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eHealth addressing global challenges through local actions
When Telemedicine does deliver!
eHealth addressing global challenges through local actions
When Telemedicine does deliver!
Wednesday, 18Wednesday, 18thth November 2010 November 2010
Giancarlo Ruscitti MDGiancarlo Ruscitti MDCEO - Fondazione Opera S. Camillo
Background of the experience of the Veneto RegionBackground of the experience of the Veneto RegionBackground of the experience of the Veneto RegionBackground of the experience of the Veneto Region
Since 2004, the Veneto strategy of economic sustainability and Since 2004, the Veneto strategy of economic sustainability and innovation has meant increasing financial contraints in Human innovation has meant increasing financial contraints in Human Resources, and developing policies for the allocation and most Resources, and developing policies for the allocation and most efficient use of health care personnel, empowered by the efficient use of health care personnel, empowered by the appropriate use of e-technologies;appropriate use of e-technologies;
National budget constraints have forced the Region to reallocate National budget constraints have forced the Region to reallocate the health budget in order to the health budget in order to guarantee the Essential Levels of Health Care provision (LEA) to all Veneto Citizens by:by:
1.1. rationalizing and renewing the hospital network;rationalizing and renewing the hospital network;2. re-organizing health services in the territory;3.3. investing in innovation, ICT and eProcurement; investing in innovation, ICT and eProcurement;
The Veneto Region: Territory and PopulationThe Veneto Region: Territory and Population
4
• 4,8 M inhabitants 4,8 M inhabitants • 18.39118.391 kmkm22 of land of land surfacesurface
Population Structure*
Members per familyMembers per family 2.6
Birth rate Birth rate 9.3
Death rateDeath rate 9.0
Natural growth rateNatural growth rate 0.3
Total growth rateTotal growth rate 5.6
% Elderly persons% Elderly persons 135.7
% population > 65 % population > 65 years years
18.5
% EU population>65 % EU population>65 years years
14.08* As of the 2001 General Consensus As of the 2001 General Consensus
5
The Veneto Region: Health Care Providers and ProfessionalsThe Veneto Region: Health Care Providers and Professionals• 21 Local Health 21 Local Health AuthoritiesAuthorities• 2 Hospital Trusts 2 Hospital Trusts
PUBLIC ACCREDITED INSTITUTIONS 64
IRCSS (SPECIALIST RESEARCH INSTITUTES)
1
Public health authority (Az. Osp.) 2
Hospital in the Provincial capital 6
Network hospital / strong integration 33
Integrating hospital of the network 8
Polyfunctional health centres 10
Management experimentation 4
PRIVATE ACCREDITED INSTITUTES 14
Care homes/ hospital 19
Classified hospital 4
IRCSS (SPECIALIST RESEARCH INSTITUTES)
1• 41.806 Medical & 41.806 Medical & Nursing staffNursing staff• 11.702 Laboratory 11.702 Laboratory TechnicianTechnician• 6.704 Administrative 6.704 Administrative staffstaff• 117 Other Professionals117 Other Professionals(* Veneto Regional Statistics Office data, 2008)
The Veneto’s responsibility in policy-making The Veneto’s responsibility in policy-making in the Health & Social Sectorin the Health & Social SectorThe Veneto’s responsibility in policy-making The Veneto’s responsibility in policy-making in the Health & Social Sectorin the Health & Social Sector
Minister for Social Minister for Social PoliciesPolicies
Minister for Health Minister for Health PoliciesPolicies
Regional Secretary for Regional Secretary for Health & Social ServicesHealth & Social ServicesRegional Secretary for Regional Secretary for
Health & Social ServicesHealth & Social Services
2121 Local Health Local Health Authorities Authorities
22 University University Teaching Teaching HospitalsHospitals
582 582 Municipalities in Municipalities in
the Veneto the Veneto RegionRegion
22 Scientific Scientific Reseach Reseach HospitalsHospitals
Minister for Animal Health
New challenges for Veneto Health CareNew challenges for Veneto Health CareNew challenges for Veneto Health CareNew challenges for Veneto Health Care
Increase in EU citizens expectations;Increase in EU citizens expectations; Ageing populationAgeing population Home-care in rural and mountain areas;Home-care in rural and mountain areas; Rising costs due to technological innovation;Rising costs due to technological innovation; Reduction of public health care expenditure;Reduction of public health care expenditure; Patient mobility: Tourists, Immigrants and Long term Patient mobility: Tourists, Immigrants and Long term
residents;residents; Lack of health professionals (mainly pediatricians and Lack of health professionals (mainly pediatricians and
nurses);nurses);
Restrictions imposed in public funding by commitments Restrictions imposed in public funding by commitments
towards maintaining EU stability treaties.towards maintaining EU stability treaties.
