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Presentaties 17juni telecaretelehealth

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  • 1. CASA Regions for Smart Living Local Dissemination Event Flanders Fabian Dominguez Lead Partner 17th June 2014, Brussels
  • 2. EPSCO Council meeting EPSCO Council meeting on 19th June 2014 in Luxemburg Adoption of the Social Protection Committee (SPC) key messages: EU citizens of 65 year of age will have less than 50% of remaining life span free of conditions that can impede normal day-to-day activities Risk of LTC increases as of the age of 80. Same goes for multimorbidity Impact on quality of life ageing population and impact on government spendings LTC: 3 major challenges: Increasing demand. Next 50 years: +80y people that will require care will triple Decrease of number of working people > threat to LTC providers Increasing demand will affect the quality of care
  • 3. EPSCO Council meeting Member states will have to evolve from a reactive to a proactive policy: Increase the autonomy of their citizens to decrease the demand for care Increase efficiency in home and residential care This can be achieved by support via technical and technological systems: Use the full potential of these innovations to keep elderly people longer at home in a comfortable and safe way Necessity of full integration of health and care Reponsability for this lies with member states (MS) EU can support MS in their policy via stimulating of testing of new solutions; research and innovation support; E.g. of EU-tool: EIP AHA MS responsible for LTC with support of the EU need to learn from each other
  • 4. CASA CASA (Consortium for Assistive Solutions Adoption) is funded under the 4th call of the INTERREG IVC programme, approved in January 2012 (end Dec. 2014) INTERREG IVC Programme is part of the European Territorial Cooperation Objective of the Structural Fund policies 2007-2013 Overall objective of the INTERREG IVC Programme is to improve the effectiveness of regional policies and instruments financing interregional projects to build on the exchange of experiences among partners Regional initiative project under Priority 1: Innovation and the knowledge economy, sub-theme: the information society Total budget = 2.635.999,32 and co-financed by a grant of 2.002.154,39 ERDF
  • 5. CASA The CASA partners are intending to work under the umbrella of the CORAL forum (Community Of Regions for Ambient Assisted Living): currently an informal community group with the aim to feed back good practices from the study visits exchange of experiences to influence future Ambient Assisted Living (AAL) policies at European level www.casa-europe.eu
  • 6. CASA 1. Context Ambient Assisted Living (AAL) is a complex field across Europe - More structured approach to accelerate the uptake and roll-out new technologies - In parallel to development and review of policies 14 participating regions joined forces to find solutions and allow best practices sharing in the field of AAL: CASA partnership = to respond to regions and governmental pressure faced with increasing pressure on health and social care - Demographic change - Ageing population
  • 7. CASA 2. Partners 14 partners: Flemish Government Lead Partner (BE) Province of Noord-Brabant (NL) Kent County Council (UK) South East Technologies Alliance (UK) Veneto Region (IT) Friuli-Venezia Giulia (IT) Scotland (UK) Southern Denmark (DK) Region Wielkopolska (PL) Catalonia (ES) Timis County (RO) Andalucia (ES) East-Sweden (SE) Region Halland (SE)
  • 8. CASA 3. CASA: what? Respond to increasing pressure on health and social care resulting from demographic change and an ageing population Use of new technologies: - Improve the comfort of citizens in managing their conditions - Reduce the economic and social burden on governmental care budget Attempt for implementation policies moving away from traditional mono-domain policy to work horizontally along the supply chain and across different departments and ministries
  • 9. CASA 4. CASA: deliverables Events and seminars to provide opportunities for demonstrating and sharing good practices amongst the partnership: 10 study visits speaker @ conferences (e.g. Open Days 2012) Transfer Task Force regional SWOT analysis Best Practice Guide 2 Knowledge Transfer Conferences 13 local dissemination events regional implementation plans final ministerial conference in Brussel 28 staff secondments
  • 10. CASA Intention: formalize and legalise the inter-regional CASA network for long term sustainability and open it to a wider European platform a. Study visits (2 days): Noord-Brabant: 'Social interaction (following AAL forum in Eindhoven) Cataluia: Healthy lifestyle and rehabilitation ICT Kent: Monitoring, safety and self management Wielkopolska: Informal care (http://www.youtube.com/watch?v=AmCN3MT_qT0)
