Summer 2019 - Interreg NWE

Summer 2019 - Interreg NWE
                                                               Summer 2019

Welcome                                           Influencing policy and practice:

to the eMEN summer newsletter, updating you       Combined expertise across the eMEN partners
on our progress and achievements in e-mental      has supported our policy work, illustrated below
health technologies across Europe.                by the German draft law for the “Digital Health
                                                  Care Act” and the promotion of safer (mental)
What has happened so                              health information exchange in the Netherlands
far?                                              by using international medical standards.

Piloting new products:                            Knowledge Sharing & Exchange:

As part of the eMEN project, each partner         We have also been sharing knowledge about
country is piloting an e-mental health product.   policy and research in new ways, through cross-
This summer’s newsletter highlights some of       disciplinary events like the Belgian seminar
the innovative approaches developing from         focussing on Return on Investment, the Irish
these pilots, including how they are addressing   seminar on technology and student mental
barriers to the uptake of e-mental health. Read   health and the Cardiff seminar on the increasing
more about the experiences of the German          access and equity of digital mental health in
Moodbuster roadshow.                              Cardiff, Wales.

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Knowledge-sharing events are being hosted by
eMEN partners throughout the project, so if you
missed out on the events above, there is still
time to attend one of our upcoming seminars or
conferences. They are all free to attend!

Recent eMEN events
Technology and mental health: a good

The 4th Belgian seminar was held in Leuven
(BE) and focused on “Technology and Health: a
good Return on Investment (ROI)?”. During the
opening of the seminar, the Federal Minister of
Public Health, Maggie De Block emphasized the
importance of a good integration of eHealth in
                                                     Charlotte Van den Broucke (Pulso Europe
the healthcare system. She elaborated on the
                                                     subsequently presented one of the Pulso tools
various e-health initiatives that have been rolled
                                                     “Studying Without Worries” (“Studeren zonder
out in recent years and was also very positive
                                                     blokkeren”), an online program which offers
about how the eMEN project is contributing to
                                                     students a wide range of guidance during their
the further upscaling of e-(mental) health.

Next, an interesting line-up of speakers shared
                                                     The second keynote, Eric Van der Hulst provided
their experience on the Return on Investment
                                                     an overview on health tech innovations
(ROI) of eMental Health products.
                                                     developed by Imec. He also discussed current
                                                     healthcare challenges and how technology or
                                                     mobile health could be of added value for the
                                                     “mobile generation”.

                                                     After these two keynotes some case studies
                                                     were presented: The Balance tool (a stress self-
                                                     assessment tool) and how it was used in the
                                                     Belgian supermarket chain, Delhaize, presented
                                                     by Eddie De Block. Next, Koen Dewit (Zenjoy)
                                                     showed us why design matters in branding
                                                     and designing apps and tools. Pamela Loges
                                                     (Ideas from Europe) presented the “Generation
                                                     Z” and their own mental health, and solutions
                                                     to empower it. Finally, a Belgian publisher
                                                     (Lannoo) demonstrated how they also invest in
The first keynote, Dirk Antonissen (Pulso Europe)
                                                     interactive products in mental healthcare. In this
spoke frankly about the difficulties to make a
                                                     case, Memory Palace, was presented by Lannoo
revenue with e-mental health products from
                                                     author Kasper Bormans. Memory palace gives
the perspective of a social profit organisation,
                                                     memories a place for people with dementia in a
providing services and tools in e-mental health.
                                                     unique way to improve contact with people with

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The program was closed by a short panel             and Prof. Jacques van Lankveld from Open
discussion. All presenters further discussed ROI    University, The Netherlands, who presented on
and concluded that such a commercial focus          eMental Health courses for students.
is often outside of the comfort zone of mental
healthcare (professionals). Nonetheless it is       The seminar also covered some examples of
an important aspect of any mental healthcare        usage of technology in student mental health
service and we should certainly be mindful of       services in Ireland, including Trinity College
this in the future.                                 Dublin Counselling Service, Dublin City University
                                                    and Participate Social Anxiety Programme of
Technology and Student Mental                       National University of Ireland, Galway.

Health Seminar
                                                    The last session focused on presentations
                                                    from students on how they have developed
On June 18th, Mental Health Reform and
                                                    technology and successfully integrated it into
the Union of Students of Ireland hosted an
                                                    their campaigns. This was followed by a student
international seminar on Technology and
                                                    leader panel, discussing the use of technology in
Student Mental Health. The event was held at
                                                    improving students’ mental health.
Technological University Dublin, Grangegorman

The seminar addressed the potential offered
by technology-supported applications (eMental
Health) in student mental health services and
supports. It covered a range of themes, including
some existing examples of eMental Health as
part of core student mental health services,
innovation in third level settings, cross-campus
initiatives and eMental Health courses.

