husband was faced with a tough decision: put her in a nursing home or keep her at home. Their daughter was there too and I had so much respect for how they handled the situation. They explored all of the possibilities and thought long and hard about ways to avoid this difficult decision. “The last thing you want is to have your own wife committed”, he explained to me. The case manager and community care services were extremely supportive.
We visited another older gentleman that day who lived alone. He was vulnerable but very happy. He was eager to share his stories with us, with no real connection between them. He didn’t know a thing about technology. He was still coming to terms with the passing of his wife. As we were walking out the door, he explained that his children were worried about him. They all live far away and don’t really know how to help.
Technology to alleviate concerns
I was very impressed that morning and it really got me thinking. All of these people have their own challenges and problems, but were extremely happy with the support of the community care services and the case managers. To them, self-sufficiency was about as abstract a concept as technology. Although, that’s not entirely true with respect to the latter. Lots of people asked me to explain what FocusCura does. So I told them about partnering with healthcare institutions to help vulnerable people live at home safely and independently.
These people in particular, who didn’t really understand technology at all, were the ones who encouraged me to continue. While the sensors may be too late for them, they would have certainly made life easier. It also would have been nice to stay in the comfort of their own home for dementia check-ups, instead of having to take their partner with them to the hospital.
Plenty of work to do
This day made me realise all the more how important technology is. While it may not help dementia patients directly, it does give them the opportunity to enjoy the personal attention of their own warm, loving, and dedicated caregivers.
I don’t want to be a doomsayer, but the statistics don’t lie. With the number of healthcare users on the rise and a shortage of healthcare workers, our problem won’t be a lack of budget in the future. The real problem is a lack of qualified nurses, caregivers, and case managers.
The clever use of technology can provide support to these caregivers in helping their clients. In this way, we can help them maximise their limited time so they can also focus on offering personal and warm care. After all, they’re the ones who know the type of care someone needs and when they need it.
How great would it be if they could use wearables to check on their clients and take immediate action when something goes wrong? And how comforting would it be for the client’s children to be able to hop by using Luscii videocare, to join a visit of the nurse?
We still have a long way to go and there’s still plenty to do and develop in terms of healthcare technology. As great as the commercials are, it’s extremely challenging to develop technologies that perfectly address the needs of users, be they healthcare providers or clients.
We also have to reform our healthcare budget system if we want to achieve this. We don’t even have to replace the current rules and regulations with new ones; in fact, I believe that almost everything we want is possible in our current healthcare system. We just have to do it, which requires courage on all sides: healthcare providers, insurance companies, and businesses. If they create the room for healthcare providers to determine their own care methods, we can make good on our promise!
It all comes down to one thing: the people.
Of course, the gadgets, robots, and new technologies are super exciting, but they really play a minor role. It’s all about the people who use these technologies: the case managers who trust that these devices will be their eyes and ears; the caregivers who know that the smart sensors will alert them if something goes wrong.
Of course, this extends beyond the technology used in dementia care. The same applies to telemonitoring for COPD and heart failure, whereby patients send their measurements to their healthcare providers. Technology plays an important and welcome role for this group as well. It does, however, have to be extremely user-friendly and often also requires a detailed explanation from our technicians. But when I hear how happy patients and caregivers are and how much calmer they feel, I know we’re on the right path.
Extra help for an extremely vulnerable group
Is eHealth only suitable for independent, trendy, and healthy people? Or for people with a strong social network? Absolutely not! We can’t forget the extremely vulnerable group of people, like the older woman at the healthcare counter. They deserve special attention and help. After all, they’re the ones who will benefit most from the support of modern technology.
Not necessarily from the technology itself, but from the warm and personal attention of caregivers who are always at hand. This personal care can continue to exist for all those who need it in the future!
*The situations were modified slightly for privacy reasons, without sacrificing the essence of the story.
