1. THE DREAMING PROJECT FINAL CONFERENCE 14th June 2012 Results and new perspectives for home care from an European ehealth and einclusion trial TRIESTE, Italy, June 14th, 2012 The new care model of the Tallinn City and East Tallinn Central Hospital (ETCH) Peeter Ross, MD, PhD Marko Parve Katrin Davõdova

2. Long TRADITION Founded in 1785 the same location – the centre of Tallinn the same name – Central Hospital, the same service – medicine – for 227 years

3. TODAY: Patient-centred Hospital Municipality owned legal entity since 2001 The result of a merge of 8 separate healthcare institutions o 4 hospitals o 2 policlinics o 1 diagnostic centre o Loksa healthcare centre

4. TODAY: 7 clinics Womens Clinic Internal Medicine Clinic Surgery Clinic Diagnostic Clinic Medical Rehabilitation Clinic Eye Clinic Long-Term Nursing Clinic

5. Dreaming site Tallinn 35 + 34 patients We started real life trials in October 2009 We redesigned workflow Dreaming appeared to be a totally new service for our patients

6. 6 Dreaming patients in the end of the project Intervention Group 17 persons - 2 exitus letalis - 15 unwilling to continue (late delivery of equipment) - 1 transfer to elderly homes Control Group 11 persons - 8 exitus letalis - 14 unwilling to continue -1 transfer to elderly home

7. Main observations Home monitoring is a totally new service for the patient New competences for hospital professionals New opportunities for the hospital

8. 8 NEW FOR PATIENT. CHALLENGE FOR PROFESSIONALS

9. Benefits of a DREAMING service More satisfied senior citizens Reduces isolation of elderly people Creates new communication possibilities between caregivers and patients Professional care according to the needs of the patient Better medical service availability Avoids unexpected situations Ambulatory visits Hospitalizations

10. Challenges Create 24/7 contact center Further delegation of medical service to contact center specialists To use up to date technology ID chipcard support for fast patient identification Condition self-assessment and instant feedback to the patient HL7 and SNOMED CT encoded data for compliance of EHR and PHR systems Integration with Estonian nation-wide Health Information Exchange platform 10

11. The future of healthcare in Estonia Joint medical and social care services Medical services 24 h monitoring Vital parameters and alarms monitoring Fall sensor Social services Alarm button Virtual services Reminders Social consultations Coaching

12. 12 FUTURE VISION: EXPORT OF TELEMONITORING DREAMING appeared to be a sustainable service DREAMING could be divided into separate components The whole service or components of it has potential to cross country borders

13. THANK YOU FOR YOUR ATTENTION! 13