EPITAL Keynote presentation by Søren Vingtoft at Health 2.0 CPH (February 6)
www.epital.org“Moving Health Care to Your Fingertip”Introduction to the EpitalKlaus Phanareth – MD, PHD, President – Danish Society for Clinical Telemedicine
The Health Care Sector A burning platformBoom of chronic conditions Ageing population(>70% of budget) Demografic bomb “The Silver Tsunami” Increase of demand Globalisation •Fewer resources •Increased competition •Decreasing workforce •Migration of services Evermore expensive forms of treatment • Increase in supply Popular demand: •Continuity •Availability •Dignity Stagnated culture •Quality Unchanged > 50 years
Lost in the Bermuda triangle 3 sectors, multiple legislations, 3 systems of reimbursement, 3 cultures GP Hospital Healthcare center Hospital Nursing home/ municipal healthcareHospital The helpless patient with a chronic condition Transformation af sundhedsydelser
Citizen centered health care system Nursing home/ Health care center municipal healthcareHospital Social services The empowered citisen with chronic condition Pharmacy GP
What is Epital Health?A research-based re-design of the healthcaresector, based upon:• empowerment• service transformation• coordination• telehealth and telecare• common senseEvolution – not revolution www.president.ee/images/stories/pdf/ehtf-report2012.pdf
Health service transformationHealthcare sector – 2012 The Epitalpatient citizendiagnose clinical pathwayfragmented coherent and coordinateddisease conditionplan responsibility empowermenttreatment service/prophylaxis/procrastinationadmitted outmitted”scheduled” ”on demand“ (available)segmented inclusive – sector neutralcentralized close to citizen
A research-based re-design of thehealthcare sector, based upon:• empowerment• service transformation• coordination• telehealth and telecare• common sense
Empowerment is…To enable people to act on their own, andthereby gain control over their lives..……especially control over the critical andcrucial factors that keep people stuck inoppression or powerlessness, where they haveno control
Organisation and services Citizen’s epital EPITALMobile unit EPITAL Health CoachHome calls Epi-callcenter EPITALSystem installation and -supportServices EPITALBlood samplingOn-site diagnostics and treatment Coordination of clinical pathways Emergency calls Outmitting Second opinion Population monitoringHospital Municipality Empowerment General Practitioner EPITAL EPITAL EPITAL EPITALDiagnostics Nursing Communities DiagnosticsInitiating treatment Rehabilitation (COPD level 2+3) Education Initiating treatmentOutpatient visits Nursing efforts Lifestyle changes Outpatient visitsRehabilitation (COPD level 3) Citizen services
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 issues1. Creating sufficient knowledge and technical competence in the front-personal2. 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 municipality1. 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 effort3. Discus partnerships with neighboring municipalities.