The event has attracted a range of national
and international expert speakers and over
100 participants. Among the keynote speakers
were: Prof. Heleen Riper from Vrije Universiteit
Amsterdam, who presented on: eMental Health,
beyond state of the art & the Caring Universities
project; Dr Derek Richards from SilverCloud
                                                    Visit the eMEN website for the full article
Health and Trinity College Dublin, who talked
about Developments in eMental Health for students

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Wales well-placed to incorporate                   Health Technology Wales and the Digital Health
                                                   Ecosystem are looking at how it can be used
digital technology into mental health
                                                   in Wales. Professor Ricardo Araya, Professor
care                                               of Global Mental Health and academic lead
                                                   of the Global Mental Health Research Group,
On July 4th 2019, the Mental Health Foundation,
                                                   King’s College London, spoke about the recent
the UK partner in the eMEN project, organised
                                                   progress and challenges in Global eMental
a seminar Digital Mental Health: Increasing
                                                   Health. With the rapidly growing ‘industry’ of
Access and Equity in Cardiff, Wales. The seminar
                                                   digital solutions to help reduce the treatment
was organised in collaboration with the Public
                                                   gap in mental health, most of these digital
Health Wales 1000 Lives Mental Health and
                                                   solutions have never been tested or evaluated in
Learning Disability team. Carol Shillabeer, CEO
                                                   a rigorous way.
Powys teaching Health Board, opened the day.
Delegates were informed that Wales is well
                                                   In the late morning session, Shari McDaid spoke
placed to incorporate digital technology into
                                                   on behalf of Rebecca Cotton, Director of Policy
mental health care and that digital technology
                                                   at the Mental Health Network, who recently
can play a key role in mental healthcare.
                                                   completed a Winston Churchill Memorial Trust
                                                   Fellowship. There Rebecca learned about how
Expert presentations focussed on recent
                                                   digital technology is being used to improve
developments in digital mental health and
                                                   mental health in Australia and the USA.
explored how such evidence-based technologies
                                                   Professor Chris Williams, Emeritus Professor
can offer innovative and increased access to
                                                   of Psychosocial Psychiatry at the University of
high-quality mental health care, including for
                                                   Glasgow, spoke about how blended learning
groups with a higher risk of developing mental
                                                   approaches offer benefits over online alone.
health problems, and those living further
                                                   Professor Williams referred to the solution of
away from more traditional service provision.
                                                   combining digital, book and class approaches.
It will also explore issues of the effectiveness
                                                   Dr Paul Best, lecturer in Social Work at Queen’s
and accessibility of digital mental health
                                                   University Belfast (QUB) and BABCP registered
                                                   Cognitive Behavioural Therapist, spoke about
                                                   the accessibility and acceptability of online
                                                   technologies to support mental health and well-
                                                   being within a Northern Irish context.

                                                   In the afternoon session, Dr Jacinta Tan, a
                                                   child and adolescent psychiatrist and medical
                                                   ethicist, and Professor Alka Ahuja, Consultant
                                                   Child and Adolescent Psychiatrist and the Lead
                                                   Consultant for the Tertiary Neurodevelopmental
                                                   service at Aneurin Bevan University Health
                                                   Board, delivered a workshop which focused
                                                   on how to collaborate and partner with other
                                                   agencies on technological mental healthcare
                                                   innovations. This was followed by a Tabletop
                                                   discussion where delegates could discuss and
                                                   propose answers to key questions regarding
                                                   the integration of digital mental health from
Addressing the issue of quality of mental health   three perspectives: service users, practitioners,
apps, Helen Northmore, Programme Manager,          organisations (e.g., the advantages and
Digital Health Ecosystem Wales, reported that      disadvantages of using digital mental health
NICE has launched an evidence standards            tools in assessments? in interventions?
framework for digital health technologies and      Concerns about digital technology in this field?

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how to establish an evidenced base for digital
technology?). The session was closed with a          Interesting
question and answer feedback session between         Developments
delegates and speakers.

