www.epital.org
Introduction to the Epital
“Moving Health Care to Your Fingertip”
Klaus Phanareth – MD, PHD, President – Danish Society for Clinical Telemedicine
Ageing population Demografic bomb
“The Silver Tsunami”
Boom of chronic conditions (>70% of budget)
Popular demand: •Continuity •Availability •Dignity •Quality
Increase of demand •Fewer resources •Decreasing workforce
Globalisation •Increased competition •Migration of services
Evermore expensive forms of treatment • Increase in supply
Stagnated culture Unchanged > 50 years
The Health Care Sector
A burning platform
Transformation af sundhedsydelser
Hospital
GP
Hospital
Hospital
Lost in the Bermuda triangle
Nursing home/ municipal healthcare
Healthcare center
The helpless patient with a chronic
condition
3 sectors, multiple legislations, 3 systems of reimbursement, 3 cultures
Citizen centered health care system
The empowered citisen with chronic condition
Health care center
Hospital
GP Pharmacy
Social services
Nursing home/ municipal healthcare
What is Epital Health?
Evolution – not revolution www.president.ee/images/stories/pdf/ehtf-report2012.pdf
A research-based re-design of the healthcare sector, based upon: • empowerment • service transformation • coordination • telehealth and telecare • common sense
Health service transformation
patient citizen diagnose clinical pathway fragmented coherent and coordinated disease condition plan responsibility empowerment treatment service/prophylaxis/procrastination admitted outmitted ”scheduled” ”on demand“ (available) segmented inclusive – sector neutral centralized close to citizen
Healthcare sector – 2012 The Epital
A research-based re-design of the healthcare sector, based upon: • empowerment • service transformation • coordination • telehealth and telecare • common sense
Empowerment is…
To enable people to act on their own, and thereby gain control over their lives.. ……especially control over the critical and crucial factors that keep people stuck in oppression or powerlessness, where they have no control
General Practitioner Municipality
Epi-callcenter
Citizen’s epital
Hospital Empowerment
Coordination of clinical pathways Emergency calls Outmitting Second opinion Population monitoring
Diagnostics Initiating treatment Outpatient visits Rehabilitation (COPD level 3)
Diagnostics Initiating treatment Outpatient visits
Nursing Rehabilitation (COPD level 2+3) Nursing efforts Citizen services
Mobile unit
Communities Education Lifestyle changes
Home calls System installation and -support Services Blood sampling On-site diagnostics and treatment
Organisation and services
EPITALEPITAL
EPITALEPITAL
EPITALEPITAL EPITALEPITAL EPITALEPITAL EPITALEPITAL
EPITALEPITAL
EPITALEPITAL
Health Coach
Empowerment services Condition monitor
Skype
Epi-plan
The Entry: Citizen - Epital
Lung monitor
Pulse-oximeter
Thermometer
Epitalet
Why are the municipality involved in the Epital?
1. History: Structural reform of local government i 2007 gives
direct financial responsibility of health cost in the hospitals => search for new ways to reduce the increasing cost to health services.
2. Windows of opportunity: Financial crisis and reduces local community budget calls for new ideas and new solutions => The idea of a project involving cross-sectorial cooperation and citizen empowerment (in combination) using new technology had a strong political impact.
The critical issues
1. Creating sufficient knowledge and technical competence in the front-personal
2. Establishing robust standard procedures that fit the tasks and objectives of the existing organization and “gives comfort” to the colleagues
3. Organizing the relevant services of the municipality so that the services can be directed to the citizens through the call-center.
Perspectives seen from the municipality
1. Extending the epital-concept to other citizen groups (other chronics, mentally ill citizens, socially vulnerable families)
2. Providing better and a higher quality health services to the citizens through a coherent and coordinated effort
3. Discus partnerships with neighboring municipalities.