1. AMEDS - PMHS Innovation for Cure and Care

2. AMEDS - PMHS SystiMed is anenterprisefordesigning and developinginnovationsforhealthcare These presentations are abouttwo brand newinnovationsdesignedby SystiMed In thisfirst part a verylargeproblem in todayshealthcare is outlined In the second part the innovations AMEDS and PMHS willbepresented

3. AMEDS - PMHS AMEDS - PMHS Part one

4. AMEDS - PMHS Do you want to know more aboutone of the biggestchallenges we face in healthcaretoday?

5. AMEDS – PMHS Do you want to know more aboutone of the biggestchallenges we face in healthcaretoday? Ifso, thenplease, readon and learnabout a mechanismwhichcan have a dominatingnegativeinfluenceonhealthcareformanyyears to come.

6. AMEDS - PMHS Medicationadherence has been a very big problem in healthcarefor a long time

7. AMEDS - PMHS Medicationadherence has been a very big problem in healthcarefor a long time and still is…

8. AMEDS - PMHS Medicationadherence has been a very big problem in healthcarefor a long time and still is… Severaltechnicalsollutions have been introduced to help patientstaketheirmedication, like the Baxter system, the Simpill, the Medido (Innospense) and recently the PicoBello (Kysos).

9. AMEDS - PMHS Althoughcurrenttechnicalsollutionsformedicationadherencecanbeverysuccesfullforsomepatients…..

10. AMEDS - PMHS Althoughcurrenttechnicalsollutionsformedicationadherencecanbeverysuccesfullforsomepatients….. there are still a lot of patientswho in spite of the usage of these technicalsollution are stillnotable to taketheirmedicationadequately

11. AMEDS - PMHS Unfortunately….

12. AMEDS - PMHS Unfortunately these are the most vulnerable, fragile, elderlypatients.

13. AMEDS - PMHS Unfortunately these are the most vulnerable, fragile, elderlypatients. These elderlypatients have severalseriousillnesses (multimorbidity)

14. AMEDS - PMHS Unfortunately these are the most vulnerable, fragile, elderlypatients. These elderlypatients have severalseriousillnesses (multimorbidity) and need to take a largenumber of different sorts of medicines eachday (polypharmacy)

15. AMEDS - PMHS The largenumber of illnesses these elderlypatients have result in cognitive and physicalshortcomings

16. AMEDS - PMHS The largenumber of illnesses these elderlypatients have result in cognitive and physicalshortcomings These shortcomingscanalsojustbeagerelated

17. AMEDS - PMHS These cognitive and physicalshortcomingsinterferewith the dailyfunctioning of these elderlypatients

18. AMEDS - PMHS These cognitive and physicalshortcomingsinterferewith the dailyfunctioning of these elderlypatients Thisincludestakingmedication

19. AMEDS - PMHS These cognitive and physicalshortcomingsinterferewith the dailyfunctioning of these elderlypatients Thisincludestakingmedication Thisleads to socalledmedication nonadherence by these patients

20. AMEDS - PMHS So, thiscategory of elderlypatients have the intention to taketheirmedicine

21. AMEDS - PMHS So, thiscategory of elderlypatients have the intention to taketheirmedicine butthey are notable to do so, because of shortcomingsdue to illnessesoroldage.

22. AMEDS - PMHS So, thiscategory of elderlypatients have the intention to taketheirmedicine butthey are notable to do so, because of shortcomingsdue to illnessesoroldage. We callthis a form of …

23. AMEDS - PMHS So, thiscategory of elderlypatients have the intention to taketheirmedicine butthey are notable to do so, because of shortcomingsdue to illnessesoroldage. We callthis a form of … ‘nonintentional medication nonadherence’

24. AMEDS - PMHS Especiallywith these elderly, vulnerablepatientsmedication nonadherence is highlyunwanted….

25. AMEDS - PMHS Especiallywith these elderly, vulnerablepatientsmedication nonadherence is highlyunwanted…. buthighlylikely

26. AMEDS - PMHS Especiallywith these elderly, vulnerablepatientsmedication nonadherence is highlyunwanted…. buthighlylikely and with these fragile and vurnerableolderpatients even the slightestmedication nonadherence can have serious, and sometimesdevastatingeffects!

