"Integrating Health & Social Care" Presentation by Joe Killen, International Business Development Director, Tunstall

1. Integrating Health and Social Care
Joe Killen
International Business Development Director

2. • Health and Social Care have grown organically over the last 6
decades in Europe, separate and fragmented
• Health has focused on acute/reactive care infrastructure
• However, 70%-80% of today´s demand for healthcare comes from
chronic diseases – prevention/contention are the priorities
• People with chronic diseases are typically >65, and at home
• BUT Health Systems consolidating – data/EHR/e-prescriptions

3. Specialized programs: Caregiver support, active
aging, telemonitoring and technology adapted
Integral care: courtesy calls, advice and information,
campaigns for the prevention and advanced peripherals
Teleassistance: sanitary & social emergencies,
loneliness and reminders
Tele-alarm: sanitary emergencies
Before
90s
90s
2000s
2010s
Telecare Service Evolution, Spanish Model.

4. Flexible Telecare Response = Impact on Health System
INTENSITY OF CONTACTS
COMPLEMENTARY TECHNOLOGY
ADDITIONAL PROACTIVE CALL CAMPAIGNS
Special programmes
Special response measures for
• Abuse
• Suicide risk
• Major disasters
Support Level 1 Level 2 Level 3
HIGH RISK SITUATIONS
INTERVENTION
Preventive Social Care
Mobile Social Alarm
Additional peripherals
CARECHAT MOBILE APP
Health promotion (eg flu vaccine)
Security (eg bogus caller)
Social integration initiatives (community activity promotion)
Carer support programmes (eg dementia, palliative care)
Promotion of health lifestyles

5. Worldwide, disease burden is
dominated by long-term conditions
5
Effect
• Mortality
• Morbidity
• Acute events
• Health costs
• Productivity
• Performance
• Social impact

6. Tackling long-term conditions requires
addressing the complex root causes
6
• Nutrition
• Activity
• Stress
• Sleep
• Mood
Cause • Finances
• Career
• Relations
• Purpose
Effect
• Mortality
• Morbidity
• Acute events
• Health costs
• Productivity
• Performance
• Social impact

7. Health outcomes data doesn’t tell the whole story.
Purpose Social Financial Community Physical
Liking what you do each
day and being
motivated to achieve
your goals
Having supportive
relationships and love in
your life
Managing your
economic life to reduce
stress and increase
security
Having good health and
enough energy to get
things done daily
Liking where you live,
feeling safe and having
pride in your community
7

8. Demand Aggregation Health and Social Care
• Health services are seeking a communications infrastructure, offering monitoring and advice options
as appropriate, to reach out to chronic disease patients at home
• Osakidetza (Basque Health Service) took over 4 regional Telecare systems (30k) from municipality social care
departments in 2011, and combined them into a single service covering the whole Basque Country (2.2M pop)
• They added Telehealth monitoring services for specific chronic conditions,
exchanging data with and providing services from the health system
• Elderly + multi-chronic disease patient increasing
demographic phenomenon

9. Demand Aggregation Health and Social Care
• Andalusia (8.5M pop) linked primary and emergency health services to the regional Telecare platform in 201
1.
• Telecare is used for emergency health calls, primary care advice, and doctor appointment bookings, while
Telecare outbound calls remind users of appointments, greatly increasing attendance and therefore system
efficiency. Voice and data exchange between health and social care.

10. 2015 2020
Current Focus
Telecare
HEALTH
SOCIAL

11. 2015 2020
Future Focus
• Coordinate health with social care
• Focus on high-cost chronic disease contention
Domiciliary focused
hardware, software, data,
physical/mental health
services packages,
disease management, prevention
and support
Resource pooling = Telehealthcare
Virtual
Health

12. Report Impact
Establish Plan
EHR, (Rx, lab, biometrics,) well-
being, devices, social networks
Analyze & Forecast Stratify population1 Collect data
Proprietary
Analytics and
Predictive Models
Engage and Support
Healthways Preventive Approach
12
2 3
4
5
6
Healthy
At Risk
High Risk
 Individualized well-being plan and guidance
Self-directed
Virtual coaching
Individual and Group Live
Coaching
Ongoing Treatment Plan
Support
High Risk and Episodic Care
Transition Management
Community /
Social Determinants
Physician and individual directed well-being actions
All progress and outcomes communicated
to PCP / Patient / Sponsor
12

13. The Opportunity for Doing Something – Savings Example Basque Country
13
0.23
0.22
0.21
0.21
0.20
0.20
0.19
0.19
1.66
0.20
0.19
0.18
0.18
0.18
0.17
0.17
0.16
1.42
0
1
1
2
2
3
3
4
Inactivity Poor SoC
Compliance
Stress Poor Diet Lack of Health
Screening
Smoking Insufficient
Sleep
Alcohol Use all
Interventions
cost savings
BillionsofEuros
Ten-Year, Cumulative Savings through Interventions in Behaviors
Medical Savings Productivity Savings

14. Transforming Healthcare
Joe Killen
International Business Development Director