Cumming, G. et al.:e-health in a Remote and Rural Setting in the North of Scotland – An Evolving Success Story

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e-health in a remote and rural setting in the North of Scotland

an evolving success story

Grant Cumming NHS Grampian & UHIAndrew Fowlie NHS GrampianAdrian Baker NHS HighlandThomas Heneghan NHS GrampianNeil Hamilton University of AberdeenStefan Agamanolis Distance Lab

1.demographic change

2.health care expensive

3.doctor shortage & changing role

4. treatment prevention

5.patient’s expectations

need to connect and collaborate

e health

Changes in health care are inevitable

The Vision & the Mission

Moray

Elgin biggest town population 20,000

Population 120,0002238km2

Remote and rural population

Poor road infrastructure

current models of health care unsustainable

Track record to date

Patient tailored - Independent clinician led websiteWomen consulted

No 1 site in UK sites and world sites if google

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

2002 2004 2006 2008

average hits/day

Miscarriage Matters (CSO pilot study)

Cumming G, Klein S, Bolsover D, Alexander D, Hamilton NThe development and evaluation of a miscarriage-related website for women and partnersfollowing early pregnancy loss : A pilot study11th World Congress on Internet in Medicine 2006: 26

Paper presented and published abstract

Patient driven (needs assessment)Low level psychological intervention

CAL dept

Resource additional information before during or after visits to health professionalFor online support groups and forums For online consultation As a therapeutic interventionFor research/surveysFor prescribing

Summary

HADS anxiety & depression scores significantly improved

SF-36 scores all approximated to the norm at 3 months (apart from general health)

SF-36 scores showed no significant improvement at 3 months cf baseline

In those who had access to the website:

Miscarriage impacts negatively on HADS and SF36 scores

In those who did not have access to the website:

New developments

STRATEGY FOR THE DIVERSIFICATION OF THE ECONOMY OF MORAY FOLLOWING RESTRUCTURING OF THE RAF BASES

AT KINLOSS AND LOSSIEMOUTH

December 2005

1/5/ 07 - 21/4/08

Baby feeding matters Statistics

Baby feeding videoconferencing study

Internet Protocol(IP)

Integrated Service Digital Network

(ISDN)

Dr Grays Buckie

VC unit - spilt screen VC unit – split screen

BFM websiteBFM website

patientHealth

pro

www.babyfeedingmatters.co.uk used as interactive teaching aid

Dufftown is situated in Moray in the North-East of Scotland 54 miles from Aberdeen 58 miles from Inverness

16 miles from Elgin

The Dufftown Project

Dufftown Pilot• Promote Self Care• Home monitoring blood pressure• Empowerment using Digital medium• Access on-line tools• Purpose built website

??as good as conventional care?? more economic

The future

PEDI principle

• Personalised predictive health care plans

• Evidence based health and care

• Digital consultations with health care professionals

• Interactive Web based care (Web 2.0 & Web 3.0)

good quality of lifephysical (community health-e-space.com Northern Scot)psychological

emotional management dealing with long term conditionrole management (coming to terms with change in life role)

online electronic support groupspersonal storiesillness narrativescomputerised cognitive behavioural therapy

spiritual – research project proposed

disease preventionbehavioural change (eg exercise, diet, smoking, alcohol)

SAE, goal setting, self monitoring, feedbackwww.babyfeeding matters & videoconferencingpredictive modelling

disease management & treatment SAE, goal setting, intervention, self monitoring, feedback

eg urinary incontinenceDufftown hypertension pilot

Hospital Care

Exte nded GPPractic e

ManagedCare

MainlySelf

Caring

Level 170-80% of

People

Level 2High risk

Service Users

Level 3Highly

complexpatients

Making e health real health

treatment → prevention (self care)

industry

Life Science BuildingConnecting & Collaborating