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Healthcare delivery in the periphery workshop output

A tri-national (CH, D, F) group of healthcare and labor experts came together at the DayOne lab to brainstorm on common initiatives to tackle the challenges of Healthcare delivery in our region. Please find attached the output of our workshop here.

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Healthcare delivery in the periphery workshop output

  1. 1. Tri-national workshop 15 November 2019 Healthcare Delivery in the Periphery
  2. 2. Our workshop!
  3. 3. Participants Name First Institution Zeisberger Peter Regierungspräsidium Karlsruhe Friesecke Manuel Regio Basiliensis Clement Amélie Pôle Emploi Direction régionale Grand Est Meier Birgit Gesundheitsdepartement des Kantons Basel-Stadt Janiczek Renate Regierungspräsidium Karlsruhe Oppel Thomas Universitätsklinikum Freiburg Jouin Patrick Agence Régionale de Santé Durupt Cedric Agence Régionale de Santé Indra Peter Gesundheitsdepartement des Kantons Basel-Stadt Burg Florian Koordinierungsstelle Telemedizin Baden-Württemberg Primosig Andrea Amt für Gesundheit Kanton Basel-Landschaft Daunke Rouven Universitätsklinikum Freiburg Dussap Anne TRISAN Schaller Claude-Henri République et Canton du Jura, Service de l’économie et de l’emploi Donzé Florent République et Canton du Jura, Service de l’économie et de l’emploi Klöpper Christof Glauser Stefano Kumli Frank
  4. 4. Goal for the day Develop an agenda and concrete steps to collaboratively tackle the challenges and opportunities of Healthcare delivery in our region
  5. 5. Steps to reach our goals Agree on the main challenges and opportunities of Healthcare delivery in the periphery for our region I Identify those that should be tackled in a collaborative effortII Ideate initiatives that we could collaborative launch to do soIII Develop a plan drive these initiatives forwardIV Agree on immediate concrete next steps (and on resources and financing)V
  6. 6. Step I: Brainstorming on challenges and opportunities Patient • Sensibiliser les patients aux nouvelles possibilités de soin • Emergencies – urgences • Prévention – promotion de la santé • Pathologies chroniques • Mentalités • Peur de la tech • Zugang an Randzeiten • Personal Prevention • Distance géographique • Lange Wege • Quel accès • Proximité des soins • Ältere Menchen sind einer fragmentierter Versorgung ausgeliefert • Mobilität Attractivity • Zu wenig Fachkurse auf dem Land • Arbeitsattraktivitat ↓ • Attractivité • Attractivité des régions péréphériques • Reactive approach to healthcare • Diferent salairies across the border • Aussprache der Bevölkerung • Sicherstellung des Notfallversorgung • Mangel an Hausärzten /Betreungspersonen • Rendre attractif les métiers de la santé dans les périphéries • Landl. Versorgung • Hausarztpraxen • Drain to the center • Salaires Training • Utiliser les nouvelles technologies pour développer de nouveaux parcours de fornation et attirer nouveaux profils • Intégrer les évolutions tech dans la formation des soignants • Human resources training • Kooperationsbereitschaft • Chance –Arbeitsteilung • RH – GPMC • Cloisonnement • No cross-national Network harmonization • Corporatisme • Berufsbilding -> unterschiede • Sprache D/F/E • General Interest • Lack of required workforces Structure • Was ist Peripherie • Kostenstruktur unterschiedlich • Différents systèmes • Différentes pratiques complémentaires • Alles zentralisieren ist zu teuer • Hopspitalo-centrisme • Eine Region? Oder drei Regionen • Abrechnung mit den verschiedenen Kassen • Tarification • Nutzungsmöglichkeiten von gü Service • Ist peripher schlechter als Zentral? • Landesgrenzen als Hindernis • Tarification transfer • Reimbursement • Braucht es immer den Rolls Royce? • Connection Internet Solutions • Integrierte Versorgung • Daseinsvorsorge • Healthcare Promotion • AAL • P4P • Health data monitoring • Telemedizin • Möglichkeiten der Telemedizin • Suivi a distance • Digitalisation des soins de la santé • Integration Telemedizin in den G.-systeme? • Telemedizin • Fehlende Datenbanken • Wissens-management Barriers • Datenschutz • Legal Issues • IT standards lack of harmonization • Reception de la tech par les usagers
  7. 7. Step I: Structuring the challenges Patients Integrated Healthcare Delivery Supporting Technologies Attracting Physicians in the Periphery Adapting Training Curriculum Adapting Structures 1 2 3 4 5
  8. 8. Step I: Structuring the challenges Main challenges are the access to Integrated Care Delivery. Technologies such as telemedicine are expected to enable new delivery models. There is a drain of physicians to the center. Different salary structures, different languages, lack of training make the periphery less attractive. The curriculums and trainings are not adapted to the challenges. New curriculums (nurse practitioners, technologies etc) and innovative approaches would help. There are major systemic barriers between the healthcare systems in the three regions. It was agreed not no focus on these in this workshop. What we discussed!
  9. 9. Step II –V : Develop projects Selection criteria: • Concrete • Pragmatic • Technology-supported • First results in 6 months Challenges and Opportunities Our three projects Integrated Healthcare Delivery A platform to harness Hospital Innovation in the region Attracting Physicians in the Periphery New models for healthcare delivery in the periphery Adapting Training Curriculum An exchange between Nurses and Nurse-students and Technology players 1 2 3
