Implications of Mobile Technology in Facilitating Integrated Care
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Implications of Mobile Technology in Facilitating Integrated Care

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Implications of Mobile Technology in Facilitating Integrated Care

Implications of Mobile Technology in Facilitating Integrated Care

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  • 1. Professional Educational Programme 2011
    The implications of mobile technology in facilitating Integrated CareAlbert AlonsoInformation Systems Directorate
  • 2. Defining integrated care
    “[Integrated care] is a concept bringing together inputs, delivery, management and organisation of services related to diagnosis, treatment, care, rehabilitation and health promotion.”
    (Grone & Garcia-Barbero: 2001)
    “[Integrated care] is a coherent set of methods and models on the funding, administrative, organisational, service delivery and clinical levels designed to create connectivity, alignment and collaboration within and between the cure and care sectors.”
    (Kodner & Spreeuwenberg: 2002)
  • 3. Why we need integrated care?
    Because of our failings in current health and social care systems:
    Addressing the changing demand for care
    Poor efficiency fragmented approaches (disease versus patient)
    Improving the quality and continuity of care
    Recognising that health and social care outcomes are interdependent
    Exclusion of vulnerable groups
    (Wait, European Social Network Conference, Edinburgh 2005)
  • 4. Innovative care for chronic conditions
    Innovative care for chronic conditions: building blocks for actions: global report. Epping-Jordan J, editor. 2002. Geneva, Switzerland : Non-communicable Diseases and Mental Health, World Health Organization.
  • 5. Service model
    Normalisation
    Redefinition of roles
    Allocation of resources
    Integrated care (80%)
    Traditional care (20%)
    Adapted from Berg M et al. Health Information Management. Integrating information technology in health care work. Routledge 2004.
  • 6. Service model
    Normalisation
    Redefinition of roles
    Allocation of resources
    ICT
    Integrated care (80%)
    Traditional care (20%)
    Adapted from Berg M et al. Health Information Management. Integrating information technology in health care work. Routledge 2004.
  • 7. Redefining roles across the system
  • 8. Platform and functionalities
  • 9. Makingitwork
  • 10. Exacerbated
    COPD patients (222)
    Home Hospitalisation (121)
    Control group (101)
    ER Intervention
    Discharge
    Discharge
    Home Intervention < 24h
    Accessibility
    Visit Outpatient clinic 8 wk after discharge
    Home hospitalisationprogramme
  • 11. Home hospitalisation programme
    28% Control group
    Readmission
    20% Intervention group
    22%
    Emergency room
    visits
    10% **
    - 2.4
     SGRQ Total
    - 6.9 **
    2033€
    Savings
    1255€**
  • 12. Home hospitalisation programme
  • 13. Home hospitalisation programme
  • 14. Home hospitalisation programme
  • 15. Prevention of exacerbationsprogramme
  • 16. Prevention of readmissions programme
  • 17. A new standard?
  • 18. A new standard?
    Yes!
    “...An integrated care pathway with flexible shared-care arrangements between primary care and hospital, facilitated by information technologies, has an enormous potential to decrease hospital admissions in chronic obstructive pulmonary disease patients.”
  • 19. A new standard?
    But!
    “... In the integrated care approach, several models are available and we now require comparative studies.”
    “We must also be aware that from a healthcare provider perspective, further
    studies of this model must include cost-effectiveness as well as effectiveness in older disabled patients with chronic obstructive pulmonary disease”
  • 20. What had we learnt (2006)?
    There were better alternatives to the current approach of chronic patient management.
    These alternatives were safe, cheaper and generated better clinical outcomes and professional and patient satisfaction.
    Information technologies facilitated some of the aspects related to their implementation.
    Most of the difficulties concerned the organisation of care delivery and professionals.
    There was a need to change our viewpoint
  • 21. Changing the viewpoint
    Disease Management System
    Health Management System
    Citizen Management System
  • 22. Time scale for integrated care at HCB
    2000-03
    • Embryonic ICT platform
    • 23. Clinical validation of limited model
    2004-06
    • Conceptual SOA platform
    • 24. Market analysis / deployment strategy
    2007
    • Integrated Care Unit is created
    2008-12
    • Effective deployment: Facing co-morbidity, articulation health / social care. Sustainable business models.
    • 25. Reliability of ICT platform
    2010
    • Creation of the spin-off
    2010-13
    • Large scale-deployment / regional level
  • New environments for action
    Prevention
    Chronic diseases
    Dependency
  • 26. Integratedcare at HCB
    Approach by programmes:
    Set of normalised actions as well as evaluation tools that target precise service objectives.
    The programme is based on a process model but it is not the (entire) process.
    Programme “A”
    Programme “B”
    Programme “C”
    Patient
    Programme “D”
    Programme ......
  • 27. Integratedcare at HCB
    Work plan
    definition
    Normalisation of practices
    Reallocation of roles
    ICT application
    Case
    evaluation
    Follow-up
    & event handling
    Case
    identification
    Discharge
  • 28. Integratedcare at HCB
    Case
    evaluation
    Workplan
    definition
    Discharge
    Case
    identification
    Follow-up
    Event handling
  • 29. Identification
    Assessment
    Working Plan
    Follow-up
    Discharge
    Linkcare® Application
  • 30. Planner
    Pre-defined Template
    Personalized
    Linkcare® Application
  • 31. Service Library
    Available Templates
    Personalized
    Linkcare® Application
  • 32. Monitoring
    Education
    Linkcare® Application
  • 33. Profile Management
    Contact details
    Availability
    Language
    Agenda Management
    Collaborative Tools
    Call Centre
    Doc. Repository
    Patient’s interactions
    Voi- IP Phone
    Personalization
    Co-morbidities
    Service Optimization
    Linkcare® Application
  • 34. Linkcare® Application
  • 35. Enhances quality and provides support for interpretation of forced spirometry testing performed by non-specialized actors (Primary Care, Home, Pharmacies, Insurance companies, …)
    CSCW tools for remotesupport: e-SpiroQ
  • 36. Integratedcare at HCB
    Summary
    HCB’s integrated care programme is a powerful approach to meet the demand of a variety of health and social care needs
    The model and associated technology (Linkcare®) is proving to meet expectations from both patients and professional
    Advanced versions should cover:
    Implementing knowledge intelligent to assist patients and professionals in the optimisation of the mix of services
    Extension of services to cover other conditions and/or different stages of the conditions