  • 11. CASA South Denmark: Telemedecine evaluation model Andalucia: Large scale deployment Veneto: Chronic diseases' (http://www.youtube.com/watch?v=uOv2V91xm5M) Flanders: Mobility and liveability/integrated regional policy business and knowledge development (http://www.youtube.com/watch?v=4v7aD_jynLQ) Scotland: Telehealth and Telecare (http://www.youtube.com/watch?v=TQER0aW2UzU) Sweden: User driven innovation through public/private partnership
  • 12. b. Communication 1 joint web site 1 policy forum Brochure DVD E-newsletters Press releases Speaking opportunities and CASA stand at 15 conferences related to Ambient Assisted Living: AAL forum (Eindhoven); EIP AHA: The Opportunity for regions (minister Vandeurzen Open Days); 1 ministerial conference in Brussels (final conference) October 2014 CASA
  • 13. c. Secondments mini study visit tailor-made to specific requests of experts At least 28 secondments (2 per partner) To Flanders Polish secondment: 24th 27th March 2014 4 experts Kent County Council: 7th 9th May 2014 9 experts Scotland: 12th 14th May 2014 2 experts Some impressions CASA
  • 14. d. Final conference 7th October 2014 Brussels > week of Open Days 2014 Joint final event of 2 INTERREG IVC-projects: CASA and INNOVAge (Improvement of the effectiveness of regional development policies in eco-independent living for the elderly) Working title of final conference: Creating unity out of diversity: sustaining lessons learnt in Active Ageing CASA
  • 15. Thank you Fabian Dominguez Social Affairs and Public Health attach Permanent Representation of Belgium to the European Union P.A.: Ministry of Welfare, Public Health and Family Affairs Staff of the Secretary-General Koning Albert II-laan 35, bus 30 BE-1030 Brussels [email protected]
  • 16. Alison Davis Director Integrated Care, North Kent 17th June 14 Integrated Health & Social Care: service transformation supported by technology
  • 17. Brief Introduction to the complexities of the Health and Social Care system in Kent History of use of telehealth/telecare ,whole system demonstrator and what we learned Current agenda including pioneer programme and Better Care Fund (BCF) North Kent approach to the Integration of Health and Social Care Content
  • 18. Kent & Medway Location Sea on 3 sides, London suburbs Mixture of Affluent, Rural and very deprived areas across the County. Health and social care structure 8 CCGs, 1 county council, 12 borough councils, 1 unitary authority, 4 acute hospital trusts Demographics Total Population: 1.7m Mixture of Affluent, Rural and very deprived areas across the County. Better health outcomes when compared to England Variation at local level with Dartford, Dover, Swale and Thanet have higher all cause mortality rates. Increasing elderly population Age 65+ predicted to grow by 9.7% between 2012 and 2016 17.3% of the population are aged 65+ Within the target population, individuals report having an average of 1.6 of the three target conditions of HF, COPD, Diabetes
  • 19. Advanced Assistive Technology in Kent 2004 The Kent Telecare Pilot 1100 users of enhanced Telecare Packages 93% felt more independent 93% also felt safer in their own homes Reduction in residential placements 2005 The Kent Telehealth Pilot One of the first in the UK to formally evaluate AAT and the benefits to the Health economy Reduction in A&E Attendances Reduction in unplanned Admissions 1800 average saving per patient over 6 months 2008 -2011 WSD (Telecare & Telehealth) Largest Randomised Control Trial in the World 6000 participants December 11 20% reduction unplanned admissions 15% reduction in A&E attendances 14% reduction in bed days 45% reduction in mortality rates. June 12 Telehealth reduces Hospital Admissions but unlikely to have a significant effect on costs. Feb 13 Telehealth did not improve quality of life Telecare has no significant impact on the use of other NHS or social care services
  • 20. A better quality of care, lower mortality rates and reduced unplanned hospital admissions are possible Patients on the whole like this type of intervention and age is no barrier Deploying appropriate technology at the appropriate time to the appropriate patient Eligibility criteria and critical mass-technology alone does not bring the change you need service transformation Clinicians key to implementation and success Education and training skilled competent workforce Need to Identify an appropriate procurement model to realise cost benefits What did we learn?
