The Timeline

Ultimately, the target market for Get-Help-Now are all employees throughout Europe at risk of or with mental illness, musculoskeletal (MSK) disorders or pain. During the 2018-19 funding, however, Get-Help-Now will start piloting and beta-testing in two German companies and two German regions and mental illness including depression, anxiety and “burnout” as well as acute and chronic MSK disorders / pain and pilot centers in Spain. From there, we will expand to other diseases and other employers / regions/ countries.

The Details

The background: Loss of work-ability due to mental illness, musculoskeletal disorders (MSKD) and pain accounts for about 2/3 of the morbidity for adults from 15 to 69 years of age. MSKD are the main cause of years lived with disability. In the EU-15, MSKD account for 53% of all work-related diseases, causing most lost days and permanent incapacity to work. Overall, they account for 50% of all absences from > 3 days, 49% of all absences lasting two weeks or more and about 60% of all reported cases of permanent incapacity The total costs of work-related MSKD are estimated to about €240 billion or up to 2% of GDP. (Bevan S. 2015 Economic impact of musculoskeletal disorders on work in Europe. Best Pract Res Clin Rheumatol; 29: 356-73).
The second most relevant contribution to years lived with disability arises from mental illness. The total direct and indirect costs of mental illness for European societies are estimated to 4% of the GDP, with most cases manifesting in adult age. (OECD 2014: Making Mental Health Count. The Social and Economic Costs of Neglecting Mental Health Care).
Early intervention (prevention in employees at risk, rapid and appropriate treatment for those affected) as a “workplace intervention” links “occupational health” to “early intervention / prevention” and supports “altering disease trajectories”. Both for MSKD and for mental illness, early initiation of appropriate treatment greatly enhances the chances of recovery and return to work.
Models of early intervention have been successfully implemented in various locations, e.g. in Spain for MSKD, in England for treatment of mental illness, at AbbVie in Germany for a comprehensive employee support program. Get-Help-Now provides a unifying digitalization solution with easy to use front-end and educational material, taking care of back-office processes for employees, employers, health care providers, insurance companies and other stakeholders. Get-Help-Now will first launch in Germany in 2019.

Our Rationale

Early intervention seizes the “window of opportunity” in which patients recover faster. This particularly holds for MSKD related Temporary Work Disability (TWD) and mental illness. In Germany, these two conditions alone account for > 50% of the 11 billion € annually spend by health insurance funds for continued salary reimbursement for long-term sickness.
Appropriate early intervention can substantially reduce the burden of disease and the loss of work: In Spain an RCT including more than 10,000 episodes of MSKD-TWD with early referral to specialized care, expert clinical management with step-up approach, education of patients and support to return to work reduced healthcare resources by 45% and permanent work disabilities by 50% compared to standard care. The total social return was estimated at 11€ for every € invested (Jover JA et al, 2017, in preparation).
The English program “Improving Access to Psychological Treatment” (IAPT) showed impressively improved recovery rates and scalability. (Gyani AAetA et al. Enhancing recovery rates: lessons from year one of IAPT. Behav Res Ther. 2013;51:597-606).
AbbVie Germany extended the concept of early intervention and prevention to the occupational world. AbbVie implemented a step -up approach for mental illness and exhaustion (burnout) ranging from encouragement of self-management to rapid transfer to psychological treatment. 45% of the work-force partook in voluntary screening. Within four months 80 high-risk employees (4% of the work-force) were transferred to psychological treatment.

Objectives & Innovation

Get-Help-Now aims at integrating these experiences into a service bridging the occupational setting and the health care sector, using the best of digitalization and the face-to-face contact for a new integrated system of early intervention. The concept is that of a meta-system allowing to integrate existing digital, blended and face-to-face services with the focus on eliminating waiting times and facilitating appropriate resource allocation.
Get-Help-Now‘s back-end processes will reduce administrative burden, support decision making and structure early identification of individuals at risk or with manifest disease. Get-Help-Now integrates the patient preferences, patient education and provides a systematic approach to quality control. The innovation is to focus on process optimization and monitoring of all risks and costs (e.g. prolonged waiting times). Get-Help-Now’s back-end provides adaptive documentation and processes aligned to the peculiarities of each country’s health care system.

Methods

For each condition, a screening questionnaire (determination of optimum cut-offs is part of the work-plan) discriminates low-, medium- and high risk individuals. For low- and medium risk, education and self-management is encouraged, potentiallyintegrating existing occupational well-being programs. For high-risk employees triage, referral and first booking take place by theoccupational health physician or a communal / regional health center (like the English first contact for self-referral in Improved Access to Psychological Therapy IAPT and the early intervention clinics for MSKD in Spain). The digital platform of the Get-Help-Now service provides brief assessments to be completed after every session of intervention.
Get-Help-Now digitalizes the organization and monitoring of the early intervention process along the fragmented health-care-value-chains by back-office administration including data-transfer-support, booking, administration, and reimbursement. The back-end support system builds on existing role-models and solutions in other business areas (e.g. logistics with simultaneous processing of documentation, information and goods). Get-Help-Now will be designed to allow integration of new services such as telephone or online consultation (e.g. Medgate) into the process. The patient information and educational material will integrate other EIT-Health initiatives such as CARE or blended care programs.

Methods

For each condition, a screening questionnaire (determination of optimum cut-offs is part of the work-plan) discriminates low-, medium- and high risk individuals. For low- and medium risk, education and self-management is encouraged, potentiallyintegrating existing occupational well-being programs. For high-risk employees triage, referral and first booking take place by theoccupational health physician or a communal / regional health center (like the English first contact for self-referral in Improved Access to Psychological Therapy IAPT and the early intervention clinics for MSKD in Spain). The digital platform of the Get-Help-Now service provides brief assessments to be completed after every session of intervention.
Get-Help-Now digitalizes the organization and monitoring of the early intervention process along the fragmented health-care-value-chains by back-office administration including data-transfer-support, booking, administration, and reimbursement. The back-end support system builds on existing role-models and solutions in other business areas (e.g. logistics with simultaneous processing of documentation, information and goods). Get-Help-Now will be designed to allow integration of new services such as telephone or online consultation (e.g. Medgate) into the process. The patient information and educational material will integrate other EIT-Health initiatives such as CARE or blended care programs.

Organization & Role of Partners

Within the eight work packages core partners contribute the scientific background, implementation expertise, guidance on the selection of interventions, and input for training activities. The Spanish partners have extensive experience in program implementation and scaling, in health-care services improvement and process automatization design and pragmatic randomized-controlled trials. Other non-core partners provide experience in user-experience design, agile development use of rapid prototyping. EIT-Health Accelerator and Campus will be consulted for business development and educational / public dissemination. The project builds on the established long-term collaboration between AbbVie, Heidelberg University and the ETH Zurich spin-off company HealthVision GmbH plus the long-term collaboration of AbbVie within the European Early Intervention Network on early intervention.


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