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2013
Active Qatar
Active Qatar Image

Organization: Qatar National Sport Sector

Country: Qatar

Forum: Obesity

As part of Qatar’s National Sports Sector Strategy (2011-2016), the ‘Active Qatar’ Campaign will educate and engage the public on the importance of healthy living and increase opportunities for people of all ages and abilities to participate in physical activity. Currently, activity levels are low across the entire population, so the campaign will initially aim to promote healthy lifestyles for all. This will be followed by targeted campaigns for priority groups with very low activity levels or at higher risk of inactivity-related diseases. The Campaign will use:

Large-scale, high-intensity mass media promotional campaigns
Tools to support individual behavioral change, such as goal-setting and self-monitoring, counseling, motivational support and performance awards
Techniques to support group behavioral change, such as social networks, relationships, community sports groups and workplace activity programs
Environmental prompts to encourage healthier choices, such as improved signposting of stairs near escalators and lifts
This will require effective partnerships across sectors and a coordinated approach between public health and primary care. Active Qatar is bound to the Qatar National Vision 2030, which sets out a number of goals which will aim to bring comprehensive development and long-term prosperity to Qatar.

Family Centered Care
Family Centered Care Image

Organization: Children’s Hospital of Philadelphia

Country: USA

Forum: Patient engagement

At the Children’s Hospital of Philadelphia (CHOP), the Family-Centered Care (FCC) Program provides a mechanism to harness the unique experience and knowledge of patients’ carers and relatives. The Program is founded on 6 core values:

  1. Dignity and respect
  2. Information sharing
  3. Participation
  4. Collaboration
  5. Access
  6. Care Coordination

FCC informs the treatment of individual patients but is also used when designing new patient safety programs, new facilities, and new services.

In order to achieve this aim, CHOP employs Family Consultants. These are paid positions for parents of former or current patients at the hospital. Their role is to integrate the family voice and ensure that it is reflected and embedded in the work of the hospital. This is done by consulting with clinical staff on specific cases, sitting on hospital steering committees, participating in root-cause analyses, reviewing and providing feedback on hospital policy and documents, assisting workgroups on specific projects, speaking to target groups on the family perspective, and participating in simulations to help staff to improve their communication skills with patients and families.

Family Consultants are supported by Family Partners. These are volunteers who are parents or caregivers of patients at CHOP. They play important roles in providing input and reviewing information on programs, policies and initiatives across the Hospital.

Ghana Health Insurance System
Ghana Health Insurance System Image

Organization: Ghana Ministry of Health

Country: Ghana

Forum: Big data & healthcare

In 2003, Ghana introduced a national health insurance system under which all citizens pay a premium, determined by their income, which entitles them to access healthcare. The government then pays healthcare providers in both the public and private sectors for the services and procedures that they have delivered to subscribers. Unfortunately, the success of the system has been mired by claims fraud, as some providers submit reimbursement claims that are overpriced or that relate to services and procedures that were not carried out.

In an attempt to combat this fraud, the National Health Insurance System (NHIS) has developed a number of data-analysis projects to track suspicious transactions and claim patterns, both before and after payments are made. Pre-payment authentication methods involve inputting the unique member ID number into a database which will:

  • flag any claims under that same ID within the last month at any provider to highlight any patterns or irregularities
  • check the credibility of the given diagnosis against age and gender
  • check that treatment correlates with previous diagnoses
  • check that agreed tariffs for services have been used.

Post-payment methods will look at overall trends within providers and districts to check the volume and value of the most prescribed medicines, service utilization, and to compare costs per claim and monthly value of claims between providers. This will identify any outliers so that further investigations can take place.

This will require an integrated approach, combining data from multiple sources throughout the care pathway. It is hoped that exposing incidences of fraud and rewarding / penalizing providers accordingly, with financial penalties, anti-fraud legislation and early reimbursement incentives for clean claims, will encourage greater compliance in the future and support the system to grow and develop.

HealthNetTPO
HealthNetTPO Image

Organization: HealthNetTPO

Country: Burundi; Sudan; Sri Lanka; Indonesia; Nepal

Forum: Mental health

HealthNet TPO is a Dutch aid agency that works on health in areas disrupted by war or disasters. It has developed a Psychosocial Care Package which combines mental health promotion, prevention and treatment to address the needs of at-risk children and adolescents in areas of armed conflict.

The package is compiled of multiple different components and includes information on the rationale and theoretical background of these components as well as a step-by-step implementation guide. The various activities and programmes are then integrated within a comprehensive system of care. Examples of these activities include:

  • Capacity building of community members and building community awareness
  • Resilience groups
  • Peer groups and group psycho-education
  • Recreational and cultural activities
  • Formation of parent-teacher associations
  • Parental guidance and support
  • Classroom-based psychosocial intervention
  • Group and individual counselling: more advanced or individualized support for children with more severe or less transient problems
  • Mental health referrals and epilepsy treatment: case management for epileptic children and children with psychiatric problems

The models, tools and presentations within the resource package are available to download for free and are continuously being expanded with new evidence and research.

The Classroom-Based Intervention has been shown to be effective in several clinical trials in Indonesia, Nepal and Sri Lanka and, according to a series of non-randomized evaluation studies, the package improved case detection and made effective care available to over 96,000 children across the five countries. The programme continues to run in Burundi; however, a lack of resources has halted the programme in the other countries.