                                                     Acceptance and benefits of internet-
Chair speakers included Dr Antonis Kousoulis,
Director of Policy & Research at the Mental          based interventions in inpatient
Health Foundation, Andrea Gray, Mental Health        settings – experiences of German
Development Lead at 1000 Lives Improvement           Moodbuster roadshow
in Public Health Wales and Simon Mudie,
Experts by Experience Involvement Consultant         The interest in e-mental health is increasing,
representative.                                      not least because of projects such as eMEN.
                                                     With increased interest comes the possibility to
During the breaks, SMEs and App developers           explore new and previously neglected areas for
had the opportunity to showcase their product.       application. Though internet-based interventions
                                                     have acquired a solid evidence base in a variety
Read the full article here                           of settings, especially when provided with some
                                                     form of human support, little is known about
Digital innovation: trying to do things in a         their application in inpatient contexts. That is
new way with the use of technology                   why researchers from the eMEN project have
Interview with Helen Northmore by Marleen Swenne     conducted a workshop on the acceptance and
                                                     benefits of internet-based interventions in 10
One of the speakers at the Cardiff seminar,          mental health institutions all across Germany:
‘Digital Mental Health: Increasing access            Schleswig-Holstein, Berlin, Brandenburg, North
and equity’, was Helen Northmore. Helen is           Rhine-Westphalia and Bavaria. Participants
Programme Manager, Digital Health Ecosystem          ranged from senior to junior physicians,
Wales and her task is building a network that        psychiatrists, psychologists, and even to
improves developing digital healthcare. Main         occupational therapists. They received a live
goal is to bring all the parties that are involved   introduction to Moodbuster, an internet-
together: industry, social care, experienced         based treatment for depression, and had the
users, IT-people. I wanted to interview her about    opportunity to work hands on with the program.
the theme of the seminar and also because            Moreover, they completed questionnaires
I thought she knew a lot about the e-mental          on the usability and acceptance as well as on
health users’ perspective, but that was not quite    advantages and disadvantages of internet-
correct…                                             based interventions in inpatient settings. Each
                                                     workshop was concluded by a group discussion.
Read the full interview here                         In these discussions, the researchers gathered

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Summer 2019 - Interreg NWE
information on the essential intervention           The German health care system is
components that staff members require in            moving towards digitalisation
order to use an internet-based intervention.
Finally, barriers to implementation, as well as     In Mid-May 2019 the German Federal Health
chances and risks associated with internet-based    Minister presented a draft law for the “Digital
interventions were discussed.                       Health Care Act (Digitale Versorgung-Gesetz –
                                                    DVG)”. By German standards, it contains almost
The results of the questionnaires will be           spectacular new regulations, as it provides,
analysed in the upcoming months. However,           among other things, for insured persons to be
a few trends emerged during the discussions.        entitled to digital health applications (“diGA”).
Generally, most participants were enthusiastic      Digital health applications might soon be
about the use of internet-based interventions,      prescribed by doctors and might gain access to
such as Moodbuster, in ambulant settings.           the primary healthcare market.
They were more reluctant however to provide
a full intervention online to their inpatients.     At request of the provider, the application would
Staff feared the reduction of already limited       be audited by the Federal Institute for Drugs and
contact hours with their patients. Despite          Medical Devices (BfArM) for compliance with all
this reservation, certain components, such          legal requirements, data protection and data
as a psychoeducation module, were deemed            security as well as for positive healthcare effects
beneficial. An often-mentioned application was      and then would be included in the directory of
bridging the time between face-to-face sessions.    reimbursable digital health applications.

Unfortunately, the largest barrier to               To be listed reimbursable, the “diGA” must be
implementation from a technical perspective         a medical device with a low risk class, i.e. risk
was the lack of infrastructure. Almost none         class I or IIa according to the Medical Devices
of the 10 institutions regarded their WIFI          Regulation. Stand-alone software, which
connection or availability of computer              prepares and makes available information to
workspaces as sufficient for implementing an        decide on diagnoses or treatments, is in risk
internet-based intervention. Finally, privacy and   class IIa. However, if it can directly or indirectly
data safety remained a concern.                     cause a serious deterioration in health, it falls
                                                    in a higher class. As a result, many applications
Visit the eMEN website for the online article       would be excluded from the new regulation.

                                                    Further development of this draft law will be
                                                    presented in the next eMEN newsletter.