  • 21. NHS - over 1 million patient contacts every 36 hours Increase in Long Term Condition 1:3 people with a Long Term Condition In England over 15 m people have a long term condition with numbers set to increase in the next 5 to 10 years, especially co-morbidity People with long term conditions use 72% of inpatient beds, 68% of out-patient appointments and 55% of GP appointments Treatment and care of those with LTCs account for 70% of the total health and social care spend in England, or almost 7 in every 10 spent Deliver more for less increasing demand and financial challenge The Challenge
  • 22. I want. less time in hospital independence empowerment own bed prevention of exacerbation in control freedom more time understand own condition fewer trips to see specialist
  • 23. North Kent Vision Transformation of the Health & social care system so that it works better for people, with a focus on promoting independence and self care, delivering the right care, right time, right place, providing seamless, integrated care for people, particularly those with complex needs Better access Increased independence More control Improved care at home Live and die safely at home Shared care plans
  • 24. A single pooled budget for health and social care services to work more closely together in local areas, based on a plan agreed between the NHS and local authorities 6 National conditions Plans to be jointly agreed Protection for social care services (not spending) 7 day services in health and social care Better data sharing between health and social care based on the NHS number Assure joint approach to assessments and care planning, where funding is used for integrated packages of care there will be an accountable professional Agreement on the consequential impact of changes in the acute sector Better Care Fund (BCF)
  • 25. The Integrated Care & Support Pioneer Programme 14 areas selected to lead on health and social care integration. Support from the Department of Health and 40 national partners. Responsibility to barrier bust. Underpinned by the Better Care Fund.
  • 26. Integrated Transformation Components Non Acute bed Provision: Consultant and GP support; Integrated Care Centres; Extra Care; Rehab Units; Community Hospital beds; Private Residential and Nursing bed provision Crisis Response Services: Access to Shared Anticipatory Care Plans by the ambulance service, enhanced rapid response ,enablement services and voluntary sector based crisis response services. Integrated Care Home support: Integrated teams including Consultant and GP support; Use of technology to Care Homes / Extra Care Housing providers. Integrated Equipment , DFGs, capital adaptations & assistive technologies at the front end of all the services video conferencing with clinicians and development of new pathways. Improved data sharing Promotion of the NHS umber, better health information, use of the health & social care information centre, patients accessing own health records. GPs linked to hospital data. Operating model: Integrated skill mix, assessors accessing integrated care direct: i.e. nurses accessing social care and case managers nursing care, skills for mental health, dementia/LD a Integrated Primary Care Teams 24/7 access to multi-disciplinary teams coordinated by the GP, inc mental health/dementia; risk stratifying patients; access to one shared care plan for patient and professionals Integrated Access: Integrated Locality Referral Unit; 7 days a week direct access and 24/7 crisis response ; Access to one shared care plan on an integrated platform. Integrated Discharge Teams: Across acute & community; 7 days a week working including Rapid Response; Enablement Going Home Teams I can plan my care with people who work together to understand me and my carer(s), allow me control, and bring together services to achieve the outcomes important to me.
  • 27. The Future of Health & Social Care By 2015 Integrated health and social care teams working 7 days, 24/7 in your local community. Your GP as the coordinator of your care, bridging the gap between your GP, social care, community health services and your hospital. Supported by the community and voluntary sector. You will have access to a shared care plan so you and everyone around you know about your care and support. Access services through a local referral unit with access to crisis teams and rapid response . By 2016: Hospitals without walls. One team, one estate working towards one budget. The continued focus on enablement, admission avoidance and crisis intervention.
  • 28. New Model of Delivery Primary Prevention Acute Care IntegratedDischargeTeam IntegratedPrimaryCareTeam Telehealth/ Care/ Medicine Shared care plans Psychological Liaison Discharge Nurses Case Management Discharge Planning Teams Pharmacy Specialist Services for example Diabetologist & Respiratory Consultant Impact/RR Falls OT/ Physio Specialist Nurses Geriatricians Mental Health Enablement Twilight Ambulance 10K Population GP District Nurses 30K Population Dementia Adult Mental Health Health Visiting Case Management Community Pharmacy Single Point of Access LRU + LRMS
  • 29. Measuring Success Patient outcome and experience measures (national voices I statements) Whole system impact reduction in emergency admissions and social care placements Financial sustainability Individual project performance indicators New integrated models of commissioning and procurement.