Health worker data recording
Health worker data recording Image

Organization: Dimagi

Country: Tanzania; Uganda

Forum: Big data & healthcare

Since 2002, Dimagi has been delivering open and innovative technologies to improve health and education in underserved rural communities. One of three key products, CommCare allows complex data to be inputted into forms on mobile devices and then viewed in real-time on the web. This is particularly useful in supporting frontline health workers when visiting patients and allows effective management of patients, the workforce and the data that they collect. More than 2.5 million patient forms have been submitted through this system by over 50 organizations across over 30 countries. The depth and detail of this data can be used to provide important new insights.

In one project, Dimagi and the University of Washington collaborated to investigate how to use CommCare to ascertain whether frontline health workers were submitting fake or real data. Frontline workers in Tanzania and Uganda were supervised whilst collecting real data and then asked to enter data on fake patients at a ‘fake data party’. Analysis of this data revealed that in fake submissions, the form took only 148 seconds to complete (100 seconds less than the average time taken to enter real data) and that instances of diarrhea were significantly exaggerated. These patterns were then used to create classifiers which automatically assess data quality and detect fake entries.

It is hoped that this study will be a preliminary step in the design of tools for automated data quality control for mobile data collection. This will be incredibly important in supporting the development and assessment of future technological interventions.

Healthy Children in Sound Communities
Healthy Children in Sound Communities Image

Organization: German-Dutch Municipalities

Country: Germany; Holland; Italy; Poland; UK

Forum: Obesity

Initiated by the Network of European Academies of Sports, The Healthy Children in Sound Communities (HCSC) initiative matches schools with community organizations and sports clubs to help students to get 60-90 minutes of physical activity each day. The project encourages schools to deliver 3 hours of Physical Education each week and partner with local community organizations and sports clubs to deliver co-curricular physical activity and health and nutrition education. HCSC also encourages healthy travel to schools, such as ‘walking buses’ (whereby children walk to school along safe routes as a group accompanied by responsible persons), and provides support for healthy eating and food preparation through cookery courses and ‘school fruit events’.

Results based on 557 children from 39 primary schools in 12 municipalities along the German-Dutch border show:

  • A significant improvement in endurance, co-ordination, velocity and force tasks (such as sit-ups, push-ups, 20-meter run and 6-minute run)
  • A significant decrease in BMI
  • In Germany, the number of children with a BMI categorized as obese or overweight decreased by 15% to 14.6%. In the Netherlands, this decreased from 12.8% to 12%.

Following the success of the intervention of the cross-border project in Germany and the Netherlands, the program has also been implemented in Italy, Poland, the UK and the Czech Republic.

Home grown school feeding Program
Home grown school feeding Program Image

Organization: United Nations

Country: Brazil

Forum: Obesity

Developed by the United Nations World Food Program (WFP), the Home Grown School Feeding (HGSF) Program aims to link school feeding with local agricultural production. It focuses in particular on connecting school feeding programs with local small-scale farmer production by creating access to a stable and long-term market for small landholders. School feeding is a well-recognized means of alleviating hunger while supporting education, nutrition health and community development. It can include providing meals or snacks to be eaten during school hours or distributing dry take home food rations to pupils in recognition of regular school attendance over a given period.

HGSF programs are running in countries across the world, including Benin, Kenya, Scotland, India and Brazil. In Brazil, the right to receive one free meal at school each day has been enshrined in the National Constitution since 1998 and a subsequent law stipulating that at least 30% of the food used in school feeding programs should be procured locally has been introduced. In the Municipality of Campinas in the State of Sao Paulo, the average daily cost of school food is US$0.27 per child. This cost is met by the State and municipal governments and the National Fund for Educational Development (FNDE).

Prior to this program, school food in Campinas often included sweet rice, porridge or pasta and soy juice. This was unpopular with the children and led to many taking their own food to school or going home to eat. Under the HGSF, fresh vegetables and fruit are now served every day and nearly 80% of pupils approve of the new menu.

Implementing Incentives
Implementing Incentives Image

Organization: Ribera Salud

Country: Spain

Forum: Accountable care

In 1999, the Ribera health district within Valencia acquired the Hospital de la Ribera. As a result of a public-private partnership, this public hospital owned by the regional government of Valencia was run by a private healthcare delivery company called Ribera Salud. In 2003, this contract was broadened to include 40 public primary-care centers as well as the hospital.

The Alzira model, as it is called, combines public funding, ownership and control with private healthcare provision. Ribera Salud receives an annual capitation fee from the regional government and it provides the full range of healthcare services for free to all residents of the designated area in return. They are incentivized to provide high quality care for fear of losing their contract with the Valencian government. The company also has an incentive to keep costs down as it retains profits of to 7.5 percent of turnover, with further profits reverting to the local government.

Another incentivizing factor of this model is patient empowerment and choice. If a patient within Ribera Salud’s catchment area opts to access a different health care provider, they have to pay 100 percent of the costs. Conversely, if Ribera Salud treats a patient from another district, it receives only 80 percent of the average regional cost. This asymmetry keeps a balance: the network can profit from attracting more patients, but must still concentrate on patients within its own districts.

The Alzira model has since been adopted or adapted elsewhere in Valencia and now covers about 20 percent of the region. The local government benefits as the capitation cost is less than 75 percent of the cost-per-inhabitant elsewhere in Valencia and patients benefit from shorter waiting times, reduced re-admission rates and increased patient-satisfaction levels.

Improving Access to Psychological Therapies (IAPT)
Improving Access to Psychological Therapies (IAPT) Image

Organization: NHS

Country: UK

Forum: Mental health

The Improving Access to Psychological Therapies (IAPT) programme is a large-scale initiative that aims to increase significantly the availability of evidence-based psychological treatments for depression and anxiety disorders within NHS-commissioned services in England.

