The value in virtual healthcare.
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1 The value in virtual healthcare. J Helen Cross UCL-Institute of Child Health, Great Ormond Street Hospital for Children, UK & Young Epilepsy, Lingfield, UK.
2 What is virtual health? Health advice delivered remotely, with or without direct patient contact Virtual health team: professionals who collaborate and share information on patients with digital equipment. ehealth: the use of modern information and communication technologies to meet needs of citizens, patients, healthcare professionals, healthcare providers, as well as policy makers European Commission
3 The Epilepsies A group of conditions characterised by tendency to recurrent epileptic seizures An epileptic seizure, a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain, remains a symptom Treatments generic Antiepileptic drugs Dietary treatment Stimulation Changing concepts: a group of rare diseases for which targeted treatment a reality Epilepsy surgery curative in carefully selected individuals
4 Childrens Epilepsy Surgery Service est 2012
5 Presurgical evaluation Localisation of responsible tissue Clinical evaluation Interictal EEG Video EEG ictal recording Optimised structural MRI Functional imaging Localisation of function Clinical evaluation Neuropsychology Functional MRI Evaluation of outcome aims Neuropsychiatric evaluation
6 Under 6 MDT: video conferencing Centre 1 Centre 2 Centre 3 Centre 4
7 Value Discuss 4-6 patients /month Discussion of full case including all investigations for presurgical evaluation Plan made for course of treatment Discussion and delivery of care by local team
8 A pilot European Reference Network The primary expected outcome of E-PILEPSY is to increase the number and proportion of European children and adult patients cured from their refractory epilepsy by improving delivery of optimal epilepsy surgery throughout Europe
9 Specific Objectives Exchange best practice and promote harmonization of care in the management of refractory epilepsy and epilepsy surgery Improve skills of EU professionals involved in the management of refractory epilepsy and epilepsy surgery Increase patient safety, accuracy of patient selection for epilepsy surgery, and favorable surgical outcome Increase access to epilepsy surgery programs
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11 Deliverables Systematic reviews, guidelines and recommendations E-PILEPSY website E-Database E-Care platform (web-based epilepsy conference) E-Neuropsych E-Processing E-Eligibility Model of sustained development Exchange program Final conference
12 Planning of web based applications E-PILEPSY Portal Public web site IT platform ecrf E-eligibility E-care, E-processing, E-neuropsy E-database Launch Technical specifications consolidated Dissemination plan Launch Translation
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16 Presurgical evaluation Localisation of responsible tissue Clinical evaluation Interictal EEG Video EEG ictal recording Optimised structural MRI Functional imaging Localisation of function Clinical evaluation Neuropsychology Functional MRI Evaluation of outcome aims Neuropsychiatric evaluation
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20 Advantages Expert multidisciplinary discussion Collaborative advice Local team acknowledge decision Use to move forward locally or external referral Continued local service delivery where possible Increased accessibility of specialist opinion Transborder care without movement of patient Education and training for those not directly involved in patient care
21 Disadvantages? Lack of direct patient contact by specialist team Reimbursement?real disadvantages
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