27. AMEDS - PMHS Question:

28. AMEDS - PMHS Question: What are the effects of medication nonadherence with these fragile, vulnerablepatients?

29. AMEDS - PMHS Question: What are the effects of medication nonadherence with these fragile, vulnerablepatients? Answer:

30. AMEDS - PMHS Question: What are the effects of medication nonadherence with these fragile, vulnerablepatients? Answer: Longterm hospitaladmissions

31. AMEDS - PMHS Question: What are the effects of medication nonadherence with these fragile, vulnerablepatients? Answer: Longterm hospitaladmissions Deterioration of patientshealth

32. AMEDS - PMHS Question: What are the effects of medication nonadherence with these fragile, vulnerablepatients? Answer: Longterm hospitaladmissions Deterioration of patientshealth Need of superimposedtreatments

33. AMEDS - PMHS Question: What are the effects of medication nonadherence with these fragile, vulnerablepatients? Answer: Longterm hospitaladmissions Deterioration of patientshealth Need of superimposedtreatments More need of elderly care

34. AMEDS - PMHS Question: What are the effects of medication nonadherence with these fragile, vulnerablepatients? Answer: Longterm hospitaladmissions Deterioration of patientshealth Need of superimposedtreatments More need of elderly care Admissions in elderly homes

35. AMEDS - PMHS Question: What are the effects of medication nonadherence with these fragile, vulnerablepatients? Answer: Longterm hospitaladmissions Deterioration of patientshealth Need of superimposedtreatments More need of elderly care Admissions in elderly homes Death

36. AMEDS - PMHS To beable to help these patients to taketheirdailypillsadequately

37. AMEDS - PMHS To beable to help these patients to taketheirdailypillsadequately a muchbettertechnical support is needed!

38. AMEDS - PMHS To beable to help these patients to taketheirdailypillsadequately a muchbettertechnical support is needed! Muchbetterthancanbeprovidedwith the currentsystems

39. AMEDS - PMHS In case a technicalapropriatesollutioncannotbefound, the onlyalternative to help these patients is by hand, which has its drawbacks:

40. AMEDS - PMHS In case a technicalapropriatesollutioncannotbefound, the onlyalternative to help these patients is by hand, which has its drawbacks: A largenumber of healthcare professionals are needed to performthistedious service.

41. AMEDS - PMHS In case a technicalapropriatesollutioncannotbefound, the onlyalternative to help these patients is by hand, which has its drawbacks: A largenumber of healthcare professionals are needed to performthistedious service. Helping these patientsby hand in this respect induceshumanerrors and bythismedication nonadherence.

42. AMEDS - PMHS In case a technicalapropriatesollutioncannotbefound, the onlyalternative to help these patients is by hand, which has its drawbacks: A largenumber of healthcare professionals are needed to performthistedious service. Helping these patientsby hand in this respect induceshumanerrors and bythismedication nonadherence. The patients are becomingtoomuchdependent

43. AMEDS – PMHS So, helping these patientstakingtheirpillspreferablywith a technicalsollution is of greatimportance!

44. AMEDS – PMHS So, helping these patientstakingtheirpillspreferablywith a technicalsollution is of greatimportance! As in countrieswhich face a verylargeupcomingincrease of the numbers of elderlypeople

45. AMEDS – PMHS So, helping these patientstakingtheirpillspreferablywith a technicalsollution is of greatimportance! As in countrieswhich face a verylargeupcomingincrease of the numbers of elderlypeople the number of thiscategory of patientswillbecomealsoverylarge.