It was created to offer patients a realistic and routine first-line treatment for depression and anxiety disorders, combined where appropriate with medication but also making use of talking therapies and guided self-help. If individuals subsequently fail to benefit from low-intensity intervention, or have a severe disorder, they are then offered high-intensity, face-to-face therapy. In order to support and deliver the program, a comprehensive course was launched to provide training for new therapists in psychological treatments based on strong evidence of effectiveness from clinical trials.

More than 1.1 million people have been treated by IAPT services in the first three years of the project. This has brought the following health and economic improvements:

  • more than 683,000 people have completed a course of treatment
  • recovery rates in excess of 45%
  • around two-thirds of those treated have shown a reliable improvement
  • training of over 5000 new therapists to form a new, competent workforce to deliver recommended treatments
  • increased employment attainment and retention, with more than 45,000 people moving off sick pay and benefits

The scope of the program is now being extended to offer services for children and young people, people with long-term physical conditions, and people with medically unexplained symptoms or severe mental illness.

Khayelitsha Community Health Workers
Khayelitsha Community Health Workers Image

Organization: Khayelitsha Township

Country: South Africa

Forum: Obesity

Khayelitsha is a township on the Cape Flats, outside of Cape Town, South Africa. A community-based project sought to increase awareness of primary prevention of non-communicable diseases (NCDs) by harnessing the power of community health workers (CHWs) as community change agents. The intervention was initiated in 2000, in response to the request of community members of Khayelitsha who had noticed an increasing number of people in their community suffering from diabetes and hypertension.

The first phase of the program focused on the health needs of the CHWs, over 90% of whom were obese and most of whom had misconceptions about the causes and consequences of obesity. An interactive training program was developed which aimed to empower CHWs with the knowledge and skills to make healthy choices and act as positive role models to others. The CHWs went on to organize awareness-raising events including a dramatized play on diabetes, discussions on healthy eating, fun group walks and a health club.

The diabetes drama was performed to 1100 people across 13 sites and at the end of each performance the audience was interviewed to assess their understanding. In 2005, the CHWs developed a health club called “Masiphakame Ngempilo yethu” (Let’s stand up for our Health). Members meet weekly and sessions are a combination of physical exercises, demonstrations, talks and discussions. Originally, the club had 35 members but by 2006 this had increased to 152. After 2 years, a study of 25 club members and 29 non-members demonstrated that club members tended to eat less red meat and were more likely to trim the fat from meat than non-club members.

The program faced several key challenges, in particular: high unemployment combined with easy and cheap access to unhealthy food; and high levels of crime and violence which discouraged people from undertaking outdoor physical activities. In spite of these difficulties, the program is still running, demonstrating the vital role that CHWs can play in the primary prevention of NCDs.

Mental Health and Development Model
Mental Health and Development Model Image

Organization: Basic Needs

Country: Africa; Asia

Forum: Mental health

BasicNeeds was founded in 2000 with the aim of addressing the hugely under-resourced and often neglected issue of mental health. Their Mental Health and Development Model is designed to empower people with mental health problems living in poverty through community-oriented treatment and self-help support. The model comprises five inter-linking modules designed to address service users’ medical, social, and economic needs:

  • Capacity building: Identifying, mobilizing, sensitizing and training Mental Health and Development stakeholders
  • Community mental health: Enabling effective and affordable community-oriented mental health treatment services which successfully re-integrate people with mental illness into their families and communities
  • Livelihoods: Facilitating opportunities for affected individuals to gain or regain ability to work, earn and contribute to family and community
  • Research: Generating evidence from the practice of Mental Health and Development
  • Collaboration: Managing partnerships and relationships with stakeholders involved in implementing the model on the ground and/or responsible for policy and practice decisions

Interventions are designed around these themes, taking into account the local needs and context and making best use of local resources.

In the 14 years since its foundation, BasicNeeds had reached over 617,000 people. They monitor and assess their impact quarterly, and have reported the following:

  • affected individuals gaining access to treatment has increased from 49% to 86%
  • 73% reported a reduction in symptoms
  • 80% of the 117,452 mentally ill people in the programme in 2013 had livelihoods, 33% were in productive work and 47% were earning
  • 518 self-help groups with 25,266 members have been established

There are plans to continue to expand the programme and use findings to influence government policy to support community based mental health development oriented approach.

Mental Health Innovation Network
Mental Health Innovation Network Image

Organization: Grand Challenges Canada

Country: Canada

Forum: Mental health

Initiated in June 2013, The Mental Health Innovation Network (MHIN) is designed to facilitate the development and uptake of effective innovation in mental health with the aim of improving the lives of people with mental, neurological and substance use disorders and reducing the global impact of mental health challenges. This is achieved through an open-access online repository, which is split into three key areas:

  • Information on mental health innovations from across the globe and their impact, as well as downloadable resources such as publications, implementation guidance, manuals and multimedia resources.
  • A resource area to provide access to key published research, toolkits, guidelines, systematic reviews and reports.
  • An online community of mental health innovators with blogs, podcasts and webinars as well as a directory of members which enables users to connect with others engaged in similar work.

In this way, the network encourages collaboration, enables learning, builds partnerships and disseminates knowledge in order to promote innovative practice in mental health prevention, treatment and care across the world.

