The aim of this session is to introduce the audience to the Strategic Plan for IS and ICT that the Health Care Department of Catalonia’s has developed. It includes goals, strategies and actions for the incoming years regarding the use of ICT in the health care environment in Catalonia. The presentation will be structured in four parts CLICK The first part, probably known by some of those present here, but unmissable to mention, has the objective to present the situation of Catalonia and its health sector features
The Catalan Healthcare Model has some specific features because of its universal coverage. This coverage is mainly provided in public facilities, so citizens have free access to it and it is funded by taxes, or by co-payment of pharmaceutical products. These features shape a model with a very specific nature , in which sustainability and the funding system are currently under discussion. Because of its specific nature , the Catalan model requires adapted solutions that go through a highly technical and connected system. This guarantees the accessibility to the health care services by the citizen ( equity ), as well as the best professional clinical practices ( effectiveness ) and the global management of the services ( efficiency )
Catalonia is an autonomous community inside Spain, as shown in this figure, and has full powers regarding its citizens’ health care. It’s developing a National Health Care System that grants assistance to every citizen, over 7 million in 2006, and where different services are requested to different providers, which will be explained in more detail futher in this section of my presentation.
Another challenge faced by the Catalan Healthcare System, as well as the rest of the world, is aging. Nowadays, 8% of the world’s population is over 65, by 2030 it is estimated to reach 12%. Longer life implies dependency and an increase in the number of chronic diseases and, in consequence, higher costs for the healthcare system. The system will be also facing the sociological and epidemiological changes due to globalization and inmigration. Finally It will also provide a great challenge when introducing scientific and technological advances to the system.
Ús d’internet 1,4 bilions de persones utilitza internet avui en dia 4,5% de les búsquedes d’internet són d’informació relacionada amb la salut Les organitzacions sanitàries han introudit portals per als pacients Aparells mòbils Telemedicina, utilitzada en diagnòstics remots Per tal de garantir la qualitat es tendeix a una resposta a nivell local Aplicacions pràctiques de softwares lliures i SMS/MMS, com a ús de tecnologia simplificada USUARIS 2.0: La tercera activitat més realitzada a Internet és la visita de Webs de Serveis Públics (després de cercar informació en general i enviar correus electrònics) Actualment ja hi ha un 30% d’iternautes actius : nombre de blocs, usuaris d’ebay, participació online (30% dels internautes) Important ús d’Internet per potenciar projectes d’autonomia personal i col·lectiva (estudis UOC: emprenedors, cerca de feina, contrastar mitjans de comunicació, informació mèdica, etc.) Gran maduresa de l’internauta mitjà: ja no navega “d’ofici”, visita webs en funció de: eines “push”, cercadors, newsletters, alertes, eines de sindicació de continguts (RSS, Atom, ...), podcasting
L’impacte de les TIC en la sanitat Propicien la millora de les relacions entre tots els agents que intervenen en el sistema: ciutadans, pacients, gestors, professionals i proveïdors Incrementen l’ equitat i la universalitat del servei sanitari portant l’assistència a zones aïllades o d'escassa dotació Milloren l’ eficiència del sistema, mitjançant la optimització dels recursos assistencials i la millora de la gestió de la demanda Afavoreixen la continuïtat assistencial i el foment de la cura de la pròpia salut per certs col·lectius de pacients Augmenten el recolzament de l’activitat dels professionals , ja sigui assistencial o formativa Milloren de la gestió de la informació , oferint suport a l’emmagatzematge, el tractament i el transport Major qualitat , sostenibilitat i personalització del sistema sanitari
The mission of the Department of Health has been the result of a strategic process of definition, carried out with the different actors and providers, and we identify two main focus: The citizens and the professionals
This slide shows the 6 big strategic lines. Each line is composed of different projects. Line 2 is related with citizens actions and line 3 with professionals.