  • 30. Any Questions?
  • 31. Telehealth and Telecare: Integrated Delivery In Scotland 17 June 2014 Alistair Hodgson 34 JIT is a strategic improvement partnership between the Scottish Government, NHS Scotland, CoSLA, the Third Sector, the Independent Sector and the Housing Sector
  • 32. Overview of Presentation Set out the Scottish Context some facts and figures Provide some background context to the Telecare Development Programme Describe the current Policy Drivers and ambitions for Scotlands health and care services
  • 33. The JIT and SCTT: An Effective Collaboration The Joint Improvement Team (JIT) is a unique strategic improvement partnership between the Scottish Government, NHS Scotland, Convention of Scottish Local Authorities, the Third Sector, the Independent Sector and the Housing Sector The Scottish Centre for Telehealth & Telecare (SCTT) was established to support and guide the development of telehealth and telecare throughout Scotland.
  • 34. 37 > Telehealth - provision of health services at a distance using a range of digital and mobile technologies. This includes the capture and relay of physiological measurements from the home/community for clinical review and early intervention and teleconsultations where technology such as email, telephone, telemetry, video conferencing, digital imaging, web and digital television are used to support consultations between professional to professional, clinicians and patients, or between groups of clinicians. > Telecare is the provision of care services at a distance using a range of analogue, digital and mobile technologies. These range from simple personal alarms, devices and sensors in the home, through to more complex technologies such as those which monitor daily activity patterns, home care activity, enable safer walking in the community for people with cognitive impairments/physical frailties, detect falls and epilepsy seizures, facilitate medication prompting, and provide enhanced environmental safety. > Telehealthcare is used as an overarching term to describe both telehealth and telecare together.
  • 35. Facts and Figures Population: 5.3 million and projected to rise to 5.8 million in next 20 years The 2011 Census was the first time that the number of people aged over 65 years was greater than the number aged 15 and under. Between 2012 and 2037, the number of people over state pension age is projected to increase by 27 per cent. Over next 20 years number of people over 75 will increase by 60%. More people living with complex long term conditions. Numbers of people with dementia will double by 2035. A girl born today has a one in three chance of reaching 100 and boys have a one in four chance Scotland getting healthier but gap widening between better well off and less well off
  • 36. 50 100 150 200 250 300 2012 2017 2022 2027 2031 2037 Indexedpopulationchange(2012=100) Scotland's projected population by age group: 2012-2037 (indexed to 2012) 85+ 75-84 65-74 0-14 15-34 35-54 55-64 Source: General Register Office Scotland; chart by Peter Knight JIT
  • 37. Long Term Conditions Ageing population Health Inequalities Workforce Challenges Affordability Sustainability System Drivers
  • 38. Overall aim of Telecare Development Programme. To help more people to live at home for longer, with safety, security, and quality, through the use of Telecare equipment
  • 39. Scottish Governments Strategic Objectives - 2007 Wealthier & Fairer Healthier Safer & Stronger Smarter Greener Increase wealth, fair shares Sustain and improve especially disadvantaged communities, local and faster access Local communities; strong, safer and better Expand opportunities Improve natural and built environmental and sustainable use
  • 40. Joining it all together Phase 1 (2006-9): Raise awareness/develop local & national expertise Phase 2 (2010-12): Joint strategic drive, strengthen underpinning infrastructure & expand/integrate national programmes (90% roll- out/10% innovation) = Robust Platform Phase 3 (2013-15): Health & Social Care integration. Increase scale of development to inform national expansion. Increase innovation/data integration & analysis. 10m Scottish Assisted Living Demonstrator announced March 2011. Expansion Innovation
  • 41. Policy Context - 2014
  • 42. Health and Social Care provision 32 Local Authorities , social care, education, housing, transport etc. 14 NHS Boards acute, hospital, community, primary care And by April 2015 32 New Health and Social Care Partnerships for social care , community, primary care and some hospital services NHS Boards and Local Authorities still providing range of services
  • 43. National Policy Drivers Overarching strategic objectives: wealthier & fairer, healthier, smarter, safer & stronger and greener (see www.scotlandperforms.com) Public Service Reform Public Bodies (Joint Working) (Scotland ) Bill 2013 Reshaping Care for Older People National Telehealth and Telecare Delivery Plan for Scotland to 2015
  • 44. A Scottish Approach to Public Service Reform: Ambitions a decisive shift towards prevention: we must prioritise expenditure on public services which prevent negative outcome and preventing problems arising or dealing with them early on. greater integration of public services at a local level driven by better partnership, collaboration and effective local delivery bringing public, third and private sector partners together with communities to integrate service provision deliver shared outcomes that really matter to people. greater investment in the people who deliver services through enhanced workforce development and effective leadership a sharp focus on improving performance, through greater transparency, innovation and use of digital technology.