MHIN’s activities are supported by a team of researchers and policy makers from the Centre for Global Mental Health at the London School of Hygiene & Tropical Medicine, and the World Health Organization’s Department for Mental Health and Substance Abuse. MHIN is funded by Grand Challenges Canada.

mHealth Greenhouse
mHealth Greenhouse Image

Organization: Cornell Tech

Country: USA

Forum: Big data & healthcare

Developed by Cornell Tech in New York City, the mHealth Greenhouse is designed to encourage collaboration between clinicians and developers in order to create new ways to improve patient care through mobile data. The mHealth Greenhouse will empower clinicians to create novel and effective personal treatment tools for patients by integrating clinical expertise into the development team.

It is hoped that new mobile applications will be able to harvest the small data traces generated daily by individuals by gathering information through mobile phone communications, the location and mobility patterns of smartphones, shopping histories, emails, instant messages, social media use, and search engine histories. These integrative applications will provide patients and clinicians new insights into the relationship between health and lifestyle factors, which will support patients to self-manage and inform their own care.

The close connection between clinicians and developers means that any new applications are quickly tested by rapid, iterative, small-scale pilots by clinicians and patients. In the long-term, this will lead to an enhanced toolkit of reusable modules which will enable faster mHealth innovation. The pilots will provide evidence that can be used by others to support applications for funding for large-scale clinical trials and further commercial development, which will allow innovation and improvement to spread.

mPedigree
mPedigree Image

Organization: mPedigree

Country: Africa

Forum: Patient engagement

Created in 2007, the mPedigree Network uses mobile and web technologies to secure products against counterfeiting and to provide powerful market intelligence and consumer behavior data. Through their flagship platform, “GoldKeys”, consumers are able to validate the authenticity of their medicines by texting a unique code (revealed under a scratch-off panel) to a toll-free hotline. This request is routed to mPedigree’s servers and consumers receive a quick response to authenticate their purchase.

Not only does this empower consumers to check the legitimacy of a product, but it also provides large amounts of market information which can be used to discern broader patterns. These patterns can reveal changes in doctor prescription preferences which can be used to model diagnostic trends in specific geographies and support epidemiological programs that track the changing face of disease in Africa. They can also be used to help to evaluate the shifts in the economic burden of disease by looking at variations in drug-purchasing behavior over time.

myhealthlocker
myhealthlocker Image

Organization: SLAM Foundation Trust

Country: UK

Forum: Patient engagement

myhealthlocker is a patient-focused website which allows service users to take an active role in their recovery and wellbeing by providing them with access to a personal health record. It has been developed by South London and Maudsley NHS Foundation Trust for young people with mental health problems.

Users can gather and store their own health information from a variety of sources, including their GP and hospital notes. They can also choose what information they want to share and who they share it with. Through the site, patients can access their care plans alongside resources, tips and support to help them manage their health and wellbeing. The clinical portal enables patients to enter information on their online record, allowing them to keep track of and monitor their wellbeing. These PROMs (Patient Reported Outcome Measures) can also be viewed by clinicians, helping them to make informed treatment decisions and assess the efficacy of different interventions.

European Alliance Against Depression
European Alliance Against Depression Image

Organization: EAAD

Country: Europe; Chile

Forum: Mental health

Established in 2008, the European Alliance Against Depression (EAAD) is an international non-profit organization involved in European research projects targeting depression and suicide prevention. Based in Leipzig, Germany, the Alliance has several European members and more than 100 regional network partners in Europe.

The Alliance aims to prevent suicidal behavior and improve the care of patients with depression through action-oriented, community-based public health interventions. These interventions operate at 4 levels:

  1. Cooperation with primary and mental health care, focusing on training general practitioners
  2. Public awareness campaigns
  3. Cooperation with community facilitators and stakeholders
  4. Support for people at high risk and their relatives

One evaluation of a 4-level program in the Hungarian town of Szolnok demonstrated a sharp decline in suicide rates from 30 per 100,000 in 2004 (before the project was started) to 12 per 100,000. This 60% decrease was significantly greater than that observed across Hungary and in the control region.

Going forward, the EAAD has identified the following action areas:

  • Improve care for patients affected by depression and prevent suicides
  • Support relatives of persons concerned
  • Raise public awareness of the occurrence and impact of depression and suicidal tendency
  • Inform and educate the general public and professionals
  • Disseminate EAAD results at regional, national and European levels
  • Support young researchers
  • Conduct further research on interventions for depression and the prevention of suicides
Healthtalkonline
Healthtalkonline Image

Organization: DIPEx

Country: UK

Forum: Patient engagement

Founded in 2001, Healthtalk.org is an online repository of over 25,000 video and audio clips in which more than 2000 patients, relatives, carers and healthcare professionals share their healthcare experiences. It is delivered by a partnership between the charity DIPEx (Database of Individual Patient Experiences) and the Health Experiences Research Group (HERG) at The University of Oxford’s Nuffield Department of Primary Care.

The video clips can be used by patients as a means of information and support, and to provide insight to healthcare providers and policy-makers which helps them to understand the patient experience. The clips are also a source of support and education for patients and their families which help individuals to learn about their condition and communicate with health professionals to support informed decision-making. It is hoped that this approach is a step towards evidence-based co-design of care, in which patient, families and providers work together to improve care quality.

Researchers from Oxford University use rigorous qualitative research methods to capture the full range of experiences associated with each health condition and the website has been certified by NHS England’s accreditation scheme for health and social care information, The Information Standard.

The site covers 85 different health topics, which capture the experiences of 40-50 people with personal experience in that area. According to healthtalk.org, three quarters of users leave the website feeling less alone and better informed, more than 90% would recommend the site to others and more than 80% say its information is better than what they’ve received elsewhere.

