Meet our inspiring Runners-up of the VBHC Prize 2020
These initiatives will be shared with you here in rotation.
We aim to offer to complex patients an approach that includes continuous monitoring and an open channel of communication to offer a better patient experience, improve outcomes and reduce costs by preventing or detecting complications. The relevance of the initiative lies in the uniqueness of the proposed model is the use of wearable technology mixed with a patient-dedicated nurse having a 24/7 open channel for communication with our team. We are aware that cancer patients need the best care and so we care and strive to deliver attention that makes them feel comfortable, warm and safe from the first consultation until the final outcome.
Some decades ago, patients with tumors of the appendix, ovary, colon, stomach and mesothelioma with involvement of the peritoneum were considered to have no therapeutic option with curative intention.
Cytoreductive surgery (CCR) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) appeared in the 1980’s in the United States as a procedure with curative intent that has been shown to be safe. Thus, our program was born in 2007 as a pioneering center in Colombia that, to date, has more than 10 years of experience in the comprehensive treatment of patients with this condition. Continuous improvement, search for knowledge and the relentless work to give patients the most qualified care accompanied by a highly specialized team, advanced surgical techniques and state of the art technology have led us to attain the certification as a Center of Excellence for the treatment of patients with peritoneal neoplasms in October 2015 by the Joint Commission International and the recertification in 2018 for the continuous compliance of the highest quality standards.
People from Colombia and other Latin-American countries, with peritoneal carcinomatosis are seen in our IPU. They are involved since the first moment being engaged in a culture of self-care and active participation in the process of decision-making. Our scope includes not only patients after CRS + HIPEC but all patients whose comorbidities, baseline health status and surgical procedure performed require continuous surveillance.
During the hospital stay, our team carefully follows the process in order to prevent adverse events and real time information about the patient’s status and medical decisions is constantly being provided to the main team. We have learned to identify the significant variables (quantitative and qualitative) that warn of a possible complication, hoping to move from early detection to complete avoidance with a protocol that clearly establishes what to do if one of these changes is detected. We have noticed a decrease in hospital stay length of about 8 to 10 days, which means an average reduction of approximately 11.097 USD in the last 15 patients. Also, although avoidance of pulmonary embolism has not been registered yet, we have made our calculations and it would translate into savings of approximately 2.248,35 USD per case.
EFID has demonstrated that many methods and approaches can be used to value the expertise of people living with the condition – peer groups, advocacy, research projects, etc – however, still a lot needs to be done across Europe where countries have different levels of awareness on dementia.
EFID and its 30 partners that are part of the CSOs fabric, work across Europe ‘valuing the expertise of people living with dementia’ in order to: listen to people with dementia and empowering them as individuals living with the condition; respect their dignity, autonomy and the right of self-determination at all stages of dementia; support people living with moderate and/or severe dementia to express their own interests and wishes regarding treatment and care; and encourage the emergence of a stronger voice and participation of people with dementia at all levels (eg. within their personal life, in a city or neighbourhood, in a hospital, in the community, in a nursing/care home).
In parallel EFID and its partners contribute to strengthening the dementia friendly community (DFCs) approach in Europe. Sustainable environments that put at the centre the voice and the expertise of people with dementia reduce stigma on the condition and improve the wellbeing of both people with dementia and their families and carers. Moreover, meaningful participation of people living with dementia in the choice of their care pathway improves the healthcare experience and outcomes. EFID aims to enlarge the knowledge of the field by deepening existing resources and establishing proofs of concept.
EFID has mapped dementia-friendly initiatives across Europe and analysed the commonalities, essential factors, differences, strengths and challenges of these initiatives. Furthermore, EFID created a quality framework that sets the criteria for a shared language and indicators for good practices on DFCs and on valuing the expertise of people with dementia. The framework has been co-designed with the EFID partners to reflect the diversity of the fields of action in DFCs.
Today breast cancer is the most frequently diagnosed cancer in women and it is also the most common cause of cancer death in women. The risk of breast cancer diagnosis varies widely by world region. Breast cancer care in any country is a costly and complex disease, where effective treatment depends on the quality of early detection, diagnosis and treatment . An important variation in treatment modalities and quality management is observed worldwide.The economic burden of breast cancer to health systems is growing and even becoming unsustainable in a lot of countries. Initiatives to tackle this world-wide problem are urgently needed and a value-based approach is becoming very important. Our initiative is the result of a project addressing a global approach to the quality of breast cancer care which began ten years ago in Paris. Since 2010, meetings have been organized in Paris, Antwerp, and Aachen as well as during several international breast conferences devoted to quality management, organization of breast cancer care, breast centre quality, guidelines, and the influence of local economics and resources in breast care. In 2012, during the 2nd International Congress of Breast Disease Centres, our group of experts joined others to draft the Paris statement which was later approved by the Chairs of EUSOMA (European Society of Breast Cancer Specialists), NAPBC (National Accreditation Program for Breast Centers), and SIS (Senologic International Society) and endorsed by the President of UICC (Union for International Cancer Control). We were unified in support of the Paris Statement that said ‘All women across the world should have access to fully equipped, quality assured, dedicated breast centers/units, that provide competent and comprehensive care.’ We joined forces with the Chairs of these organizations and added a large network of highly motivated experts to make this statement a reality.