We selected four of them: HC³ Shared Medical Record in Catalonia : making accessible anytime from anywhere, any patient information useful to guarantee continuity The Personal Healt Folder as the citizens’ access to the Shared medical record Electronic prescription Medical Image: digital back up for the imaging diagnosis exams , to be attached to the Electronic Clinical History. Telemedicine
The main objective of the Shared Medical Record is the improvement of citizens healthcare service by using a tool to improve and facilitate the physicians’ task, by allowing them the shared use of the available information of patients from the Catalonian care centers.. The HC³ should facilitate and potentiate the continuity care avoiding the repetition of diagnostic explorations or procedures. It is not a centralized model, but to take into consideration the Catalan reality in terms of diversity of health care provider and IS is a model based on Interoperability and Standarts. The basic principle of the initiative is allow information exchange among different health organizations being the Department the entity responsible for the normalization and for the network. Shared Medical Record implies multiple benefits, among which, and just to summarize, some of them are highlighted here. The basic characterization criteria for the HC 3 are: Unique model to access to the different informative registers from the different clinical information system. It’s not just the addition of medical histories. High security : Exclusive access for professionals by identifying the care relationship profile between patient-professional. Exhaustive and guaranteed traceability Initial: information and access to/from the Catalan Health network. Citizen: has personal access and the right give access to a third party . Normalized information : Utilization of integration and functional standards
One of the outstanding activities belonging to the Shared Medical Record project is the SNS interoperability pilot project for the Spanish Electronic Medical Record. A pilot project its being carried on this year with the objective of validating the model of interoperability among different electronic records existing in other autonomous communities in Spain. The key points for the project success are the use of common standards and codifications, the ability to develop and use a unique Spanish patient and professional record, and the global electronic access for citizens and professionals based on Shared Medical Record project. Through Shared Medical Record Project in Catalonia, we participate in epSOS,. This is an ICT Health initiative for European Large Scale Pilot of Patient Summary and Electronic prescription. epSOS is a 3 year project with a 22 million of euros budget, where 26 partners, from 12 european countries are involved in the project. The members participating from Spain are: Andalucía, Castilla la Mancha and Catalonia, together with the Health Ministry of Spain.
Also in Catalonia, acces and use of internet is growing. Citizens not only use internet to search information but also services. Almost 40% of the internet users in Catalonia execute arrangements or searches for information about health related topics (INE 2006) The amount of active and well informed people, that make a better use of their health is increasing This social context requests more and new health services to the Health Digital Channel from the Public Administration The Health Channel aims to provide citizens and professionals access to validated medical and health care information, and to provide health related e-services in each moment, when needed.
It should also: Guarantee the communicative coherence from the Generalitat de Catalunya to internet about health related items, which is one of its main competences Facilitate to the citizens access to quality contents and services in this sector Ensure the access to the health e-services available in each moment Become the reference organization in the health professional services Give acces to the citizens to his medical information in a secure way, what we named My Health folder. There they will found his medical information providing from Shared Medical Record in Catalonia and why not in the future add theirself personal medical information.
The Integrated System for the Electronic Prescription facilitates the prescription and dispensation process. An improvement of the efficiency of these processes, together with the reduction of the routine visits and the increase of the prescription control, will drive the improvement of patients’ healthcare attention.
The key idea of the medical image digitalization is to simplify the access to the diagnostic examination independently of the place where the exam is realized or the patient’s and professional’s location. In consequence, access from anywhere of the network to all the medical images would create value of an add value not only for the patient but also for the physician and all the organizations that are involved in. The idea is to use the same model than for the HC³: Providers: he takes the digital images, saves them and also facilitates the access to them. Health department/Catsalut: ensures the interoperability with security and back-up.
We believe that in the ehealth the telemedicine can be sorted out from the tele-assistance: The Telemedicine is the exchange of patients information among professionals for the treatment or the care of the patients; likewise it gives the patient the opportunity to contact directly the professionals through the Information Technologies and the Communications. The Tele-Assistance is the attention remote and personalized for a person that, being in her home, she requires from some type of help or follow-up, using the information technologies and the communications Creiem que dintre de l’esalut es pot separar la telemedicina de la teleassistència: La Telemedicina és l’intercanvi d’informació de pacients entre professionals per al tractament o la cura dels pacients; així mateix dóna al pacient la oportunitat de contactar directament amb els professionals a través de les Tecnologies de la Informació i les Comunicacions. La Teleassistència és l’atenció remota i personalitzada per a una persona que, estant a la seva llar, requereix d’algun tipus d’ajuda o seguiment, utilitzant les tecnologies de la informació i les comunicacions
CLEAR project could be squeezed in the projects of innovation and of international relations that carries out the Foundation TicSalut
Finally, Catalonia because its Health Care Sector and consequent IT situation, full competences, many and different providers, base its strategy on: Interoperability & Standarts to improve health care And also the Spanish Ministry of Health should guarantee an interoperability framework , supported by standards and that is also the direction towards which Europe is and should be working towards.