A new organization, DIPEx International, has since been founded, and its members are delivering similar programs in Canada, Germany, Japan, Republic of Korea, the Netherlands, and Spain.

Establishing outcomes & evaluation metrics
Establishing outcomes & evaluation metrics Image

Organization: Geisinger Health System

Country: USA

Forum: Accountable care

In 2005, the Geisinger Health System in Pennsylvania, which cares for more than 25,000 patients with diabetes, began transforming its approach to diabetes care.

Geisinger’s solution was to redesign care around national guidelines on key clinical metrics for diabetes management. Having compiled a list of best-practice guidelines, distilled from a variety of national sources, Geisinger found that nine of the underlying components – such as haemoglobin levels, immunizations, smoking status, and so on – could already be tracked through its EHR system. The nine criteria formed an “all-or-none bundle,” on which the new care regimen was to be based. An “all-or-none bundle” is a performance target that is met only when patients satisfy all of the individual criteria. It reflects “ideal” care, and fosters teamwork, as multiple individuals rely on one another to register a success. The nine criteria were “hard-wired” into clinical care, via various EHR-enabled tools that flag up requirements for completing the full bundle. Patients could monitor their own progress with the help of an online portal, and thereby manage their own care more actively.

Geisinger developed a process to monitor the performance levels of individual physicians and teams and compared the data against national benchmarks. This process helps identify gaps in care and motivates each team to improve its results. Up to 20 percent of a clinician’s income depends on improving all-or-none scores for the patients in his or her care.

The new approach has proved very effective. Scores on the diabetes bundle began rising impressively, and within three years this rise translated into dramatically improved end-state outcomes for patients, including reduced risk of retinopathy, stroke, and myocardial infarction. Two factors were critical to success: the national frameworks for best-practice diabetes care, which helped in defining evidence-based targets; and Geisinger’s own data systems and tools, which helped to evaluate patient-level data and integrate it speedily into care delivery. Geisinger is working to personalize the targets for individual patients; for example, by specifying target HbA1c readings to reflect each patient’s priorities and realistic goals.

Arrive-Alive!
Arrive-Alive! Image

Organization: Victoria Government

Country: Australia

Forum: Road traffic injury

In 2001, the Victoria government launched the Arrive Alive! road safety strategy with the aim of reducing road trauma by 20% in 2007. There was an increase in speed enforcement, with more active mobile speed cameras, new fixed speed camera locations and increased enforcement. The strategy is conducted by a ‘road safety partnership’ comprised of VicRoads, Victoria Police and the Department of Justice and the Transport Accident Commission. All have their own specific enforcement responsibilities, but often act in consultation with one another and with other road safety partners, including NGOs.

An evaluation by the Auditor General of Australia showed positive results for the first phase of the strategy, with a 16% decrease in fatalities between 2002 and 2005. The most impressive trauma reductions were experienced in Melbourne’s low-speed zones, where fatalities decreased by 40%. Based on this success, the Arrive Alive 2008-2017 strategy was launched, which aimed to achieve a 30 per cent reduction in the road toll and a 30 per cent reduction in the number of serious injuries. A wide range of new strategies were introduced including: a tough new focus on drink driving; a peer passenger restriction on first-year probationary drivers; a program to give drivers the chance to redeem demerit points by undertaking a comprehensive road safety program; and mandating the instalment of Electronic Stability Control (ESC) and head protection technology in new cars.

Bloomberg Global Road Safety Program
Bloomberg Global Road Safety Program Image

Organization: Bloomberg Global Road Safety Program

Country: Russia

Forum: Road traffic injury

The Bloomberg Global Road Safety program was launched in February 2010 in Moscow and initiatives relating to seat belt rates and speed commenced shortly after in two oblasts (Lipetskaya and Ivanovskaya) in September 2010. Following observational studies and focus group discussions, a large social marketing campaign was launched in Lipetskaya Oblast in November 2010 and in Ivanovskaya Oblast in May 2011. The motto was “Do not break the line of life”. The campaign, developed and conducted with the support of local police, was publicized through TV, radio, outdoor advertising, and public relations activities.

The initiative ‘Dva Sh: shokolade/shtraf’ received considerable attention from regional and federal media. In this initiative, drivers and passengers who were buckled up received a bar of chocolate with the logo of the campaign, whereas those who were not received a fine, in keeping with the legislation currently in force. During the period of the campaign, police officers strengthened enforcement activities up to ten times to the level of pre-campaign measures.

The combination of the social marketing campaign, strong police enforcement and other awareness building efforts has significantly increased seat belt use. In Lipetskaya Oblast, use of restraints for all occupants increased from 52 percent in October 2010 to 75 percent in March 2012, and has remained stable since. In Ivanovskaya Oblast, restraint use for all occupants increased steadily from 48 percent in April 2011 to 93 percent in May 2013.

Blue Button
Blue Button Image

Organization: US Veterans Association

Country: USA

Forum: Patient engagement

The Blue Button Program was launched in August 2010 by US Department of Veterans Affairs to enable patients to access their health records online. The program encourages data holders to provide individuals and their caregivers secure, timely and electronic access to their health information and use it to improve their health and care.

The Blue Button is an icon which is featured on websites. By clicking on the button, patients can download their health information, including digital health records and insurance claims, in a number of formats. Increasing access to health information is designed to empower patients to become partners in their own health and take a more active role in self-managing their health and making treatment decisions.