During the last three years, a faculty of 115 experts from five continents and 25 different countries communicated during expert meetings, mailings, Skype conferences and telephone conversations to form a collaborative vision on defining quality breast cancer care. We have collected the insights and perspectives of leading experts including physicians, epidemiologists, economists, pharmacists, psychologists, nurses, patient advocates, journalists, and academics. Our project focuses on the melding of high-quality value-based breast care influenced by local economics and personnel resources affecting breast centres in all countries. This project is not the endpoint, rather it serves as the foundation for further innovations on organization and integration of breast cancer care for all women.
We believe this initiative has value for everyone working in the field of integrated breast cancer care. Whereas established breast care experts will find value in the topic-oriented chapters of this book, non-experts, such as those new to the field or caregivers focusing on other types of diseases/cancers which demand a multidisciplinary approach, will be interested in the general overview provided by the book as a whole. Individuals involved in forming breast centres will find valuable and practical information to include into the foundations of their new centres. Policymakers will have special interest in the social, financial, and political integration in the total scope of breast cancer care as the book leads the reader through the labyrinth of organizations and modalities. Whereas the Breast Health Global Initiative focuses on low- and lower-middle income countries, this project is applicable to all regions.
Beyond discussions on how to integrate the different breast care disciplines into a coordinated breast unit, the book provides practical considerations regarding accreditation and certification as well as discussions about the influence of budget on value of treatment. Finally, it demonstrates how best practices may be altered by emerging technologies and transitions of future societal values.
After a thorough review process ( 2 rounds – 9 worldwide reviewers ) the project was accepted for publication. The E-book is available on the Oxford University Press digital platform hosting OUP’ prestigious medical titles. https://oxfordmedicine.com/.
Based on the National Cancer Registry in Saudi Arabia, and published research cancer cases are being diagnosed and referred to tertiary care cancer centers at late and advanced stage. Primary care and screening programs are deficient in Saudi Arabia. On the other hand advanced tertiary care services such as BMT, Organ transplants are available in the country. Part of the Value Based initiatives within King Faisal Hospital and Research Center (KFSHRC), the department of Family Medicine and Polyclinic established a value based Cancer Screening Initiative to be implemented within the catchment population of our family medicine clinics (50,000) to lead the country and the region in the field. KFSHRC is a JCI, MAGNET and HIMSS 7 accredited hospital.
A multidisciplinary team consisting of family physicians, specialists, nurses, IT, and patient representatives were involved in the development of evidence-based cancer screening pathways. The team involved expert from different countries, including UK, USA, Canada, and Saudi Arabia. Clinical pathways were established for the screening of breast, colorectal and cervical cancers. These pathways were converted into an innovative decision support tool (called the Health Maintenance Decision Support Tool) within the Electronic Medical Record (EMR). Clinically integrated care was delivered through coordinated interdisciplinary teams of family physicians, radiologists, gastroenterologists, and oncologists, aligned within interdisciplinary teams to improve process of care outcomes and to achieve important patient’s oriented outcomes, over the full cycle of care. The program was established on June 2015.
We evaluated different outcomes 3 years before and after the implementation of the initiative (June 2015). Significant increases were found in the uptake of all the cancer screening tests within the targeted population. Faecal Occult Blood Test (FOBT) uptake increased from 1572 to 5021 annually. Mammogram uptake increased from 1334 to 2180 annually. PAP smear uptake increased from 938 to 1225 annually. Clinical diagnoses of early cases of cancer increased significantly for breast cancer (2 cases before vs 14 cases after) colorectal cancer (3 cases before vs 11 cases after) cervical cancer (1 case before vs 3 cases after). Screening pathways were mapped to be able to do a cost analysis of the initiative. Preliminary cost analysis showed an estimated annual direct cost saving of at least 66,000,000$, annually.
We were able to establish a value based cancer screening initiative based on the principles of VBHC. Results were impressive, which prompted the team to work with other local and regional stakeholders to expand the initiative across the country and the region. We look forward with the help of our multidisciplinary, international team to help implementing VBHC cancer screening initiatives within Saudi Arabia, the region and the world.
We have developed an animated video as a pitch:
The Script of the animated video:
“Collagen is a complex protein that is present in many parts of the human body. It is like a glue that holds the body together. Collagen type I is present in muscles, bones, skin, bloodvessels, tendons, ligaments and other tissues. When collagen is produced incorrectly the person has OI. The severity of OI can vary from mild to severe.
There is currently no gold standard in treating OI. It is treated differently everywhere. Often doctors have not even heard of OI. Others only have a few patients and very few hospitals worldwide support more than 100 people with OI and treat them over a longer period of time.
Most hospitals are focusing on addressing fractures and improving bone mineral density. But good quality of life for OI is dependent on a much broader spectrum of topics including also functional limitations, problems of the spine, pain, fatigue or psychosocial issues. Also attention is required for positive outcomes that people with OI are aiming for: like living independently and participating in society.
