Dr. Jordi Martínez, ICT Strategy in the Catalan Health Care and Social Care System

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The Journey from a Chronic Care Program toward an Integrated Health and Social Care Model

The Journey from a Chronic Care Program toward an Integrated Health and Social Care Model

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  • 1. ICT Strategy in The Catalan HealthCareand SocialCare System ICT Services
  • 2. Table of contents TicSalut Foundation Catalan Healthcare System Electronic Health Record in Primary Healthcare iSIS.Cat. Integration Health and Social Care 1 2 3 4
  • 3. TicSalut: Technology, Innovation & Health Founded in 2006, TicSalut Foundation is an agency within the Ministry of Health that works to promote the development and use of ICT in the health and social care domain, acts as a trends, innovations and emerging initiatives observatory, and provides services for the standardisation and accreditation of products.
  • 4. The Catalan Healthcare System Health Plan
  • 5. Current System The Catalan healthcare model is a multi- provider one integrated in a unique public network. It enhances the autonomous management of each provider. Providers are free to select their information systems; however 85% of the primary care centers have the same system (eCAP) Interoperability among systems must be guaranteed. Decentralized System
  • 6. Catalan Healthcare System Insurance Services USER CATALAN HEALTHCARE SERVICE CONTRACTED PROVIDERS 100% DEPARTMENT OF HEALTH: Draws up Health Plan and Transfers economic resources Plans Governance  The history of the Catalan healthcare system, made it highly fragmented at a healthcare supply level:  Around 80% of the specialized care and around the 20% of the primary care is provided by suppliers not belonging to the Department of Health  Inexistent common Information System for all the healthcare suppliers due to the healthcare system diversification ICT’s Strategic component of the Healthcare System 20% Supplementary Private Insurers CATALAN INSTITUTE OF HEALTH Private Centres 20% 70% 10%
  • 7. Goals and health programs Chronic care patients orientation Integrated care system Quality and equitry in tertiary care Focused in patients and families Outcome-based commissioning Clinical and professional knowledge management System governance and participation Shared information, transparency and evaluation eHealth Plan Citizen centered healthcare HEALTH PLAN
  • 8. 97% Hospitals 98% Primary Care 82% Long-term care 67% Mental health Catalonia Spain USA 27 hospitals 6 EMRAM 2013 Current Situation. Some Figures
  • 9. VIDEO
  • 10. 1.8m docs/month 23% Current model 121.390 access/month 64% New model BPM Rules CDSS IS Web services Care processes Health intelligence Messaging platform BI/visor Future model: ISISS.cat Health and social integration Healthcare processes integration Integration Health Data
  • 11. The Shared Medical Record – Look & Feel
  • 12. Adding Value through ICT: From documents to cooperation  Adds “value” to professionals  Enables continuity of care Sharing Documents Images Publishing  Professionals share knowledge  Serving continuity of care Exchanging Information ePrescripcion  Clinical practice is connected with ALL the agents demanding a change in behaviour  Increase of quality of care Collaborative Model eHealth
  • 13. Folder Information Digital certificate Documents Channel Communication Robust password Services CITIZENS ACCES TO DATA
  • 14. Home Diagnosis ePrescription Vaccination Connect My controlsReports Search by: - Report type - Date - Center Report search results: - Date - Report type - Diagnostic - Service - Health Center PHC: Clinical reports
  • 15. Active health problem Non active health problem Home Diagnosis ePrescription Vaccination Connect My controlsReports PHC: Diagnosis control
  • 16. Online: always updated Printable PHC: ePrescription – Available and printable medication and chronic treatment Home Diagnosis ePrescription Vaccination Connect My controlsReports
  • 17. Reported from provider center Reported from vaccination book Reported verbally from patient Duplicated PHC: Vaccination – Reports vaccines supplied Home Diagnosis ePrescription Vaccination Connect My controlsReports
  • 18. o Blood donors o Public procedures desk o Other reference health centers PHC: Connect Home Diagnosis ePrescription Vaccination Connect My controlsReports
  • 19. Telemonitoring - Controlling of diabetic disease - Preventive medicine (SISO) PHC: My controls Home Diagnosis ePrescription Vaccination Connect My controlsReports
  • 20. Health care environment Budget reduction + Increase chronicity Guarantee the quality of the service + = Challenge: manage efficiently the resources assigned to chronic patients Information TechnologiesProcess & OrganizationCurrent environment • Systems oriented to the medical act. • Low personalization of complex cases • Low consensus level of agreement in the patient treatment • High traditional units activity: A&E • Reactive system • Difficulties for the treatment adherence • Low integration with palliatives units • No patient centric vision • Systems oriented to treat the pathology not the patient (clinical pathways, processes…) • No case management role extended • No transversal care plan treatment • Low culture of homecare • Low telemedicine processes • No alternative units for A&E treatments. • No integration with social services • No integration with intermediate care attention • Systems with low level of integration • No 360º vision of patient • No proactive systems for given support to the professionals. • No clinical pathways implemented in all healthcare levels (partial implementation). • Difficulties to measure the KPIs • No mobiles development solutions
