General

The objective of the joint participation of the Finnish consortium is to provide new technical solutions and work processes supporting care and prevention of chronic diseases. Concerning clinical care, the piloting units are Sipoo Health Centre and the Cardiology Clinic of the Hospital District of Helsinki and Uusimaa (HUS). In both units, the patients will be given technology for reporting their health parameters for the health professionals. Another pilot is hosted by Nokia, targeting at new mobile solutions and business models for corporate wellness domain.

The common objective of the pilots is to assess the benefits of new models for healthcare and health maintenance. In each case, decision support systems have a central role. Traditionally Clinical Decision Support Systems (CDSS) have been used exclusively for providing support for health professionals in their work. In Care4Me we have extended decision support also to patients and healthy citizens. The new decision support approach includes automatic analysis of data reported by the users and automatically generated user messages, for motivating and guiding the users to achieve their health goals. 

Clinical trials

In Sipoo, the target group is composed of diabetes and hypertension patients. The patients are equipped by technology for carrying measurements at home for blood pressure, blood sugar and daily activity. A mobile phone application is provided for easy reporting of the data to the care personnel at the health centre.

The advantage of the decision support system for the care personnel is that they are alerted about any problems observed in the reported data. This enables the personnel to concentrate on the patients which are in most need for support.

In HUS Cardiology Clinic, the target group is composed of heart failure patients. In this case the patients are measuring their blood pressure and weight at home and reporting these to the care personnel at the clinic. Additionally, the patients are reporting their self-assessment of symptoms such as dizziness, weakness, dyspnea and arrhythmia. 

Both pilots – Sipoo and HUS – are clinical trials, where the effects of the new self-care model will be assessed. There are currently 27 patients participating the self-care programme in Sipoo and altogether 46 patients have been enrolled for the self-care programme in the HUS trial. In both trials a control group of similar size continuing the traditional care have been enrolled for the study.

Corporate wellness trial

The corporate wellness pilot carried out by Nokia is targeted to a randomized group of employees, which use a mobile application for personal health and life style reporting and receive motivating messages and reminders generated by the decision support service. There are currently about 600 employees participating the trial. Additionally an open trial with Wellness Diary application is ongoing with more than 10 000 participants (Nokia phone users who have installed the application).

Technology 

In the Sipoo, pilot the patients are given a personal web folder – a so called Personal Health Record (PHR)– to access their personal health information. This Medinet service, provided by Mediconsult contains measurement data uploaded by the patient as well as clinical information e.g. medication list and laboratory results. The availability of clinical information is facilitated by the integration of Medinet with the Mediatri patient record system. For regular uploading of measurement data, the patients use the Monica mobile application provided by VTT . The Medinet system is connected to Duodecim’s Electronic Health Check service , which provides guidance for deciding about the care plan. 

In HUS, the patients are using the Monica application without a PHR.  Additionally a web service is available for the health professionals to follow-up the monitoring data and to make adjustments to the personal targets.

In the Nokia trials the Wellness Diary application is used. The mobile application also contains a server part where data collected by the phone application is periodically synchronised. Nokia provides an open web interface for partner companies to access the data at the Wellness Diary server subject to the consent by the users. This enables innovative applications integrated to the Wellness Diary to be provided. Duodecim is using this model to provide personal decision support services to Wellness Diary users.         

Besides the project pilots listed above, Prowellness is taking Nokia’s Wellness Diary and Duodecim’s Electronic Health Check to operational use as part of Oulun Omahoito, the health portal of Oulu.