The program is supported by the Blue Button Pledge, which can be made by both data holders and non-data holders. Data holders pledge to “make it easier for individuals and their caregivers to have secure, timely, and electronic access to their health information”. Non-data holders pledge to “engage and empower individuals to be partners in their health through information technology.”

As of 2013, over 450 organizations had taken this pledge, enabling more than one million patients to use the Blue Button to download their health data.

The program has since been transferred to the Office of the National Coordinator for Health Information Technology.

Care.Data
Care.Data Image

Organization: Care.Data

Country: England

Forum: Big data & healthcare

Care.data will be a giant database of medical records which will link information across all health and care services in England. This will enable researchers to develop new treatments and provide a new means of assessing and comparing the performance of NHS services and interventions nationwide. The information will include details of patient demographics, symptoms and investigations, diagnoses and treatments to give a complete picture of an individual’s care experiences across primary and secondary care.

The project was initially intended to be rolled out at the beginning of 2014; however, concerns about patient consent, data security and a perceived lack of public awareness have meant that the implementation date has been pushed back to autumn 2014. This demonstrates the importance of public engagement and education campaigns before embarking on large data-sharing initiatives.

Once the information has been linked, it will be used to improve the quality of care provided, to tailor services to local needs, and to ensure resources are allocated appropriately. This will allow the identification of best practice and highlight areas where improvements are needed which will help to raise standards of care across the country.

CATCH Living Lab
CATCH Living Lab Image

Organization: MIT & Massachusetts General Hospital

Country: USA

Forum: Big data & healthcare

The CATCH (Center for Assessment Technology of Continuous Health) is a partnership between the Massachusetts General Hospital and the Massachusetts Institute of Technology which aims to pioneer new human measurements and integrative analytic methods in order to transform how individuals monitor their own health and how clinicians prevent, diagnose, and treat disease.

They run a number of projects based on the understanding that effective medical care requires a complete appreciation of the patient’s full life, including behavioral and environmental factors, and a continuous monitoring of these factors over time and space. This is in contrast with the episodic and symptomatic nature of many current healthcare systems.

One example of such a project is encouraging patient-centered management of type 2 diabetes. Non-traditional data and behavior modifications have an important impact on type 2 diabetes and the risk of complications. Using a virtual cohort of 65,000 type 2 diabetics, CATCH will develop algorithms and probabilistic risk models for certain complications and display them on a visual dashboard. It is hoped that this will help to inform decision-making at both population and individual patient levels.

Another project focuses on type 1 diabetes. It uses smartphone technology to combine passive behavioral information on activity, mood, stress and social interactions with continuous glucose monitoring and traditional metabolic data. It is hoped that analysis of this data will provide new information on diabetes physiology and care which will improve outcomes for patients.

Bleep Bleeps
Bleep Bleeps Image

Organization: Bleep Bleeps

Country: UK

Forum: Innovation Showcases

Bleep Bleeps are a range of devices and a smartphone app that are designed to help the consumer get pregnant, give birth and take care of their baby. Each device has been designed to be a Bleep Bleeps character that connects to the Bleep Bleeps app on the consumer’s smartphone. The Bleep Bleeps provide the user with simple guidance and information to make parenting easier.

An example of one of the Bleep Bleeps characters is ‘Sammy Screamer’, a motion alarm. ‘Sammy Screamer’ is a movement sensor that connects to the Bleep Bleeps app. By putting the sensor on an object such as a door or a buggy, the consumer is able to monitor the movement of the object due to a notification being sent to the user’s phone when the object moves. The Bleep Bleeps app is designed so that the costumer can also change the sensitivity and sound on the Sammy Screamer.

In addition, Bleep Bleeps has created an ear thermometer called ‘Tony Tempa’. ‘Tony Tempa’ measures the body temperature by taking a reading from inside the user’s ear. It instantly shows the results on a LED display and the device sends the reading to the Bleep Bleeps app for tracking and guidance.

Other devices being produced by Bleep Bleeps include an Ultrasound pregnancy scanner, GPS bracelets and a video baby monitor.

D-rev
D-rev Image

Organization: D-rev

Country: USA

Forum: Innovation Showcases

D-Rev is a non-profit product development company that aims to design and deliver products to people living on less than $4 a day. Their belief is that with access to needed quality products, people can lift themselves out of poverty. D-Rev works with a global network of partners to design disruptive and radically affordable products to improve health and incomes. In the delivery process they leverage for-profit market mechanisms to ensure economic sustainability and scalable impact.

The ReMotion Knee is one of the products that D-rev has developed to improve health and sustainability in the developing world. The ReMotion Knee is a high-performance knee joint for developing world amputees. It is designed with high strength polymers and stainless steel components which provide the user with a high range of motion including 165-degree range enabling kneeling squatting and biking. The ReMotion Knee is an affordable price at under $80.

Research studies have been carried out globally with different iterations of the ReMotion Knee. In total, 6243 patients were fitted with version 1 of the ReMotion Knee and 79% of those involved in the trial are still using it. 95% of the knees fitted did not break and there was an average satisfaction rate of 86% among users. The results on the latest trials are to be confirmed.

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E-Ranger
E-Ranger Image

Organization: E-Ranger

Country: Africa; India

Forum: Innovation Showcases

eRanger provides vehicles which are specially designed for use on the toughest terrain to ensure that its cargo – whether a patient, medical equipment or water – is delivered safely and in one piece. In addition to the eRanger ambulance, the eRanger vehicles enable packages for hospital treatment or other important kits to be delivered to rural areas of Africa, India and the Caribbean.

