Søren Vingtoft introduces EPITAL and the current activities and goals at first Health2.0 Copenhagen event 2013 20

1. www.epital.org
“Moving Health Care to Your Fingertip”
Introduction to the Epital
Klaus Phanareth – MD, PHD, President – Danish Society for Clinical Telemedicine

2. The Health Care Sector
A burning platform
Boom 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

3. Lost in the Bermuda triangle
3 sectors, multiple legislations, 3 systems of reimbursement, 3 cultures
GP
Hospital Healthcare
center
Hospital
Nursing home/
municipal
healthcare
Hospital
The helpless patient
with a chronic
condition
Transformation af sundhedsydelser

4. Citizen centered health care system
Nursing home/
Health care center municipal healthcare
Hospital Social services
The empowered citisen with chronic condition
Pharmacy
GP

5. What is Epital Health?
A research-based re-design of the healthcare
sector, based upon:
• empowerment
• service transformation
• coordination
• telehealth and telecare
• common sense
Evolution – not revolution
www.president.ee/images/stories/pdf/ehtf-report2012.pdf

6. Health service transformation
Healthcare sector – 2012 The Epital
patient citizen
diagnose clinical pathway
fragmented coherent and coordinated
disease condition
plan responsibility empowerment
treatment service/prophylaxis/procrastination
admitted outmitted
”scheduled” ”on demand“ (available)
segmented inclusive – sector neutral
centralized close to citizen

7. A research-based re-design of the
healthcare sector, based upon:
• empowerment
• service transformation
• coordination
• telehealth and telecare
• common sense

8. Empowerment is…
To enable people to act on their own, and
thereby gain control over their lives..
……especially control over the critical and
crucial factors that keep people stuck in
oppression or powerlessness, where they have
no control

9. Organisation and services
Citizen’s epital
EPITAL
Mobile unit
EPITAL
Health Coach
Home calls Epi-callcenter
EPITAL
System installation and -support
Services EPITAL
Blood sampling
On-site diagnostics and treatment
Coordination of clinical pathways
Emergency calls
Outmitting
Second opinion
Population monitoring
Hospital Municipality Empowerment General Practitioner
EPITAL EPITAL EPITAL
EPITAL
Diagnostics Nursing Communities Diagnostics
Initiating treatment Rehabilitation (COPD level 2+3) Education Initiating treatment
Outpatient visits Nursing efforts Lifestyle changes Outpatient visits
Rehabilitation (COPD level 3) Citizen services

10. The Entry: Citizen - Epital
Empowerment services Condition monitor
Lung monitor
Epitalet
Epi-plan
Skype
Pulse-oximeter
Thermometer

11. 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.

12. The critical issues
1. Creating sufficient knowledge and technical
competence in the front-personal
2. 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.

13. Perspectives seen from the municipality
1. 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
effort
3. Discus partnerships with neighboring municipalities.