THE HAGUE – Collaboration in the healthcare sector is becoming increasingly important. It is therefore vital that patient data can be shared easily between healthcare providers and with patients themselves. Unfortunately, the multitude of different systems in the healthcare sector has always complicated matters. But that’s about to change. The Reinier Haga Group is the first organisation to put Zorgplatform (the Care Platform) into use, which enables simple, structured and secure exchange of patient data.
The Reinier Haga Group (consisting of Reinier de Graaf Hospital in Delft, Haga Hospital in The Hague and LangeLand Hospital in Zoetermeer) has become the first to put Zorgplatform into action. Using this platform, patient data in the electronic patient file can be shared in a simple, secure and structured manner between healthcare institutions and eHealth solutions, such as the Luscii Vitals (formerly cVitals) app. The introduction of Zorgplatform is a welcome boost to the cabinet’s ambition to promote collaboration in the healthcare sector by actively developing ICT standards and making them compulsory. Today, Secretary General Erik Gerritsen talked about this development during a working visit.
“The Reinier Haga Group strives to offer its patients the right care in the right place at the right time. To achieve this ambition, it is essential that healthcare is tailored to suit individual patients as much as possible, increasingly making patients the directors of their own care processes. The introduction of a home-measurement app to measure vital statistics, such as blood pressure, weight and pulse rate, will facilitate this greatly. In addition, the availability of a patient file to our doctors and nurses is vitally important”, explains ICT manager Marcel Slingerland. “An increasing amount of the patient data we use is now obtained from other healthcare organisations and innovative apps used by patients at home. Zorgplatform has allowed us to tap in to these rich wells of data”.
Standard data exchange
A long-held desire among doctors and nurses is to have a total picture of each individual patient’s health. This is often impossible as the data required is locked away in a maze of separate systems. “We specially developed Zorgplatform to solve this problem simply and securely”, explains ChipSoft’s Remko Nienhuis. “Zorgplatform allows data to be shared with the hospital’s electronic patient file in a standard manner with the aid of the Healthcare Information Building Blocks (Zorg Informatie Bouwstenen or ZIBs) developed by the government. In this way, hospital EPFs can connect to other patient files and even to other innovative healthcare technologies”.
Luscii is the first to have its Vitals app (formerly cVitals) connected to Zorgplatform. This allows medical specialists to prescribe ‘Vitals home measurements’ directly via the electronic medical record (EMR), to access these home measurements and to receive alerts if any deviations are identified. They can then respond to these alerts, for example, via a video call using Luscii Contact (formerly cContact). Cardiologist Jan Willem Borleffs, who works at the Haga Heart Centre at Haga Hospital, is very impressed with the new possibilities. “Last year, we saw exactly how Luscii’s home measurements and video calls can provide vital assistance to patients with heart problems. Patients feel safer and we can take action earlier, which means hospital admission is often prevented”.
The right care in the right place
Mr. van der Hoeven, a heart patient, agrees. “This new form of care means better check-ups for me and that works really well”.
To connect more patients to this system, it is vital that these home measurements are integrated into ChipSoft’s EMR HiX, as this will prevent a whole separate system from being required simultaneously. “I am very happy that Zorgplatform has made all data available in our EMR”, says Borleffs. “This is a key step in gaining acceptance of eHealth”.
The connection of the home-measurement functionality in Zorgplatform means other healthcare institutions who connect to Zorgplatform can also access this data. The Netherlands has therefore made an important medical breakthrough in the field of sharing patient data.
The integration of Luscii into EMR Chipsoft:
A team of Luscii and Chipsoft HiX (the biggest EMR vendor in the Netherlands) integrated Luscii deeply into Chipsoft using ‘Zorgplatform.’ The integration has three features: 1) sign up of patients for telemonitoring directly from the EMR, 2) alarm handling of Luscii alarms in the EMR workflow and 3) all data measured with Luscii delivered directly into the EMR. The first hospital system to use the integration is Haga Group (three hospitals in The Hague, Delft and Zoetermeer).
This press release was published by Luscii and Chipsoft at the beginning of 2018.