46. AMEDS - PMHS Impact of the increase in numbers of these elderlyfragile, vulnerablepatientswho are notable to taketheirmedication:

47. AMEDS - PMHS Impact of the increase in numbers of these elderlyfragile, vulnerablepatientswho are notable to taketheirmedication: Largeincrease of healthcarecosts.

48. AMEDS - PMHS Impact of the increase in numbers of these elderlyfragile, vulnerablepatientswho are notable to taketheirmedication: Largeincrease of healthcarecosts. Severeshortage of healthcare professionals to copewith the increasedworkload.

49. AMEDS - PMHS Question:

50. AMEDS - PMHS Question: whatcosts are involved?

51. AMEDS - PMHS Question: whatcosts are involved? Answer:

52. AMEDS - PMHS Question: whatcosts are involved? Answer: In the Netherlands the totalcostsinvolvedwithmedicationadherence are ca. 1 billion Euro a year.

53. AMEDS - PMHS Question: whatcosts are involved? Answer: In the Netherlands the totalcostsinvolvedwithmedicationadherence are ca. 1 billion Euro a year In the US the totalcostsinvolvedwithmedicationadherence are ca. 300 billion USD a year (!)

54. AMEDS - PMHS

55. AMEDS - PMHS Answercontinued:

56. AMEDS - PMHS Answercontinued: Although the mentionedtotalcostsdue to medicationadherenceseemvery high…

57. AMEDS - PMHS Answercontinued: Although the mentionedtotalcostsdue to medicationadherenceseemvery high… it is stillunclearhowmuch the mentionedcategory of patientstribute to these costs

58. AMEDS - PMHS Answercontinued: Although the mentionedtotalcostsdue to medicationadherenceseemvery high… it is stillunclearhowmuch the mentionedcategory of patientstribute to these costs Butitmightbevery high!

59. AMEDS - PMHS Answercontinued: Although the mentionedtotalcostsdue to medicationadherenceseemvery high… it is stillunclearhowmuch the mentionedcategory of patientstribute to these costs Butitmightbevery high! And these costsmighteasilyskyrocketthe coming years!

60. AMEDS - PMHS Answercontinued:

61. AMEDS - PMHS Answercontinued: And costs are not even the biggest issue here

62. AMEDS - PMHS Answercontinued: And costs are not even the biggest issue here The biggestproblem we face here is that we won’tbeable to provide the healthcareprofesionalsneeded to care for these patients - and otherpatients – anymore.

63. AMEDS - PMHS Question:

64. AMEDS - PMHS Question: how is itthatcurrent system fall short of helping these oldpeopletaketheirmedicationadequately?

65. AMEDS - PMHS Question: how is itthatcurrent system fall short of helping these oldpeopletaketheirmedicationadequately? Answer:

66. AMEDS - PMHS Question: how is itthatcurrent system fall short of helping these oldpeopletaketheirmedicationadequately? Answer: unfortunately these currentsystemsfall short heremainlyontwoessentialaspects:

67. AMEDS - PMHS Question: how is itthatcurrent system fall short of helping these oldpeopletaketheirmedicationadequately? Answer: unfortunately these currentsystemsfall short heremainlyontwoessentialaspects: Ergonomic design

68. AMEDS - PMHS Question: how is itthatcurrent system fall short of helping these oldpeopletaketheirmedicationadequately? Answer: unfortunately these currentsystemsfall short heremainlyontwoessentialaspects: Ergonomic design Multi-userfriendlyness

69. AMEDS – PMHS Ergonomic design:

70. AMEDS – PMHS Ergonomic design: Most currentsystems are someform of pillboxes, baxter systems (Medido, PicoBello) whichworkwithpillbagsorpill cups (MD.2; Philips); someexamples:

71. AMEDS – PMHS Ergonomic design: Most currentsystems are someform of pillboxes, baxter systems (Medido, PicoBello) whichworkwithpillbagsorpill cups (MD.2; Philips); someexamples: A patientwith a hemiparalysis and apraxiadue to a strokestruggles to getpills out of a plastic bagsuppliedby a Baxter system; the patientunfortunately is notable to do this and justthrowsaway the full bag.