  • 21. i-SISS.Cat Strategic plan for the implementation and deployment of the platform for the management of healthcare and social Processes in Catalonia
  • 22. BENEFITS Gestiódel coneixement Modelsde predicció Anàlisi impacte pacient Mesurade resultatsen termesde salut Analítica Avançada Model de Interoperabilitat i regles de negoci Model de gestió de processos clínics integrats Gestióde processos Guies clíniques Monitorització del servei Gestió d’acords de servei Integració Publicació catàleg de serveisd’informació pacient Missatgeria entre proveïdors Estàndards del sector i de país (HL7, WIFIS) Gestióde regles Ruta al territori Events del pacient Protocols Govern Visió programes Gestió oferta –demanda Control econòmic/consum Professionals Visió 360 Gestió del procés Entorn de col·laboració / educació Alarmes Pacients– Canal de Salut Interacció amb el sistema sanitari Educació Pacient expert Gestiód’informació HCE Continguts iSALUT Motortràmits Access informació clínicapersonal Accésa apps. Telemonitoritza ció Modelde col·laborac ió amb el ciutadà - Canalde Salut AQuAS- VISC • Distributionand source of informationwith different level of detail • Evaluationof care processes • PredictionModel • Internationalprojects.Pilots Citizen • Proactivity • Non-face-careModel • CPS – follow-upof the process • Co-responsability • APPs • Personalizedmedicine Department • Comply with the objectivesof the health care plan • Gettinghealth policies to citizens • Integrationwith other departments Professionals • Continuumof care • Vision and process monitoring • mhealth • Collaborativemodel • Proactiveand predictive medicine Supplier • Integrationsinto their systems of information • Common Model • Processmanagement • Interconsultes • Definitionof rules of derivation – supply & emand control systems for clinical decision support • Facilitatethe adaptiation to the new billing models among other introduceds DGORS • Integrationwith the history of the Center • Accreditations.Quality managementof the Center • Patientcollaborative environments CatSalut • Model Government • Common Model Standardization • Informationon line • Monitoringof regional healthcare processes • Proactivity.Have data, don’t ask for them • Demand control • Adjustmentof payment models • Proforma Invoice: identificationof clinical processes • Integrationwith 061CatSalut Respon Public Health • Suitabilityof prevention programmes • Integrationwith SSII asistencials • Prescribehealth tips • Library of Consells de Salut and mobility • Integrlvision of citizen information • Epidemicpredictive models DG Planning • Decisionson-line • Design stage based on activity • Alliance Planning • Trainingmaterial linked with clinical processes • Telemedicineand telemonitoring • PPAC and Pacient Expert
  • 23. Governance of the program Holistic view of the patient Integral vision of healthcare processes Integral vision of the citizen Government programs: Summary of Processes Governance i-SISS.Cat •Creation of programs and tracking key performance indicators (KPIs). •Allocation of KPIs for each program. •Display of results for program and service provider. 360 °view of the patient: • Access to the broad view of the patient and the process (the supplier can decide to use this functionality or not). • Environments of collaboration between professionals. Healthcare process integration: • Social and health-related information sharing of the patient by the definition of integral processes. • Unique file generation and healthcare. Integral vision of the citizen: • Platform that will allow us to expand the coverage to other social benefits and giving coverage to the unique social, labour and health record.
  • 24. 360 °view of the patient: • Access to the broad view of the patient and the process (the supplier can decide to use this functionality or not). • Environments of collaboration between professionals. Integració procés sociosanitari: • 306º view of the patient. • collaborative environment of professionals.
  • 25. • Management the different clinical processes included in the Healthcare Plan • Govern the health model in terms of efficiency and direct towards processes • Facilitate the adoption of new models for health care providers billing • Fit the new models of purchase without adding complexity to the supplier • Self-management. Customized of the clinic processes to the reality of each of the territories and suppliers.. • Integrate suppliers at different levels: processes, information and management tool at the discretion of the level of evolution that they have their systems of information • Make interoperability between different providers, unifying the model of integration and sharing of information • Measure the relevant indicators established within the Health Plan • Co-responsible for the patient in the management of their health and the health system itself The solution i-SISS.Cat should allow
  • 26. Thank you Jordi Martínez Chief Innovation Officer, TicSalut Foundation