  • 45. Setting the Context for Health & Care in Scotland The Quality Strategy Safe - There will be no avoidable injury or harm to people from healthcare they receive, and an appropriate, clean and safe environment will be provided for the delivery of healthcare services at all times. Person-Centred - Mutually beneficial partnerships between patients, their families and those delivering healthcare services which respect individual needs and values and which demonstrates compassion, continuity, clear communication and shared decision-making. Effective - The most appropriate treatments, interventions, support and services will be provided at the right time to everyone who will benefit, and wasteful or harmful variation will be eradicated.
  • 46. And our 2020 Vision By 2020 everyone is able to live longer healthier lives at home, or in a homely setting and, that we will have a healthcare system where: We have integrated health and social care There is a focus on prevention, anticipation and supported self- management Hospital treatment is required, and cannot be provided in a community setting, day case treatment will be the norm Whatever the setting, care will be provided to the highest standards of quality and safety, with the person at the centre of all decisions There will be a focus on ensuring that people get back into their home or community environment as soon as appropriate, with minimal risk of re- admission
  • 47. The Public Bodies (Joint working) (Scotland) Bill (2013) Improve the wellbeing of recipients.... Is integrated from the point of view of recipients Takes account of the particular needs of different recipients Takes account of particular needs of recipients in different parts of the areas in which the services is being provided Is planned and is led locally in a way which is engaged with the community and local professionals Best anticipates needs and prevents them arising, and Makes the best use of the available facilities, people and other resources
  • 48. Reshaping Care: A Programme for Change 2011-2021 Integration in Action 10 year whole system transformation programme that seeks not only to shift the location of care (from institution to community) but also to transform the culture and philosophy of care from reactive services provided to people towards preventative, anticipatory and coordinated care and support at home delivered with people 300 million Change Fund 2011/12 2014/15 120 million Integrated Care Fund for 2015
  • 49. 0 50000 100000 150000 200000 250000 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 NofAdmissionsperyear Emergency Admissions in Scotland 65+ Real data 65+ Prediction if solely due to demographic change. Based on changes from 2007/08 demographic 75+ Real data 75+ Prediction if solely due to demographic change. Based on changes from 2007/08 demographic
  • 50. Trend in emergency admissions (Index) by length of stay (LOS), aged 75+ 90.0 100.0 110.0 120.0 130.0 140.0 150.0 160.0 2005/6 2006/7 2007/8 2008/9 2009/10 2010/11 Index(yeMarch06=100) 0 days 1 day 2 days or more All LOS Source data ISD Chart PK JIT
  • 51. Local Authority Commissioned Services: Telecare and Home Care
  • 52. 58 December 2012: National Delivery Plan Significant role of Telehealth and Telecare in the reform of health, care, housing and wellbeing in Scotland
  • 53. 59 4 Objectives > Telehealth and telecare will enable choice and control in health, care and wellbeing services for an additional 300,000 people > People who use our health and care services, and the staff working within them, will proactively demand the use of Telehealth and Telecare as positive options > There is a flourishing Innovation Centre where academics, care professionals, service providers and industry innovate to meet future challenges and provide benefits for Scotlands health, wellbeing and wealth. > Scotland has an international reputation as a centre for the research, development, prototyping and delivering of innovative Telehealth and Telecare services and products at scale.