I extend a warm invitation to all of you to the ehealth week 2010 wich will be heald in Barcelona in March. Thank you very much for being here today. I will be pleased, now, to answer any question you have. Moltes gràcies
20090609 Am Cham Eu J Cv1
June 9th, 2009 Mr. Joan Cornet Chief Executive Officer Fundació TICSalut What do we need to do to accelerate e-Health in Europe? Learning from experience: What is working?
The ICT Strategy in Catalonia Key ICT projects in Catalonia The Fundació TICSalut The catalan reality Outline The Catalan reality
The catalan reality <ul><li>Funded by taxes </li></ul><ul><li>Decentralized to regional autonomies </li></ul><ul><li>Universal coverage </li></ul><ul><li>Free access </li></ul><ul><li>Very wide range of publicly covered services </li></ul><ul><li>Co-payment of pharmaceutical products </li></ul><ul><li>Services provided mainly in public facilities </li></ul><ul><li>Sustainability and funding system under discussion </li></ul>The Spanish National Healthcare System
The catalan reality An autonomous Community of Spain Autonomous Community of Spain Government: Generalitat de Catalunya Area: 31.895 km 2 Population (2006): 7.135.000 Life expectancy (2005): 80,55 years Birth rate (2005): 11,57 Gross Mortality rate (2005) : 8,89 Infant mortality (2005): 2,74 GDP/Capita (PPP 2006): US$ 34.645 High urban concentration Own language and culture
The catalan reality Why e-Health? Main challenges facing the Catalan Healthcare System <ul><li>Demographic and cultural changes: </li></ul><ul><ul><ul><li>Aging -> Dependency </li></ul></ul></ul><ul><ul><ul><li>Immigration </li></ul></ul></ul><ul><ul><ul><li>Birth rates </li></ul></ul></ul><ul><li>Sociological and epidemiological changes </li></ul><ul><li>Scientific and technological advances </li></ul><ul><li>Economic sustainability </li></ul>Years old Year 0 to15 % 16 to 64 % > 65 % 2007 16,02 67,21 16,76 2008 16,75 66,39 16,86 2009 17,1 65,89 17,01 2010 17,43 65,35 17,22 2011 17,73 64,9 17,36 2012 17,99 64,44 17,56 2013 18,19 63,97 17,85 2014 18,36 63,59 18,05 2015 18,47 63,33 18,2 2020 18,04 62,7 19,26 2030 15,58 61,82 22,6 5,84% increase in 2030: 1.914.000 people > 65
The catalan reality Why e-Health? Chronical diseases co-morbidity and persistence A multi-pathology scope is needed
The citizens as the driving force for future changes The catalan reality <ul><li>Internet use: </li></ul><ul><ul><li>1,4 bilion users </li></ul></ul><ul><ul><li>4,5% are health related internet searches </li></ul></ul><ul><ul><li>Increasing patient sites </li></ul></ul><ul><ul><li>2.0 USERS </li></ul></ul><ul><ul><li>Public Services websites, the 3rd most popular activities on internet </li></ul></ul><ul><ul><li>30% active internet users (blogs, ebay users, online participation...) </li></ul></ul><ul><ul><li>Maturity of the average internet user </li></ul></ul>
ICT impact on healtcare The catalan reality <ul><ul><li>Better communication among all the agents involved on the system: citizens, patients, managers, professionals and providers </li></ul></ul><ul><ul><li>Increase of the healthcare service equity and universality , bringing assistance to isolated areas or with limited healthcare attention </li></ul></ul><ul><ul><li>Improvement on the system efficiency through the resources' optimization and a better management of the demand </li></ul></ul><ul><ul><li>Promotion of the own health attention </li></ul></ul><ul><ul><li>Increase and support to the professionals activity, either healthcare attention or personal training </li></ul></ul><ul><ul><li>Improvement of the information management, offering support to the storage, backup, processing and transportation </li></ul></ul>Better quality , sustainability and personalization of the healthcare system
The Catalan reality The ICT strategy in Catalonia Key ICT projects in Catalonia The Fundació TICSalut Outline