Telemedicine eHealth Projects: ObservatoryTelemedicine eHealth Projects: Observatory
8
Number of Telemedicine projectsSource: “Observatory and
projects on Telemedicine applications
2009”,Vol. 1/2009,
Arsenàl.IT
N. progetti
1 12
1
3
13
17
11
7
0
2
4
6
8
10
12
14
16
18
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Cumulative number of active Telemedicine projects
9
The Consortium Arsenàl.IT:Veneto’s Research Center of eHealth Innovation The Consortium Arsenàl.IT:Veneto’s Research Center of eHealth Innovation
Founded in 2005 as “Telemedicine Consortium”, currently groups together all the 23 Local Health Authorities of the Veneto Region.
The Consortium Arsenàl.IT:Veneto’s Research Center of eHealth Innovation The Consortium Arsenàl.IT:Veneto’s Research Center of eHealth Innovation
10
Has acted as Observatory by performing systematic surveys on Telemedicine applications developed over time by the member Health Authorities.
Has succeeded in highlighting the critical issues of interoperability, standardization and organizational impact as factors for driving to the diffusion of Telemedicine applications in care delivery process.
Telemedicine eHealth Projects: ESCAPETelemedicine eHealth Projects: ESCAPE
11
Example in a Local Health Authority
Extraction
Hospital wards &Internal Services
Digital Signature
Forwarding
Storage
Certification
Diagnostic Servicesproducing Clinical
Reports
Mail Service
GPs
HomePC
Territorial Service Providers
Citizens
Citizens’ Clinical Document SharingCitizens’ Clinical Document Sharing
Telemedicine eHealth Projects: Doge, General Practitioners NetworkTelemedicine eHealth Projects: Doge, General Practitioners Network
12
A Regional project to create a communication network and connect general practioners and
family doctors to the hospital and Local Health Authority.ACTORSACTORS: :
Regional information system
Information system of Locl Health Authorities
GP
Citizens Personal EHR
SHARED INFORMATION:SHARED INFORMATION:
Population data and personal data
E-prescription
Clinical data, documents and reports
Consents (privacy)
SERVICSERVICESES
GPGP(Primary(Primary
Care)Care)
VENETO VENETO REGIONREGION
CitizensCitizens (Personal (Personal
EHR)EHR)
Information Information SystemSystemLHAs LHAs
Telemedicine eHealth Projects:DREAMING & Telecare systemTelemedicine eHealth Projects:DREAMING & Telecare system
13
Telemedicine eHealth Projects: HEALTH OPTIMUMTelemedicine eHealth Projects: HEALTH OPTIMUM
14
Provincial area of Vicenza
Provincial area of Belluno
Provincial area of Treviso
Provincial area of Venezia
Provincial area of Rovigo
Provincial area of Verona
Provincial area of Padova
XDS Repository
XDS Registry
RENEWING HEALTH:The ConsortiumRENEWING HEALTH:The Consortium
15
GREECE
FINLAND
SPAIN
NORWAY
DENMARK
ITALY
AUSTRIA
GERMANY
SWEDEN
EUROPEAN ASSOCIATIONS COUNTRY
European Patients’ Forum (EPF) Luxembourg
European Health Telematics Association (EHTEL)
Belgium
COMPETENCE CENTER COUNTRY
Arsenàl.IT Italy
Medcom International Denmark
Center for Distance-spanning Healthcare Sweden
Norwegian Center for Integrated Care and Telemedicine
Norway
Catalan Agency for Health Technology Assessment and Research (CAHTA)
Spain
VTT – Technical Research Center - Finland
e-Trikala AE Greece
TSB Innovationsagentur Berlin GmbH Germany
ADVISORY BOARD COUNTRY
Continua Health Alliance Private Stichting (CHA)
Belgium
Integrating the Healthcare Enterprice(IHE)
Italy, Spain, UK
RENEWING HEALTH:The expected impactsRENEWING HEALTH:The expected impacts
16
Reduce hospitalisation and improve disease management
Increased links and interaction between patients and health professionals, facilitating more active participation of patients in care processes
Improvement of quality of life for patients suffering form chronic conditions
Increased use of existing or commonly agreed standards and demonstration of interoperability of the new solutions in regular healthcare practice
Provide a convincing business case to be presented to National, Regional and Local Health Authorities and to stimulate them to speed up the deployment of patient-centered eHealth service solution
Conclusions and challengesConclusions and challengesConclusions and challengesConclusions and challenges
The The Veneto Region Veneto Region is actively involved in the area is actively involved in the area of of innovationinnovation and and health care reformshealth care reforms, with , with purchasing, payment systems and contracting as purchasing, payment systems and contracting as tools for restructuring, and in tools for restructuring, and in benchmarking benchmarking itsits health care system;health care system;
eHealth development is a way of empowering the eHealth development is a way of empowering the quality of human resources;quality of human resources;
The use of modern technologies in and out of The use of modern technologies in and out of hospital should be understood as a way of improving hospital should be understood as a way of improving quality and safety for the benefit of patients.quality and safety for the benefit of patients.
Thanking you for your kind attention!Thanking you for your kind attention!
[email protected]@camilliani.net