  • 54. 60 Example Telecare for People with Dementia: Evaluation of Renfrewshire Project Renfrewshire Councils Telecare Service has data on 325 people with dementia using telecare to enable them to stay safely at home. Most relevant are door contacts and Responder Service. Provide evidence on cost-effectiveness of using telecare in people with dementia. Quantitative using assessed savings from avoided admissions. Qualitative from interviews
  • 55. Findings From 2007 to 2012, avoided 114 hospital (35% of 325) and 88 care home admissions (27% of 325) Mean length of stay: 19.5 days in hospital and 606 days in a care home Mean cost: 336 per hospital day (or 6,522 per admission), 577 per week in a care home (49,998 per admission) Annual cost of telecare less user fee: 1,330 Annual cost of social care for clients: 12,570 Net savings: 2.8 million over 5 years (about 8,650 per client) 61
  • 56. Findings Safe for users and staff Effective equipment and Responder service Accessibility improve by earlier referral before dementia sever, better links to NHS (e.g. discharge planning) and housing providers Acceptability high for clients, carers, families and police Satisfaction rated by users and carers as very or satisfied High quality cost-effective telecare service for people with dementia 62
  • 57. Key Messages Shared learning is vital Telehealthcare Learning Network Political support plays a big part Continuity of policy shared ambitions across portfolios Recognition of local priority national government can set the ambition, but local areas drive change However, must continually support and challenge Dialogue must be encouraged and maintained; delivery cannot exist in isolation from policy See slide from 2011!
  • 58. What have we learnt? This is about complex change management and takes time, effort & resources Technology can play a significant part in remodelling our health & care services Incremental implementation establish key priorities, have robust monitoring in place and review as progress It can be hugely personalised and empowering for the service user and their carer, but it is not suitable for everyone Needs effective leadership nationally & locally - champions Build on what you have and keep going!
  • 59. For more info: @jitscotland and @SCTT_NHS_24 www.jitscotland.org.uk and www.sctt.nhs.scot.uk www.livingitup.org.uk [email protected]
  • 60. CASA Seminar - Flanders 17 June 2014 Scaling-up? From pilot to routine care 68
  • 61. Scaling up innovation in healthcare Marc Lange, EHTEL Secretary General CASA Seminar - Flanders 17 June 2014
  • 62. Competence Centre Health Care Authorities Industry Health Care Delivery Citizens/Patient Representative Innovation Agency Insurers Social Care Dissemination Organisation European Health TELematics A cross-(any)border and multidisciplinary collaboration forum CASA Seminar - Flanders 17 June 2014 Sustainable and large scale eHealth deployment requires engagement and synergies 70
  • 63. Innovation in healthcare: CASA Seminar - Flanders 17 June 2014 71 Patients home Hospital or primary care or eHealth centre SERVER PATIENT REGIONAL CENTRES OPERATOR TELEMONITORING DEVICES GENERAL PRACTITIONER CARDIOLOGIST AT HOSPITAL OR LOCAL HEALTH DISTRICT OTHER INVOLVED HEALTHCARE PROFESSIONALS GATEWAY & APP
  • 64. eHealth actions in DAE KA 13 Undertake pilot actions to equip Europeans with secure online access to their medical health data by 2015 and to achieve by 2020 widespread deployment of telemedicine services; EMPOWERING 17 June 2014 CASA Seminar - Flanders 72
  • 65. European Innovation Partnership on Active & Healthy Ageing health & quality of life of European citizens growth & expansion of EU industry sustainabl e& efficient care systems +2 HLY by 2020 Triple win for Europe Improving prescriptions and adherence to treatment Better management of health: preventing falls Preventing functional decline & frailty Integrated care for chronic conditions, inc. telecare ICT solutions for independent living & active ageing Age-friendly cities and environments Specific Actions crosscutting, connecting & engaging stakeholders across sectors, from private & public sector Pillar I Preventio n screening early diagnosis Pillar II Care & cure Pillar III Independe nt living & active ageing 17 June 2014 CASA Seminar - Flanders 73
  • 66. Identify the problem Recognize the need for change Explore Search for a solution Build Create, test and assess potential impact Apply, scale-up and monitor Real-life solution CASA Seminar - Flanders 17 June 2014 74 Innovation and Service Redesign
  • 67. Testing of Service Routine Care Service Small Scale Deployment Large Scale Deployment Hospital Group Department Department HealthCare System Piloted Service Lessons learned from deployment inside an organisation Local champions Limited constraints (e.g. at legal level) Cost and benefit analysis Lessons learned from deployment across organisations (for servicing the healthcare system) Institutional endorsement Legal constraints (if it is a D2P relationship) Need for robust methods Socio-economic analysis From pilot to routine care 17 June 2014CASA Seminar - Flanders 75