72. AMEDS – PMHS Ergonomic design: Most currentsystems are someform of pillboxes, baxter systems (Medido, PicoBello) whichworkwithpillbagsorpill cups (MD.2; Philips); someexamples: A patientwith a hemiparalysis and apraxiadue to a strokestruggles to getpills out of a plastic bagsuppliedby a Baxter system; the patientunfortunately is notable to do this and justthrowsaway the full bag. A patientwith a tremor due to Parkinsontries to gethispillsfrom a MD.2- cup, due to the tremor all pillsfallon the floor.

73. AMEDS - PMHS Multi-userfriendlyness:

74. AMEDS - PMHS Multi-userfriendlyness: currentsystemsdesignedforreducingmedication nonadherence are mostlyuser-friendlyforonlyonegroupinvolved, someexamples:

75. AMEDS - PMHS Multi-userfriendlyness: currentsystemsdesignedforreducingmedication nonadherence are mostlyuser-friendlyforonlyonegroupinvolved, someexamples: The Baxter system orderrivativeslike the MedidoorPicoBello are veryuser-friendlyfor the pharmacist, unfortunatelynotfor all patients.

76. AMEDS - PMHS Multi-userfriendlyness: currentsystemsdesignedforreducingmedication nonadherence are mostlyuser-friendlyforonlyonegroupinvolved, someexamples: The Baxter system orderrivativeslike the MedidoorPicoBello are veryuser-friendlyfor the pharmacist, unfortunatelynotfor all patients. The MD.2 (Philips) mightbeuser-friendlyforsomepatients, but is veryuser-unfriendlyfor the pharmacist, as the pharmacist is bound to fill all cups by hand.

77. AMEDS - PMHS Question:

78. AMEDS - PMHS Question: so, with all this in the back of ourhead, what do we want for these elderly, fragile, vulnerablepatients?

79. AMEDS - PMHS Question: so, with all this in the back of ourhead, what do we want for these elderly, fragile, vulnerablepatients? Answer:

80. AMEDS - PMHS Question: so, with all this in the back of ourhead, what do we want for these elderly, fragile, vulnerablepatients? Answer: to support these patients we need a system which combines the followingattributes:

81. AMEDS - PMHS Question: so, with all this in the back of ourhead, what do we want for these elderly, fragile, vulnerablepatients? Answer: to support these patients we need a system which combines the followingattributes: Muli-userfriendlyness

82. AMEDS - PMHS Question: so, with all this in the back of ourhead, what do we want for these elderly, fragile, vulnerablepatients? Answer: to support these patients we need a system which combines the followingattributes: Muli-userfriendlyness Optimalergonomic design

83. AMEDS - PMHS Question: so, with all this in the back of ourhead, what do we want for these elderly, fragile, vulnerablepatients? Answer: to support these patients we need a system which combines the followingattributes: Muli-userfriendlyness Optimalergonomic design Safety in usage

84. AMEDS - PMHS Question: so, with all this in the back of ourhead, what do we want for these elderly, fragile, vulnerablepatients? Answer: to support these patients we need a system which combines the followingattributes: Muli-userfriendlyness Optimalergonomic design Safety in usage Reliability in usage

85. AMEDS - PMHS Ifyou want to knowhow a system with all these attributescanbedesigned, keep on the look out herefor the upcomingpresentation of AMEDS and PMHS

86. AMEDS - PMHS Ifyou want to knowhow a system with all these attributescanbedesigned, keep on the look out herefor the upcomingpresentation of AMEDS and PMHS In the meantime….

87. AMEDS - PMHS Ifyou want to knowhow a system with all these attributescanbedesigned, keep on the look out herefor the upcomingpresentation of AMEDS and PMHS In the meantime…. Try and design a system likethatyourself!

88. AMEDS – PMHS Thankyou