1. Dutch OpenHealth 2.0 Challenge TEAM GGZVS-09BThe Netherlands

2. THE NAME OF OUR PROJECT ISSMS-CARE TO YOU

3. Introduction of the team Thijs Beckers We are students of the Master Advanced Nursing Practice GGZ at the GGZ-VS in Utrecht We work in Heerlen, Woerden and Den Haag. At various mental health institutions. Arie Belo Sergej Koopmans Moleveld

4. Describeyouridea Our product is like the invention of the paperclip. It seems so simple that you could invent it yourself. But just like the paper clip you did not and therefore this idea is the Health 2.0 idea of the year. It is simply redeploying an existing system in favor of the patient. SMS-CARE TO YOU lends itself perfectly to overcome the handicap of the schizophrenic patient. We have chosen an electronic prosthesis in the form of a mobile phone with SMS function. The ultimate of this prosthesis is that it is universal in every health system to implement. The advantage of this SMS service is that it allows the patient to overcome his cognitive impairment.

5. Operationof the product The care employee creates an SMS via an SMS message application and at the right date and time this message then is delivered to the patient. The patient receives the SMS. And then has the choice whether or not to respond. Therefore this idea is so good, the patient retains its own autonomy. But the SMS can therefore be used by the patient to improve his cognitive problems. The healthcare worker is given the opportunity to do direct, without infringing on the lives of the patients, to increase activities and participation of the patient. We use a system what is also used by the Dutch police. This system cost nothing only 0,09 euro per send SMS.

6. Describe the impact of your plan Our plan will have a great impact among patients with schizophrenia. Inside Parnassia we had a pilot on a department where patients with schizophrenia where treated and the no-show of the participantshave already gone from 44% to 4%. And where not even talking about the better relationship between care giver and patient. And with this health 2.0 project we want to go beyond this pilot. Not only no-show reduction, but also improvement of the life of the patient. SMS messages that go beyond appointments and will stimulate the patient to participate in social events outside his own small world. Patients can be stimulated to participate in sport clubs, do their own housekeeping or be reminded to get out of the house to go to the beach for a walk.

7. Describe the number of peopleyour plan affects. That is a difficult question. There are between 60.000 and 80.000 people with schizophrenia in the Netherlands. So the numbers can be enormous. What we have done is not only look at the number of patients but also to the people around the patient. In the survey on the next slide you see the patient in the center and the rest of the people who benefits from the SMS-CARE TO YOU project. Our profit is in the overall system of the patient. And that’s why we cannot give any numbers, but at least all patients can have benefit from our project!

8. The number of peopleour plan affects.

9. Describe the cost of your project The costs of our project are low. We use an SMS program that only costs us € 0,09 per SMS sent. The use of the program is free of charge and is used by other companies. If we start with 40 patients with in Parnassia the cost will be as follows: 20 pre-paid cell phones (not everybody has a cell phone)€ 500,00 (cost of a pre-paid cell phone is €25,00) 10000 SMS messages at € 0,09 per SMS sent (for a year) € 900,00 (assuming 250 SMS messages per patient per year) 130 hour for typing the SMS messages in the system (for a year is an average of 30 SMS messages a day is 30 min. a day) € 2600,00 (salary is € 20,00 gross an hour) Total cost for 40 patients for 1 year € 4000,00 a year

10. Describe the cost of your project As you’ve seen the costs for 40 patients is € 4000,00 euro a year but the profit is much more!!! Reduction of 40% no-show of the patients. A patient has at least 10 contacts with his caregiver per year. The average no-show is 44%. For 40 patients this is 40 no-shows a year reduced to 2 no-shows a year. Knowing that a face-to-face contact is worth around € 88,00 per f-t-f contact. A simple calculation is from 40 no-shows to 2 no-shows is a profit of 38 f-t-f contact at € 89,00 per contact is an increase of € 3382,00 income a year. So for the empowerment of 40 patients the cost are net € 618,00 a year! And we’re not talking about al the other costs that are being reduced by a better treatment of the patients.

11. Describe what else is needed What we really need is a change of direction in the mind of the caregivers. They must see the advantage of this system. The system falls or stands by the caregivers and not by the patients. The patients will embrace this product as we have seen within Parnassia. And also the lost of given cell-phones was low. From the 25 cell-phones we gave away only 4 where lost or broken.

12. Make a clear risk/benefit analysis Risk-benefit analysis is the comparison of the risk of a situation to its related benefits. For research that involves more than minimal risk of harm to the subjects, the investigator must assure that the amount of benefit clearly outweighs the amount of risk. Only if there is favorable risk benefit ratio, a study may be considered ethical. The only risk in this project is the risk that every cell-phone user has. Namely don’t use a cell-phone when you are driving a vehicle. In the Parnassia pilot, patients signed a agreement not to use the cell-phone in situations that are forbidden by the law. So the risk is nil.

13. What about the privacy The patient data is safe. In the Parnassia pilot we used only the first name of the patient and a numerical code of the caregiver. So the patients who where in the SMS application with there mobile number where addressed as ‘piet31’. As sender there was no phone number in the patients cell-phone just the name ‘Parnassia’. So when a phone is lost, a finder cannot recall from which number the SMS was send. The sender name could also be changed if patients want this.

14. Notes We hope we have given you an idea of our project and we want to point out that you can see our film on youtube, http://www.youtube.com/watch?v=r3YkQidARD0 And we suggest, you also read our paper with the substantive background to better understand our project. And last but not least thank you for your time and sorry for the ‘Steenkolen” English. We are just nurses not scholars. ThijsBeckers Arie Belo Sergej Koopmans-Moleveld (team captain)