  • 68. Tools and methods are needed to deploy telehealth services Impact assessment framework The results and lessons learned from Renewing Health The approach of United4Health Guidelines for large-scale deployment The Momentum blueprint Cost and benefit analysis toolkit Innovation governance 17 June 2014CASA Seminar - Flanders 76
  • 69. 17 June 2014 A European Telemedicine Deployment Blueprint CASA Seminar - Flanders 77
  • 70. Strategy & Management Legal, Regulatory & Security Organisation & Change Mgmt. Technical & Market relations Four domains for deployment guidelines 17 June 2014CASA Seminar - Flanders 78
  • 71. Critical Success Factors for Deployment Strategy CASA Seminar - Flanders 17 June 2014 1. Check that there is cultural readiness towards telemedicine and the need to change the way to care. 2. Ensure leadership through a champion. 3. Create a community consensus on the compelling need to address 4. Put together the resources needed for deployment. Strategy & Management Legal, Regulatory & Security Organisation & Change Mgmt. Technical & Market relations 79
  • 72. Critical Success Factors for Organisational Change CASA Seminar - Flanders 17 June 2014 5. Address the needs of the primary client(s). 6. Involve health care professionals and decision- makers. 7. Prepare and implement a financial plan. 8. Prepare and implement a change management plan. 9. Put the patient at the centre of the service. Strategy & Management Legal, Regulatory & Security Organisation & Change Mgmt. Technical & Market relations 80
  • 73. Strategy & Management Legal, Regulatory & Security Organisation & Change Mgmt. Technical & Market relations Critical Success Factors for Legal, Regulatory and Security Compliance CASA Seminar - Flanders 17 June 2014 10. Establish the conditions under which the service is legal. 11. Seek for advice from legal, ethical, privacy and security experts. 12. Seek for relevant legal and security operational guidelines to help setting the service up 13. Ensure that telemedicine doers and users have privacy awareness. 81
  • 74. Strategy & Management Legal, Regulatory & Security Organisation & Change Mgmt. Technical & Market relations Critical Success Factors for Technology Decisions and Procurement CASA Seminar - Flanders 17 June 2014 14. Ensure that the IT and eHealth infrastructures needed are in place. 15. Ensure that the technology is user-friendly. 16. Put in place the technology and processes required to monitor the service. 17. Maintain good procurement practices. 18. Guarantee that the technology has the potential for scale-up (i.e., think big). 82
  • 75. The challenge for scaling-up innovative services in healthcare This is about moving From building tools and infrastructure to developing service, redesigning care pathways From collecting data to integrating data into care processes New Technology + Old System = New Old System CASA Seminar - Flanders 17 June 2014 83
  • 76. Any questions? More at www.telemedicine-momentum.eu CASA Seminar - Flanders 17 June 2014 84 Marc Lange Secretary general EHTEL Association 49/51, rue de Trves B-1040 Brussels Belgium Tel: +32 (0)2 230 15 34 Fax: +32 (0)2 230 84 40 Mobile: +32 (0)475 27 71 45 [email protected] www.ehtel.eu
  • 77. TELEMONITORING & NIHDI ALPHONSE THIJS ( NATIONAL INSTITUTE FOR HEALTH AND DISABILITY INSURANCE)
  • 78. HISTORY 31th July 2009: call-up for telemonitoring projects via website www.riziv.be Budget: 500.000,00 Results: 22 proposals - 6 approved by the jury - 16 not approved by the jury
  • 79. NOT APPROVED BY THE JURY Diabetes Multiple Sclerosis Chronical obesity Blood preassure Heart failure
  • 80. APPROVED BY THE JURY Service Cardiologie Clinique Saint Jean de Bruxelles: Heart Failure OLV-Ziekenhuis Cardiovasculair Centrum - Aalst: Telemonitoring of NYHA III-IV: patients with heart failures Virga Jesse Ziekenhuis Hasselt (AZ Groeninge Kortrijk): Heart failure Wit-Gele Kruis Oost-Vlaanderen: bloodpressure measuring by telemonitoring off high-risk patients with hypertension Asbl PSD (Permanence soins domicile) Bouge + Le Service Aide et Soins domicile Namur Asbl: dementia CHU Sart-Tilman Lige UZ Brussel: COPD - BPCO
  • 81. ROLL OUT PROJECT Signature of the convention Realization project Follow up meetings as mentioned in the convention+ annual reporting: factual situation Closure: final report ( June 2013 December 2013)
  • 82. CONCLUSIONS need for more research : According to EBM-guidelines According to (legal) regulations Renumerations How to implement Privacy-reglementations Organisation Communication/information Telephone, .. Tele-conferences ? ?