We have reviewed the current clinical practice and research and found that health care providers often track a lot of information about their OI patients. We found more than 600 different measures reported in literature! Because everyone is measuring something else and because OI is rare and very complex, it is challenging to use this information for improving healthcare and research.
This is where project Key4OI will make a difference. The goal of the project is to improve the quality of life 4 people with OI. Measurably.
More than 150 people – healthcare providers and people with OI – have worked together in project Key4OI to develop a core outcome set for OI, – a set of measures that covers the most important health areas that are relevant for most people with OI. The “lowest common denominator”.
Throughout a life time. Worldwide.
The project started in 2018 with a project team in the Netherlands. The team consisted of healthcare providers for adults and children and foundation Care4BrittleBones.
Together they built a multidisciplinary network of some of the best experts worldwide including experts with OI.
They reviewed where health in the widest sense is affected by OI. Using the internationally well respected ICF – Framework, several modified Delphi-surveys and support from the NGO ICHOM they reduced the initial very long list to a short list of 24 topics related to health in OI.
These themes were then discussed in the OI community according to a consistent protocol, so called “focus groups”. After conducting 16 focus groups worldwide involving adolescents and adults with OI – we have learned that their views are surprisingly aligned on what matters to them!
Based on the input of the focus groups the expert team developed the Key4OI Core Outcome set.
Using state of the art, validated ways of measuring
It covers children and adults with OI
It can be used for healthcare and for research
The topics covered are Patient reported outcome measures so called PROMS and clinically reported outcome measures so called CROMS .
Whilst the core outcomes set will be useful in routine clinical practice to improve the outcomes for individual people with OI like Rebecca, the aspiration longer term goes further.
With a standard set of outcomes widely used around the world, comparable data will become available. This will help identify best practices and boost improvements in healthcare and research. By using the standard set of outcome measures, we will be able to work together more easily around the world and learn quicker what treatments work for people with OI.
This work has started in 14 different countries. But this is just the first step. Everyone is invited and everyone is needed! The more institutions and people use it, the more we will learn about OI and the bigger will be the difference we can make.”
By providing and early and comprehensive introduction to addictive behaviors, and their longer term chronic and proinflammatory consequences to mid and late life health and disease, public health policy can address the cost of treating the effects of these conditions in mid and late life, which could potentially bankrupt private and government health care budgets. By implementing “an ounce of prevention is worth a pound of cure”, diseases can be prevented, functional longevity increased, and with an educated public, less dependence on the burgeoning medical industrial complex and more personal initiative in addressing personal health.
Rising Healthcare costs and new formal quality requirements are leading to the centralization of laboratories, pharmacies and blood banks. This results in an increased demand for time critical medical transport of biological samples and pharmaceuticals. Already now, medical transport demand faces congested ground transportation solutions, preventing sufficiently predictable and timely delivery. Medical professionals are increasingly alarmed as healthcare quality and lives themselves are at stake. The Helicus concept itself is triggered by those medical healthcare professionals that request an alternative solution to their urgent transport needs.
Fortunately, the UAS (Unmanned Aerial Systems) technology is maturing. There is also an increased public acceptance supported by progressive European timelines for new drone related legislation. By deploying drones, Helicus wants to provide a new agile, automated and integrated logistic solution for the healthcare sector. The most important short-term use cases for medical transport by drone concern human tissue, clinical test samples, blood products and pharmacy products. Further use cases include transport of organs and transport of AED.
Developing a drone based medical transport is a complex undertaking that requires a collaborative and multidisciplinary approach that is anchored within a well-defined overarching partnership program: “Helicus Aero Initiative” (HAI). HAI forms an ecosystem of leading organizations that join forces to make medical transport by drone a reality. These partners collaborate on joint projects, not only aimed at ensuring the required aviation solutions needed for medical transport but also aiming for a complete automated and integrated solution.
HAI partners contain industrial enterprises from different sectors as well as 27 hospitals from 4 different large hospital networks. This ensures not only that state-of-the-art solutions are developed, but also a direct check for medical relevance by our medical partners.
The HAI eco-system also collaborates in different projects:
- [2018-2019] SAFIR (HAI phase 1): Commissioned by the EU to create a set of traffic rules for drones, including a demonstration to organize medical transport together with other air-based vehicles.
- [2018-2019] Medrona (HAI phase 2): Commissioned by the Belgian federal government (Ministeries of Transport and Communication) to create a future oriented interface with the air traffic management authorities for flight authorisation related handshakes.
- [2018-2019] Test flights in Droneport focused on continuous platform improvement
- [25/09/19] Helicus medical conference with the highest health care authorities, industry and medical professionals (300 participants from 8 countries)
- [03/10/19] First urban inter hospital flight based on Unmanned Traffic Management in non-segregated airspace, using an IT-interface.
- [2019-2021] HAI-SCS: Commissioned by the Brussels and Flemish regions for upscaling the developments made in Medrona and SAFIR. End goal is to operate multiple drones in parallel.
- More HAI projects have been submitted aimed at integrating medical and aviation flows.