Vilnius 22.10.2002 Infobalt
Telemedicina Workshop
More time to patients, less to bureaucracy
Harry Piela
Sybase Solutions UAB
Copyright © Sybase Baltic 2002, All rights reserved

Sybase is the enterprise infrastructure company that bridges heterogeneous technologies. With industry-leading Enterprise
Portal (EP), mobile and wireless solutions, essential integration products, and high performance database management systems,
Sybase is one of the largest independent software companies in the world. Sybase Baltic is strongly focused on mobile solutions development.
www.sybase.com
Copyright © Sybase Baltic 2002, All rights reserved

The number of patients needing home health care is increasing (age structure) all around Europe.
– People are kept in expensive hospitals beds because of the lack of personnel (resources) for home care.
Ask from eldery, where they want to be, in home or in hospital ?
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Europe has the world’s oldest population structure. The proportion of elderly people in Europe of around 20% is predicted to increase to 25% by 2020
To meet the challenges of an ageing population, which includes realising the positive opportunities of a longer and healthier life,requires all sorts of decisions to be taken individually and collectively, by ordinary people and by professionals.
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For the Member States, overall levels of public expenditure would range between 7.5% of GDP (for Italy) to 12.1% of GDP in 2050
(in Sweden). This compares with a range of expenditures in 2000 ranging from 5.5% (again in Italy) to 8.8% of GDP (again in
Sweden) in 2000.
On average, the increases would lead to levels of public expenditure on health and long-term care in 2050 around 30 to 40 per cent greater than in 2000 !
(EPC/ECFIN/655/01-EN final Budgetary challenges)
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• Daily schedule is reviewed
• Patient information is collected at the office
– Address, treatment history, recent tests, medication, treatment goals
• Patient is visited
– notes are written on paper forms or on loose papers
• Patient information folders are returned to the office
• Notes are recorded on a terminal
• Statistics and other clerical work is performed
• Non-nursing job takes half the day time !
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• Patient care is main task
• No more paper work, than it is mandatory
• Secrets are secrets
• When needing information, I can get it easily and it is up to dated
• My team knows what treatment and care I have given to our mutual patients
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New way to work !
• Nursing situation
– entering notes during conversation
– less errors and mistakes
– treatment amend due new information availability
– making patient to participate for treatment
– automatic erasing of personel data after home visit – personel security
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Thalia means less administration, better care quality and improved efficiency.
All patient information is constantly available and up to date.
The same staff can help more patients.
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Care providers don´t have to look up patient records before making a house call- data is automatically transferred to Thalia for the patients who are scheduled.
Nurses and home helpers can spend their valuable time providing care instead of handling administration.
They can spend more time with patients, even when they are entering data in Thalia.
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With Thalia, no folders or loose papers are left in cars or patients´ homes.
Relevant information is transferred directly to the care provider before each house call.
Only information on patients who are entered in the day´s schedule is accessible.
After the visit, data is erased from the handheld computer once it is synchronized with the back-end systems – which can be done by cell phone.
Copyright © Sybase Baltic 2002, All rights reserved

When employers invest in better equipment, they say to employees, ”We value you”.
Care personnel appreciate having the latest and best support.
Their motivation only grows when they see how easy is system is to learn and how useful it is on the job.
Copyright © Sybase Baltic 2002, All rights reserved

• Patient information does not need to be collected prior the calls as it is automatically transferred to mobile workstations based on nurses’ schedule.
• Less administrative work
– Time previously used at the offices for the information collection is used with patients.
• Better care quality
– more time can be spent with each patient
• Improved economics
– more patients can be served with the existing resources
– less hiring, savings in hospital bed costs
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• All the required patient information is up-to-date and always available
• Improved care quality
– potential for the care errors decreases
– treatment matches better with patients current state
• Discussion with the patient while entering data
– improved quality on the entered information
– improved quality on the next visit
– patient’s positive involvement and feed back
• Less incorrect and missing data
– Health care system will contain higher quality detailed data
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• Employers willingness to invest on modern tools and provide better working environment signals employee appreciation.
• Improved workers’ motivation
– improved productivity, care quality
– less stress and days off
• Personnel can spend their time on field instead of administrative work
– feeling of being able to do important things
• Hiring and retention
– Attracts new employees
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• Ease of use
• Implementation is not dependent on the health care application’s logic
• Displays and dialog are adaptive to smaller devices and their usability features
– very short learning cycle and rapid adaptation
– automatic routines replace manual processing and leaves more time for care work
– all information is just a button away for iterations
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• Improved information security
• No loose binders and papers lying around in car and in patients home
• Patient information is transferred to workstation prior the call
• Only patients defined in a nurse’s schedule are available
• After visit, information is deleted from the workstation
Copyright © Sybase Baltic 2002, All rights reserved

Copyright © Sybase Baltic 2002, All rights reserved

Copyright © Sybase Baltic 2002, All rights reserved

Copyright © Sybase Baltic 2002, All rights reserved

Copyright © Sybase Baltic 2002, All rights reserved

Copyright © Sybase Baltic 2002, All rights reserved

Copyright © Sybase Baltic 2002, All rights reserved

workstations
Back End System
Back End System
Food services
Sybase
PowerDesigner database designer
Replication Server
Replication Agent
Sybase REP
Sybase Adaptive Server
Enterprise (ASE) -database
Sybase ASE
Data is syncronized between a mobile server and back-end systems
Gsm/Gprs
Thalia functions
•Daily scheduler
•Weekly scheduler
•Patient data
•Healthcare and house call casebooks
•Care and service planning
•Medication data
•Lab data
•Statistics
•E-mail (can only be sent between backend system and Thalia)
•Food services/orders
Sybase MobiLink software / servers
Sybase PowerJ RAD development tool
Sybase UltraLite database
Copyright © Sybase Baltic 2002, All rights reserved

The City of Helsinki implemented Thalia in a care district with 1 500 home nurses and home help providers who make 1,8 million house call annually.
Training took a half-day per user.
Helsinki has already verified a 30-35 percent improvement of productivity.
Previously, nurses spent up to 50 percent of their time at the office collecting and entering patient information in backend systems.
With Thalia, the application they use is stored on a handheld computer and the nurses and home help staff use their cellular telephones to get and send data.
Copyright © Sybase Baltic 2002, All rights reserved

The development of technology is rapid and the number of mobile terminals’ features increases continuously. Features such as internet connections enable the Health and Social
Departments to offer some new web-based services in the future such as meal and laundry service orders over the mobile web. But technology will never replace the human touch and the helping hand that are needed in the future more than ever
Copyright © Sybase Baltic 2002, All rights reserved

Take contact
:
Sybase Solutions UAB
Vytenio g-9/25 2009 Vilnius tel +370 2 683 327 fax +370 2 683 346 lietuva@sybase.com
Copyright © Sybase Baltic 2002, All rights reserved