                                                    You can read the online article here

                                                    Promoting safer (mental) health
                                                    information exchange in the
                                                    Netherlands by using international
                                                    medical standards (SNOMED CT and
                                                    HL7 FHIR)

                                                    In the Netherlands different types of healthcare
                                                    service providers use different information
                                                    standards and digital systems (sometime even

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The Dutch Ministry of Health, Welfare and Sport
                                                     has started the MedMij program together with
                                                     the Dutch Patients’ Federation, Nictiz and the
                                                     Care associations. MedMij is an agreement
                                                     system aimed at the safe exchange of health
                                                     information. It is a framework of agreements
                                                     and standards that is represented on
                                                     government level in the so-called ‘Information
                                                     Consultation’ (IB), a partnership without further
within their own organisation). This makes           legal entity. Nictiz, the centre of expertise for
the exchange of medical data and prevention          eHealth, develops and manages these standards
of mistakes very complex. Healthcare is              (health information blocks) and provides advice
increasingly occurring in networks. These are        on their implementation.
networks between patients, care providers,
colleagues and organisations conducting              Currently a large funding program called VIPP,
research and contributing to the improvement         which focuses on IT optimization, is being
of quality. Also, there is a need for patients       implemented by the main sector organisation
to access and retrieve their medical data and        for mental health care in the Netherlands (GGZ
participate in their own treatment.                  Nederland). VIPP makes it possible that patients
                                                     themselves have access to their digital files and
In 2014 The Dutch Ministry of Health proposed        documents and increase the use of e-mental
plans to take a digital approach to make             health. Furthermore, the data exchange within
healthcare even safer, more patient-oriented         the entire care sector is supported, starting with
and more efficient. This means that health           medication safety.
organisations can digitally exchange information
with patients in a standardized and secure
manner. This helps people to take control
of their own medical data and to be able to
manage and use it securely within their own
digital Personal Health Environments. A personal
health environment (PHE) is a digital tool
which you choose yourself and in which you
can keep track of information about your own
health and actively work on your health. The
PHE allows you to manage and access medical
data and also share it with others. This way
you keep a grip on your health care data, from       The VIPP program also includes scaling up the
treatments to laboratory results, medications        use of e-Health by demanding the integration
and vaccinations. And these data are yours and       of direct access to e-health systems from
remain accessible throughout your entire life.       the primary health system of professionals.
In order to achieve this, it is important that, as   Healthcare service providers need to achieve
a first step, all healthcare service providers use   patient e-health usages percentages of between
the same information (exchange) standards            10-15% in order to reach the minimum goals to
and legal contracts and healthcare information       keep the VIPP grant amount allocated to their
blocks. Healthcare suppliers must be Medmij          organisation.
certified. Medmij is a national trust framework
on information exchange between a Personal
Health Environment (PHE) and a healthcare

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Although the first information blocks are not         politicians and other health care stakeholders
so exciting this is a very important first step.      to find the best way into the digital future of
The mental health sector is already working on        psychiatry and psychotherapy.
new information blocks like the (more dynamic)        A preliminary program will be published here
treatment plan and functionality to enable not        soon.
only retrieving information but also enable
digital cooperate together between patient and        You can already register for the event here:
professional.                                         online registration.

For more information about the VIPP program in
the Netherlands please contact Arq Foundation         Share our animation!
                                                      Our eMEN animation is available at nweurope.
Read the full article online                          eu/emen. It explains the concept of e-mental
                                                      health and the many ways it can support mental
Upcoming FREE                                         wellbeing. We encourage you to share this with
transnational seminars                                your networks, embed it in your website and use
and conferences                                       it in your presentations.

Over the life of the project, eMEN is delivering 24
transnational events across Europe addressing
e-mental health evidence-based innovations,
quality, access and scale.

29 November 2019: Berlin, Germany

Digital Innovations in Psychiatry and
                                                      Why not join our
                                                      transnational network?
The aim of the event is to provide an overview
of future key technologies in psychiatry and          eMEN is an e-mental health project running until
psychotherapy. What is the state of research and      May 2020, funded through the Interreg North
how can innovations transfer into health care         West European Innovation Programme with a
routines? A highlight will be the presentation        value of €5.36million. The six country partners
of several German innovation fund projects            are led by the Netherlands and include Belgium,
in the field of e-mental health. In addition, the     France, Germany, Ireland and the UK, who
current legal and political framework conditions      together combine diverse technological, clinical,
in Germany are examined and discussed.                research, and policy expertise.
An insight into the latest developments
is provided by a start-up slam in which               To receive updates on our future activities and
innovative applications are presented in short        connect to e-mental health stakeholders across
presentations. There is also a marketplace            Europe, we encourage you to register to join our
for e-mental health companies. The event is           network.
free and will take place in the context of the
biggest German congress on psychiatry. It             We also welcome invitations to contribute to
brings together developers, researchers, users,       your event. Further contact information for all
                                                      the partners is available at

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