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Professional Educational Programme 2011,[object Object],The implications of mobile technology in facilitating Integrated CareAlbert AlonsoInformation Systems Directorate,[object Object]
Defining integrated care,[object Object],“[Integrated care] is a concept bringing together inputs, delivery, management and organisation of services related to diagnosis, treatment, care, rehabilitation and health promotion.”,[object Object],(Grone & Garcia-Barbero: 2001),[object Object],“[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.”,[object Object],(Kodner & Spreeuwenberg: 2002),[object Object]
Why we need integrated care?,[object Object],Because of our failings in current health and social care systems:,[object Object],Addressing the changing demand for care,[object Object],Poor efficiency fragmented approaches (disease versus patient),[object Object],Improving the quality and continuity of care,[object Object],Recognising that health and social care outcomes are interdependent,[object Object],Exclusion of vulnerable groups,[object Object],(Wait, European Social Network Conference, Edinburgh 2005),[object Object]
Innovative care for chronic conditions,[object Object],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.,[object Object]
Service model,[object Object],Normalisation,[object Object],Redefinition of roles,[object Object],Allocation of resources,[object Object],Integrated care (80%),[object Object],Traditional care (20%),[object Object],Adapted from Berg M et al. Health Information Management. Integrating information technology in health care work. Routledge 2004.,[object Object]
Service model,[object Object],Normalisation,[object Object],Redefinition of roles,[object Object],Allocation of resources,[object Object],ICT,[object Object],Integrated care (80%),[object Object],Traditional care (20%),[object Object],Adapted from Berg M et al. Health Information Management. Integrating information technology in health care work. Routledge 2004.,[object Object]
Redefining roles across the system,[object Object]
Platform and functionalities,[object Object]
Makingitwork,[object Object]
Exacerbated ,[object Object],COPD patients (222),[object Object],Home Hospitalisation (121),[object Object],Control group (101),[object Object],ER Intervention,[object Object],Discharge,[object Object],Discharge,[object Object],Home Intervention < 24h,[object Object],Accessibility,[object Object],Visit Outpatient clinic 8 wk after discharge,[object Object],Home hospitalisationprogramme,[object Object]
Home hospitalisation programme,[object Object],28% Control group,[object Object],Readmission,[object Object],20% Intervention group,[object Object],22%,[object Object],Emergency room,[object Object],visits,[object Object],10% **,[object Object],- 2.4,[object Object], SGRQ Total,[object Object],- 6.9 **,[object Object],2033€,[object Object],Savings,[object Object],1255€**,[object Object]
Home hospitalisation programme,[object Object]
Home hospitalisation programme,[object Object]
Home hospitalisation programme,[object Object]
Prevention of exacerbationsprogramme,[object Object]
Prevention of readmissions programme,[object Object]
A new standard?,[object Object]
A new standard?,[object Object],Yes!,[object Object],“...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.”,[object Object]
A new standard?,[object Object],But!,[object Object],“... In the integrated care approach, several models are available and we now require comparative studies.”,[object Object],“We must also be aware that from a healthcare provider perspective, further,[object Object],studies of this model must include cost-effectiveness as well as effectiveness in older disabled patients with chronic obstructive pulmonary disease”,[object Object]
What had we learnt (2006)?,[object Object],There were better alternatives to the current approach of chronic patient management.,[object Object],These alternatives were safe, cheaper and generated better clinical outcomes and professional and patient satisfaction.,[object Object],Information technologies facilitated some of the aspects related to their implementation. ,[object Object],Most of the difficulties concerned the organisation of care delivery and professionals.,[object Object],There was a need to change our viewpoint,[object Object]
Changing the viewpoint,[object Object],Disease Management System,[object Object],Health Management System,[object Object],Citizen Management System,[object Object]
Time scale for integrated care at HCB,[object Object],2000-03,[object Object],[object Object]
Clinical validation of limited model2004-06,[object Object],[object Object]
Market analysis / deployment strategy2007,[object Object],[object Object],2008-12,[object Object],[object Object]
Reliability of ICT platform2010,[object Object],[object Object],2010-13,[object Object],[object Object],[object Object]
Integratedcare at HCB,[object Object],Approach by programmes:,[object Object],Set of normalised actions as well as evaluation tools that target precise service objectives.,[object Object],The programme is based on a process model but it is not the (entire) process.,[object Object],Programme “A”,[object Object],Programme “B”,[object Object],Programme “C”,[object Object],Patient,[object Object],Programme “D”,[object Object],Programme ......,[object Object]
Integratedcare at HCB,[object Object],Work plan,[object Object],definition,[object Object],Normalisation of practices,[object Object],Reallocation of roles,[object Object],ICT application,[object Object],Case,[object Object],evaluation,[object Object],Follow-up,[object Object],& event handling,[object Object],Case,[object Object],identification,[object Object],Discharge,[object Object]
Integratedcare at HCB,[object Object],Case,[object Object],evaluation,[object Object],Workplan,[object Object],definition,[object Object],Discharge,[object Object],Case,[object Object],identification,[object Object],Follow-up,[object Object],Event handling,[object Object]
Identification,[object Object],Assessment,[object Object],Working Plan,[object Object],Follow-up,[object Object],Discharge,[object Object],Linkcare® Application,[object Object]
Planner,[object Object],Pre-defined Template,[object Object],Personalized ,[object Object],Linkcare® Application,[object Object]
Service Library,[object Object],Available Templates,[object Object],Personalized,[object Object],Linkcare® Application,[object Object]
Monitoring,[object Object],Education,[object Object],Linkcare® Application,[object Object]
Profile Management,[object Object],Contact details,[object Object],Availability,[object Object],Language,[object Object],Agenda Management,[object Object],Collaborative Tools,[object Object],Call Centre,[object Object],Doc. Repository,[object Object],Patient’s interactions,[object Object],Voi- IP Phone,[object Object],Personalization,[object Object],Co-morbidities,[object Object],Service Optimization ,[object Object],Linkcare® Application,[object Object]
Linkcare® Application,[object Object]

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