To boost the objectives and strategies of the Department through ICT, guaranteeing the right of citizens to access information and supporting the task of professionals to improve the quality of healthcare assistance. The Department will develop a leadership role in the ICT sector, promoting the image of Catalonia as an innovative territory and assisting in the participation of the different healthcare agents. Mission of the Department of Health in ICT The ICT strategy in Catalonia What role should the Department of Health play? The ICT Strategic Plan 2008-2011
6 strategic lines, 34 lines of action Strategic lines for the ICT Strategic Plan 2008-2011 S.L. 4 Answer efficiently the needs of information, management and security in the sector and the Department The ICT strategy in Catalonia S.L. 3 Endow professionals with ICT tools to perform quality care S.L. 6 Boost and project Catalonia as an innovative territory in Healthcare ICT S.L. 1 Develop ICT as a strategic element in Healthcare S.L. 2 Assist citizens in the access of information and services to look over their health S.L. 5 Endow agents with the proper infrastructures and guarantee interoperability
The Catalan reality The ICT strategy in Catalonia Key ICT projects in Catalonia The Fundació TICSalut Outline
Key ICT projects in Catalonia Key projects included in the ICT Strategic Plan Strategic Line 3 Endow professionals with ICT tools to perform a quality care 3.2 Introduction of the HC 3 Program in the Catalan health sector Strategic Line 3 Endow professionals with ICT tools to perform a quality care 3.3 Develop the Digital Image Strategic Plan Strategic Line 3 Endow professionals with ICT tools to perform a quality care 3.5 Develop and deploy the plan for telemedicine and tele-assistance Strategic Line 3 Endow professionals with ICT tools to perform a quality care 3.2 Introduction of the Electronic Prescription around the territory
Objectives Shared Clinical History in Catalonia (HC 3 ) <ul><li>Improvement of the health care service to the citizen through a tool that makes health professionals work easier by allowing the shared use of the available information about patients among healthcare centers </li></ul><ul><li>The Shared Clinical History (HC 3 ) should make easy and potentiate the care continuity and improve the computer resources </li></ul><ul><li>The Shared Clinical History (HC 3 ) should allow that patients seen in different centers are not going through repeated explorations or procedures </li></ul>Key ICT projects in Catalonia HEATH CENTER REPOSITORY
Shared Clinical History in Catalonia (HC 3 ) Key ICT projects in Catalonia Outstanding Activities <ul><li>SNS interoperability pilot project: Spanish Electronic Clinical History </li></ul><ul><li>Pilot project during 2008 </li></ul><ul><li>Objective: Validate the model of interoperability among different electronic records existing in other autonomous communities in Spain. </li></ul><ul><li>Use of common standards and codifications </li></ul><ul><li>Unique Spanish professional record </li></ul><ul><li>Global electronic access for citizens and professionals based on HC 3 project </li></ul><ul><li>UE SOS (Smart Open Services) project </li></ul><ul><li>Involvement of 26 partners from 12 European countries. </li></ul><ul><li>Objective: </li></ul><ul><ul><li>Develop an electronic health framework and an ICT structure to allow the secure accesss to the pacient health related information, specially the medical history and the electronic prescription, among the european health systems </li></ul></ul>
www.gencat.cat/salut/ SERVICES AND PROCEDURES Actual procedures extension HEALTH Procedures Virtual Office Multichannel: TDT, cell phones SERVICES AND PROCEURES ( personalized ) PUSH: RSS, podcast, bulletins “ my contents” “ my services” “ my communities ” INFORMATION (CONTENTS) Objective: clarity, access, validation Gencat-health: subjects , webs A-Z,GECO Catalan health searcher Gencat.salut.tv COMUNICATION (WEB 2. 0) Patient-patient training Professional tools Healthcare interaction: pilot tests “ MY HEALTH FOLDER” Personal Health Folder Key ICT projects in Catalonia