  10. 10. A platform to harness Hospital Innovation in the region Integrated Healthcare Delivery What is it about? Hospital Innovation • Sharing innovation best practices between hospitals in the region • Exchange son what works and what doesn’t • Exchanging on methodologies ad frameworks to support innovation Adherence app • An application developed between hospitals as an initial test of collaboration • An application that supports patient adherence to medication • An application that allows the exchange of medication information with physicians and pharmacists across our borders Scope • Workshops and events to sharing innovation best practices and methods between hospitals in our region • Collaboratively develop an initial solution focused on adherence Why should it be tri-national • The three regions share the same bottlenecks as it related to innovation • An adherence app would support the management of medication information for patients traveling across our borders What are the bottlenecks? Hospital Innovation • Innovation is hospitals happens in siloes (also inside hospitals) • The ”wheel” is reinvented for each challenge Adherence app • Adherence the medication difficult especially for patients with poly –medication • Exchange of medication information is often lacking (at the pharmacy or at the doctor) and even more difficult across borders Team Birgit Meier, Renate Janiczek, Rouven Daunke, Florian Burg, Thomas Oppel, Frank Kumli Deliverables in the next 6 months • An initial workshop between hospital innovation teams in our region
  11. 11. New models for healthcare delivery in the periphery Attracting Physicians in the Periphery What is it about? • Provision of healthcare in the periphery is getting harder due to the difficulty to lure general practitioners into the regions • Financial incentives and new forms to work together (shared doctors' office) might have a positive impact but group agrees that these will not solve problem alone • That’s why also organizational (nurses taking over more tasks) and technological solutions would be needed Scope • Workshop for decision makers in healthcare provision at Oberrhein • Presentation of different technological solution (Medgate Miniclinics, Apps from Grand Est) Why should it be tri-national • Problem affects all parts of the Oberrhein • Problem is not connected to the border but every region has peripheral parts (Vosges, Schwarzwald, Jura) What are the bottlenecks? • No single easy solutions to the problem • No general understanding/information which technological solutions might alleviate the problem Team Anne Dusap, Manuel Friesecke, Andrea Primosig, Peter Zeisberger, Christof Klöpper Deliverables in the next 6 months Event workshop organized that bring together decision makers and suppliers of technology
  12. 12. An exchange between Nurses and Nurse-students and Technology players Adapting Training Curriculum What is it about? • Every Country and even Region has it’s own curriculums for healthcare professionals, therefore for also for nurses • To hire someone cross border is therefore still nearly impossible and makes it hard to satisfy the demand for HCP’s • Different skills and level of skills in different hospitals/clinics/POC makes it hard to unify a curriculum/diploma • Most of the times technologies are just shown top- down, but actual “users” are not getting asked Scope • The long-term scope is to unify / translate the individual skills of a HCP over all 3 borders • Secondly getting a glimpse and understanding of potential future technologies used in nursing, as well as already in use tech Why should it be tri-national • We’re a region with a lot of exchange and flow of people, therefore the country border should not be a career border • The workshop will also give the chance that all nursing schools in the region have the chance to do something together for a first approach to “unify” their curriculums • Unifying nursing technologies cross border can help to reduce shortages in HCP’s by solving issues in new ways What are the bottlenecks? • Complexity of the curriculums • 2 Level of translation needed : 1) Language 2) Skill • Different durations for training (f.e. F 2 years, DE 3 years) • Technology and Processes in Hospitals • Still language barrier => how to prove that someone is able to use the language correctly (no negative impact for patients) Team Clement Amélie, Join Patrick, Durupt Cedric, Schaller Claude-Henri, Stefano Glauser Deliverables in the next 6 months • An initial workshop between hospital innovation teams in our region where nursing professionals can get in touch with innovative nursing technologies
  13. 13. Next steps by Claude-Henri Schaller Report to the Plenary Session of the Conférence du Rhin supérieur / Oberrheinekonferenz on 22 November 2019 Transition lead to the future presidents of the working groups “economy and labour” and “health policies” Organization of a workshop at expert level during the first trimester 2020 in co-operation with Euro-Institut in Kehl and on a specific topic to be defined by the two working groups 1 2 3
  14. 14. An initiative managed by in close collaboration with the Canton of Basel-Stadt.