The eRanger combines the benefits of a motorcycle with the cargo capacity of a sidecar in a package that is cost effective and simple to maintain. The vehicles have been tested in the hardest conditions and have proven to be very reliable in making a positive impact in various parts of the world.

eRanger further provides a maintenance unit that contains different tools and equipment needed to properly maintain and repair the vehicles. eRanger is simple to repair allowing the consumer to maintain the same high standard. eRanger’s products include ambulances, mobile clinics, mobile education units, needle cutters and oasis water purification units.

By providing ambulances as well as vehicles for transport to rural communities, eRanger are able to save lives by contributing to local infrastructure.

Chain Free
Chain Free Image

Organization: Habeb Public Mental Hospital

Country: Somalia

Forum: Mental health

It is estimated that one in three Somalis has been affected by some kind of mental illness and yet mental health care systems in the country remain limited. Care is delivered through a small number of psychiatric facilities where conditions and access to drugs are poor and the practice of keeping mentally ill people in chains is common.

The Chain-Free Initiative aims to improve the quality of life for people with mental disorders and restore their rights and dignity. The programme has been organized into 3 main phases:

Phase one focuses on reforming current hospitals into chain-free, humane facilities where patients can receive treatment and care with minimum restraints.
Phase two provides education and training to the families of people living with mental health problems in order to reduce the use of chains in private residences.
The final phase seeks to remove the “invisible chains” of societal stigma and human rights restrictions.
Between 2007 and 2010, over 1700 people had their chains removed. The majority of these people were receiving treatment at Habeb Hospital but over 400 people in private residences were also unchained. In addition, the WHO delivered training to 55 health workers to equip them with the knowledge and skills needed to provide and organize mental health care in the community, while taking into account the resource constraints in the country.

The Initiative has raised national and international awareness of the lack of mental health care in Somalia. The European Union has since provided funding for the cause and a national mental health policy working group has been set-up to support the integration of mental health services into primary care.

Chronic Disease Self Management Programme
Chronic Disease Self Management Programme Image

Organization: Stanford School of Medicine

Country: USA

Forum: Patient engagement

The Chronic Disease Self-Management Program has been developed by the Patient Education Research Center at Stanford University. It is a 6 week training program, delivered through weekly workshops hosted in community settings such as senior centers, churches, libraries and hospitals. People with different chronic health problems attend together. These workshops are facilitated by two trained leaders, one or both of whom are non-health professionals with chronic diseases themselves. Subjects covered include:

techniques to deal with problems such as frustration, fatigue, pain and isolation
appropriate exercise for maintaining and improving strength, flexibility, and endurance
appropriate use of medications
communicating effectively with family, friends, and health professionals
nutrition
decision making
evaluating new treatments.
Each participant in the workshop receives a companion book and an audio relaxation CD. Classes are highly participative, making the most of mutual support and success to build the participants’ confidence in their ability to manage their health and maintain active and fulfilling lives.

A randomized controlled trial of 1000 people demonstrated that over a three year period, those who participated in the program experienced significant improvements in exercise, cognitive symptom management, communication with physicians, self-reported general health, health distress, fatigue, disability, and social/role activities limitations. They also spent fewer days in hospital and had fewer outpatient appointments and hospitalizations. These data yield a cost to savings ratio of approximately 1:4.

Clubhouse International
Clubhouse International Image

Organization: International Centre for Clubhouse Development

Country: Global

Forum: Mental health

A Clubhouse is a local community center that offers people living with mental illnesses hope and opportunities to achieve their full potential. It is based on the belief that work and normalized social and recreational opportunities are instrumental to an individual’s wellbeing and recovery. Clubhouse members are not seen as patients but as valued participants, colleagues and contributors.

The basic components of successful Clubhouses are:

  • A work-ordered day which parallels the typical business hours of the local community
  • Employment programs which provide opportunities to return to paid employment
  • Evening, weekend and holiday activities
  • Community support when accessing social and medical services and finding housing
  • Ongoing communication to remind members that they are missed, welcome and valued
  • Education opportunities, including certificate and degree programs at academic institutions and adult education providers. Making use of members’ talents and skills to provide educational opportunities to others, particularly in literacy
  • Joint decision-making and governance between members and staff as colleagues

The Clubhouse model is replicable in any location because it relies on the concepts of community and local cultural norms; there are currently 330 Clubhouses across 33 countries over 6 continents.

Each year, Clubhouses are accessed by about 100,000 people with mental health problems, of whom about 60,000 are active members and regular users. Clubhouses have been shown to deliver the following benefits:

  • significant decrease in the number of hospitalizations
  • significant increase in working days and average earnings
  • about half the annual costs of Community Mental Health Centers
  • in China, Clubhouse participants showed significant improvements in their symptoms, self-esteem, employability and quality of life after attending the clubhouse for six months
Coordinate my Care
Coordinate my Care Image

Organization: UK Government

Country: UK

Forum: End-of-life

Research has shown that Londoners have a strong preference to die at home (57%) rather than at hospital. However, 66% of people die in hospital as supposed to the 20% of London who die in their own homes. The UK Government developed an End-of-Life care Strategy whose aim was to reduce hospital deaths and allow people to die at their place of preference. Part of the strategy included the setting up of Electronic Palliative Care Coordination Systems (EPaCCs), one of which was Coordinate my Care (CMC).