  • 83. QUESTIONS? Thank you!
  • 84. Prof. Dr. Paul Dendale [email protected]
  • 85. Telemonitoring : personal experience The past: Tema HF 1 Dendale et al. Eur J Heart Fail. 2012 Mar;14(3):333-40
  • 86. Telemonitoring in heart failure The present : Tema HF 2
  • 87. Telemonitoring in heart failure The future: Incorporation of smart algorithms (Censtat) Health economic analysis (RIZIV)
  • 88. Telerehabilitation in heart disease The past: TeleRehab 1 I Frederix et al. J Telemed Telecare. 2011;17(5):231-4
  • 89. Telerehabilitation The present: TeleRehab 2 Frederix et al :Eur J Prev Cardiol 2013
  • 90. Telerehabilitation The near future: TeleRehab 3
  • 91. Telerehabilitation 2015 (?): MobileHeart EU funded (?) International Multidisciplinary State of the art
  • 92. Incasa : integrated care to stimulate adherence
  • 93. INCASA Online platform Integrated Care to Stimulate Adherence Patient Hospital GP Medication Vaccination Intake Informed consent
  • 94. Point of care testing Bloodpressure Weight BMI HbA1c Lipids Questionnaires Connection to eHealth box and Vitalink Health management Education Supportive actions Promotional messaging Tailored screens Connection towards online patient platform Encrypted data storage (intra muros)
  • 95. Barriers to implementation - Low quality of providers - Lack of business case for service providers - Lack of reimbursement - Patient and GP acceptance - Liability, confidentiality Totally new health care organisation and financing
  • 96. -Patient empowerment/increased self care -Tsunami of data -Integration in Electronic Patient Files -Constantly changing technology -Elderly population -Hospital-centric or patient-centric (or GP-centric)? -Multimorbidity
  • 97. Questions ? [email protected]
  • 98. Restart meeting at 15h45
  • 99. Reflectie en interactie Doel: Ideen genereren over toekomst zorg op afstand Wat leeft er in Vlaanderen? Beleid afstemmen? Uitkomst: Regional Implementation Plan voor CASA Vlaams overheid Relevante ideen laten doorstromen naar federale collegas
  • 100. Opdracht 1 Goede ervaringen met zorg op afstand: Vertel elkaar een verhaal over zorg op afstand Eigen ervaringen Inspiratie uit de voorbeelden Gedeelde elementen noteren op flipover Tijd: 30 minuten
  • 101. Opdracht 2 Zorg op afstand in de toekomst Dromen over een ideale wereld waarin zorg op afstand de standaard is. Er is geen fout antwoord. Twee groepen: telecare en telehealth (zie definities) Zoek de gedeelde elementen. Noteer de 5 belangrijkste elementen op 1 blad Tijd: 40 minuten
  • 102. Opdracht 3 Prioriteiten kiezen (20 minuten): 5 belangrijkste elementen voorstellen en blad ophangen 3 elementen kiezen die voor jou prioritair zijn: stickers
  • 103. Bedankt Thank you
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CASA Regions for Smart Living Local Dissemination Event – Flanders Fabian Dominguez Lead Partner 17th June 2014, Brussels
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