<ul><ul><ul><li>Citizens and professional access to: </li></ul></ul></ul><ul><ul><ul><li>Validated medical information </li></ul></ul></ul><ul><ul><ul><li>Health-care information </li></ul></ul></ul><ul><ul><ul><li>Available health related e-services (procedures) in each moment </li></ul></ul></ul><ul><ul><ul><li>Citizens accessibility by IdCat and Electronic Spanish ID (DNI) </li></ul></ul></ul>Key ICT projects in Catalonia Personal Health Folder
<ul><ul><ul><li>Immediate availability of the medicines use </li></ul></ul></ul><ul><ul><ul><li>Coordination of the prescription and dispensation processes </li></ul></ul></ul><ul><ul><ul><li>Facilitate the patient’s therapeutic follow up </li></ul></ul></ul><ul><ul><ul><li>Improve the healthcare quality </li></ul></ul></ul><ul><ul><ul><li>Improve the patients’ healthcare attention </li></ul></ul></ul><ul><ul><ul><li>Increase safety in the medicines use </li></ul></ul></ul>Key ICT projects in Catalonia Objectives Electronic Prescription
<ul><li>Availability of all the ‘radiologic’ image digitalized </li></ul><ul><li>Establish the digitalization basis for the rest of the medical images </li></ul><ul><li>Promote the organizations digitalization including aids for: </li></ul><ul><ul><ul><li>Software </li></ul></ul></ul><ul><ul><ul><li>Hardware </li></ul></ul></ul><ul><ul><ul><li>Services </li></ul></ul></ul>Key ICT projects in Catalonia 2010 Objectives Medical image digitalization
Tele-assistance Medical Tele-assistance Telemedicine Person with dependency Person without dependency Social services Health services Key ICT projects in Catalonia Plan for Telemedicine and Tele-assistance A person with dependencies who receives telemedicine services will need tele-assistance services from home
Stakeholders Type of communication 1 2 3 Key ICT projects in Catalonia Plan for Telemedicine and Tele-assistance <ul><li>Tele-consultation: </li></ul><ul><ul><li>Cardiology </li></ul></ul><ul><ul><li>Dermatology </li></ul></ul><ul><ul><li>Pediatrics </li></ul></ul><ul><ul><li>Neurology </li></ul></ul><ul><ul><li>Psychology </li></ul></ul><ul><li>Diagnostic: </li></ul><ul><li>Radiology </li></ul><ul><li>Anatomy </li></ul><ul><li>Pathology </li></ul><ul><li>Dermatology </li></ul><ul><li>Ophthalmology </li></ul><ul><li>Chronic disease management: </li></ul><ul><ul><li>Diabetes </li></ul></ul><ul><ul><li>Insufficient respiratory </li></ul></ul><ul><ul><li>Other chronic diseases </li></ul></ul>Professional - Professional Professional – Professional & Patient Professional - Patient
The Catalan reality The ICT Strategy in Catalonia Key ICT projects in Catalonia The Fundació TICSalut Outline
TICSALUT organization in Catalonia The Fundació TICSalut Fundació TICSALUT ICT Providers Health Care Providers DEPARTAMENT OF HEALTH / CATSalut Strategic ICT plan INFORMATION & QUALITY AGENCY Operability ICT plan TICSALUT Information Systems To manage the health information generating knowledge of the system TICSALUT Service Center Endow the sanitary system of public coverage of infrastructures and ICT services
<ul><li>Department of Health </li></ul><ul><li>Department of the Presidency </li></ul><ul><li>Department of Innovation, Universities and Industry </li></ul><ul><li>Department of Governance and Public Administration </li></ul><ul><li>Municipal government of Mataró </li></ul><ul><li>Catalan Health Services </li></ul><ul><li>Catalan Institute of Health </li></ul><ul><li>Consortium of Hospitals of Catalonia </li></ul><ul><li>Union of Catalan Hospitals </li></ul><ul><li>Group of Catalan Health Establishments </li></ul>The Fundació TICSalut Patrons of the Foundation