The Coordinate my Care is a clinical service which shares information between patients and their healthcare providers, coordinates their care and records the wishes of how the patient would like to be cared for. It went live across London in early 2013 following a two-year pilot study. By the end of 2013, there were 8030 CMC records, and 2548 of these patients had died. Of the patients who had died with a Coordinate my Care plan in place, 79% died in their place of preference and 81% of patients died outside of the hospital setting. In 2014, access to Coordinate my Care was made even easier through the introduction of a mobile app which patients can use to update their wishes.

D4D
D4D Image

Organization: Data for Development

Country: Global

Forum: Big data & healthcare

Launched in June 2012, Data for Development is a challenge organized by Orange based on using anonymized data extracted from the mobile phone network to contribute to the development and welfare of populations. The data was used to reveal information on the mobility and call patterns of the citizens of Ivory Coast, a country struggling with poverty and in the aftermath of a recent civil war.

Several D4D projects utilized this mobile phone data to tackle key health issues. For instance, analysis of human mobility patterns was used to map how disease spreads across the country, revealing that small changes in the health system could potentially reduce the spread of flu by 20% as well as substantially reduce the spread of HIV/AIDS and malaria. The data was also used to map ethnic boundaries, based on the fact that ethnic and language groups communicate far more within their own group than they communicate with others. Mapping social boundaries is important because, while we know that ethnic violence often erupts along such boundaries, the government and aid agencies are usually uncertain about the geography of these social fault lines.

In April 2014 a new year-long project was launched based on information on the hours of sunshine as well as mobile phone data in Senegal. The project will close in April 2015 when the D4D Committee will choose the best projects.

Electronic Health Records
Electronic Health Records Image

Organization: Qatar Supreme Council for Health

Country: Qatar

Forum: Big data & healthcare

In January 2012, Hamad Medical Corporation (HMC) and Cerner signed a landmark agreement to digitize the entire public health system of Qatar, including all HMC hospitals and Primary Health Care centers (PHCs). All major hospitals in Qatar have adopted the same Electronic Health Record (EHR) solution, which enables easy consolidation and sharing of health data for a large part of the population.

EHRs will enable Qatari health professionals to elevate the safety, quality and efficiency of their services by granting them immediate access to up-to-date, comprehensive patient information, including past attendances, medical history and test results. This will support the creation of a personal health record for every Qatari citizen which will allow patients to connect with their care team to book appointments and ask questions. It will allow the development of personalized health risk profiles and care plans which will support patients to better manage their own health.

On a larger scale, the rich data collected through the system will provide evidence-based best practices and improve the clinical care processes. The information obtained will provide the foundation for medical research initiatives related to population health management, including non-communicable diseases and other chronic health conditions, and will assist the government in planning for further improvements to health healthcare provision in Qatar.

My Medication Passport
My Medication Passport Image

Organization: NIHR

Country: UK

Forum: Patient engagement

My Medication Passport is a written record of a patient’s medicines. It is designed to improve communication between patients, carers and healthcare professionals and maintain a record of changes made to the patient’s medication. Features of the My Medication Passport include:

  • Relevant information about the patient
  • Relevant information about the patient’s GP/ other healthcare professional
  • List of medicines the patient cannot take and the reasons why
  • Compliance aids in use
  • List of the patient’s current medicines
  • Changes made to current medicines and why
  • Blank pages for the patient to record additional medical information such as vaccinations, screenings etc.

The passport aims to help patients/carers have a complete record of their medicines as well as an understanding of the reasons for any changes being made to their medicines. It’s designed to empower patients/carers to take control of their medication and help seamless transfer of medication information across healthcare interfaces. It is available as an easy to carry booklet or as a free app for iPhone and Android smartphones and tablets.

The idea behind the passport was generated by patients in Northwest London in September 2010. 7000 booklets were distributed as a pilot in 2012 and in April 2013, the tool was launched to the northwest London community. In the first 48 hours following its launch, 1400 copies of the passport were ordered. It has since been used throughout the UK and the app has been downloaded by over 2000 individuals from more than 37 countries.

2015
4D Health
4D Health Image

Organization: 4D Health

Country: Spain

Forum: Innovation Showcases

The 4DHealth Innovation Simulation Center is a pioneering simulated hospital located in Barcelona, Spain. 4DHealth uses state-of-the-art simulation to recreate the whole health environment in which a variety of real scenarios can be played out by participants. Training via simulation allows the participants to acquire technical and non-technical competencies without exposing training professionals to patients. This results in a reduction in errors and increased patient safety.

Healthcare professionals and students of different specialties can train within 4D health and design new plans, processes and applications, which can be applied in a number of healthcare scenarios. The center also interacts with health companies and suppliers.

Studies have concluded that simulation and team training for complex situations can have a positive impact on healthcare provision, and initial studies have shown that 4DHealth is producing positive qualitative and quantitative results.

Arbutus Medical
Arbutus Medical Image

Organization: Arbutus Medical

Country: Canada

Forum: Innovation Showcases

Arbutus Medical has developed a $400 alternative to $30,000 surgical drills, allowing safe and effective treatment of patients in resource-constrained settings, as well as in disaster relief. 25 million people are injured in traffic accidents each year, with 90% of that burden in the developing world. Treating these patients with bone injury requires expensive surgical drills; when these are unavailable, surgeons will resort to non-sterile drills from the hardware store, or manual drills that are inaccurate and hard to use.

The Drill Cover is a sterilizable, reusable, medical-grade cover that envelops a ‘dirty’ hardware drill, transforming a low-cost tool into a $30,000 surgical device. It has been in use in Uganda for 18 months, treating over 2,000 patients, and recently launched across Syria.

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