Mission The mission of Tic Salut is to encourage the development and use of information and communication technologies to enhance the health system in the region of Catalonia, Spain. Observatory Maps of ICT in health trends Innovation Normalization Office of standards DEPLOYMENT Telemedicine and Tele-assistance DEPLOYMENT Collaboration Agreement Fundació TIC i Salut – Health Department / CatSalut International relations and projects Projects, agreements, congresses Business Council Council of Professionals and Citizens Scientific Council The Fundació TICSalut
The Fundació TICSalut Normalization Office of Standards and Interoperability Approval of solutions / suppliers Translation of international codifications to Catalan Innovation Deployment of the Telemedicine and Tele-assistance Plan Sponsorship of pilot tests Sponsorship of applied research Trend Map Directory of ICT Professionals Map of ICT innovation in Catalonia Technological Maturity Index Observatory International Relations & Projects eHealth week 2010 EU Projects Knowledge exchange & best practice Strengthening capacity
Contributions of Fundació TicSalut <ul><li>Development of standards </li></ul><ul><li>Education / Outreach </li></ul><ul><li>Projects </li></ul><ul><li>Implementation plans </li></ul><ul><li>NET </li></ul>
Alliances World Heath Organization CC Canada Health Infoway European Commission HIMSS MedCom ECHC Latin America Regions European Union Mediterranean Networks EHTEL SEIS Continua International Projects European Projects Ministerial Conference eHealth week 2010 The Fundació TICSalut Contributions of Fundació TICSalut
<ul><ul><li>15 - 19 March 2010: eHealth week </li></ul></ul><ul><ul><li>Collaborative agreement with EC DG Infso, HIMSS, Ministry of Health and Consumer Affairs Spain, Government of Catalonia Department of Health </li></ul></ul><ul><ul><li>Participation EHTEL and IHE </li></ul></ul><ul><ul><li>Participation International Foundation for CARS and MyCARS. </li></ul></ul><ul><ul><li>25 - 27 March 2009 - Continua Health Alliance </li></ul></ul><ul><ul><ul><li>Incorporation as members of CONTINUA </li></ul></ul></ul><ul><ul><li>World Health Organization. FTS reference center for Catalonia and Spain </li></ul></ul><ul><ul><ul><li>WHO-FIC (WHO Family of International Classifications), </li></ul></ul></ul><ul><ul><ul><li>ICD (International Statistical Classification of Diseases-Health Problems, </li></ul></ul></ul><ul><ul><ul><li>ICF (International Classification of Functioning, Disability, and Health) </li></ul></ul></ul>The Fundació TICSalut Contributions of Fundació TICSalut
<ul><ul><li>Department of health: </li></ul></ul><ul><ul><ul><li>GAP - Guard, Anticipation and Prediction (completed) </li></ul></ul></ul><ul><ul><ul><li>BetterBreathing - A new model for continuous care of chronic patients - eCare, eRehabilitation, eCommunity and eLearning for patients with breathing handicaps (completed) </li></ul></ul></ul><ul><ul><ul><li>Healthreats -Integrated Decision Support System for Health Threats and crises management </li></ul></ul></ul><ul><ul><li>TicSalut: </li></ul></ul><ul><ul><ul><li>epSOS – Patient summary and ePrescription – with Spain Health Ministry. </li></ul></ul></ul><ul><ul><ul><li>NEXES – Supporting healthier and independent living chronic patients and elderly. With Hospital Clínic Barcelona </li></ul></ul></ul><ul><ul><ul><li>CLEAR – Clinical Leading Environment for the assessment and validation of rehabilitation protocols in home care with Institute Guttmann </li></ul></ul></ul><ul><ul><ul><li>AAL - RGS – Rehabilitation Gaming System. With UPF, V.Hebrón i H.Mar </li></ul></ul></ul>The Fundació TICSalut Contributions of Fundació TICSalut
Interoperability Standarts Conclusion: Interoperability framework ¿HOW? National and international collaboration and a globally coordinated effort will be required The ICT solutions proposed and implemented in Catalonia are essential for connectivity with the rest of Spain and Europe
THANK YOU ! WE HOPE TO SEE YOU IN eHealth Week Barcelona 2010