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European Innovation Partnership on Active and Healthy Ageing EIP AHA Action Group B3 Integrated Care Dr. Toni Dedeu Senior International Officer Ministry.

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Presentation on theme: "European Innovation Partnership on Active and Healthy Ageing EIP AHA Action Group B3 Integrated Care Dr. Toni Dedeu Senior International Officer Ministry."— Presentation transcript:

1 European Innovation Partnership on Active and Healthy Ageing EIP AHA Action Group B3 Integrated Care Dr. Toni Dedeu Senior International Officer Ministry of Health of Catalonia Istanbul, 10 th September 2013 Chair - EUREGHA European Regional and Local Health Authrities Association

2 European Innovation Partnership on Active and Healthy Ageing B3 ACTION GROUP ON INTEGRATED CARE EFPC – ISTANBUL 10 SEPTEMBER 2013

3 E uropean I nnovation P artnership on A ctive and H ealthy A geing How many of you have ever heard about EIP AHA? Are your organisations involved in any EIP Action Group?

4 European Innovation Partnership on Active and Healthy Ageing B3: INTEGRATED CARE COLLABORATIVE AN OVERVIEW

5 Ageing society Chronic conditions Lack of health professionals Financial challenges Health inequalities HLY vs LE

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7 HEALTH IN EUROPE 2020 EUROPE 2020 FLAGSHIPS FOR SMART, SUSTAINABLE AND INCLUSIVE GROWTH Innovation Union New Skills and New Jobs Digital Agenda Youth on the Move New Industrial Policy Platform against Poverty Resource Efficiency innovation for tackling societal challenges, e.g. ageing and health innovation for addressing the weaknesses & removing obstacles in the European innovation system Innovation Union ICTs for tackling societal issues - ageing, health care delivery sustainable healthcare & ICT-based support for dignified & independent living Digital Agenda for Europe E UROPEAN I NNOVATION P ARTNERSHIP ON A CTIVE AND H EALTHY A GEING

8 health & quality of life of European citizens growth & expansion of EU industry Sustainable & efficient care systems +2 Healthy Life Years by 2020 Triple win for Europe Improving prescriptions and adherence to treatment (A1) Better management of health: preventing falls (A2) Preventing functional decline and frailty (A3) Integrated care for chronic conditions, inc. telecare (B3) ICT solutions for independent living & active ageing (C2) Age-friendly cities and environments (D4) Action Groups Reference Sites

9 A1 Improving prescriptions and adherence to treatment (A1) A2 Better management of health: preventing falls (A2) A3 Preventing functional decline and frailty (A3) ACTION GROUPS EIP AHA

10 B3 Integrated care for chronic conditions, inc. telecare (B3) C2 ICT solutions for independent living & active ageing (C2) D4 Age-friendly cities and environments (D4)

11 develop policy on active & healthy ageing Political added value of the EIP EC: facilitator & supporter align policy priorities with funding support from the ground mobilise efforts & resources inspire for policy action identify good practices working in real life High level conferences (e-health, Gastein Forum, Conference of Partners, Frailty and Adherence Conferences) Alignment of priorities in Horizon 2020, CIP 2013, PHP 2013 etc. Joint Action on Chronic Diseases and Healthy Ageing (28 countries + 5 networks) Reflection process of the MS: Towards modern, responsive and sustainable health systems

12 PERSONACTI VE AGEINGCIT IZENHEALTHY POLITICAL ADDED VALUE OF THE EIP AT A REGIONAL LEVEL eu Initiative Commit mments Reference sites region ministries sme s Providersacademia

13 OPPORTUNITY CATALONIA EUROPEAN COMMISSION

14 2013 14 EIP AHA A1 A2A3 B3 C2 D4 C RS OM STRATEGIC IMPLEMENTATION PLAN FOR AHA Commitment / Reference Site / Market Place

15 1,000 regions & municipalities 1 billion euro mobilised 30 mio citizens, >2 mio patients > 500 commitments 3,000 partners Marketplace >30,000 visits >650 registered users Building up EIP scale and critical mass

16 Invitation For Commitments 2013 Stronger network of partners -10 submissions expand existing commitments -30 submissions involve existing AG member Focus on Implementation -close to half of the committed organisations are care providers -over half of the commitments are directly contributing to the implementation of integrated health and care systems Closed: 28 February 2013

17 European Innovation Partnership on Active and Healthy Ageing B3 Action Group ‘Replicating and tutoring integrated care for chronic diseases, including remote monitoring at regional level’

18 B3 Objective (Operational Plan 11/11) Reducing avoidable / unnecessary hospitalisation of older people with chronic conditions, through the effective implementation of integrated care programmes and chronic disease management models that should ultimately contribute to the improved efficiency of health systems.

19 WHAT SOME ‘BRAINS’ SAY ABOUT INTEGRATED CARE System Integration Organisation Integration Financial Integration Professional Integration Service Integration Person al Integra tion Population Based Person Focused Care Micro Level Meso Level Macro Level Normative Integration Personal Integration

20 +2 HEALTHY LIFE YEARS by 2020 A triple win for Europe +2 HEALTHY LIFE YEARS by 2020 A triple win for Europe provide input – expertise, best practice inspiration B3 Integrated Care Collaborative iterative, flexible process collect experience, evidence to support policy-making scale up innovative solutions synergies Regions, delivery organisations, patient / carers organisations, academia, industry

21 B3 ACTION GROUP MEMBERSHIP 135 EIP commitments received from: Regions Delivery organisations Patient / carer representative organisations Academia Industry 199 individual stakeholders from committed regions / organisations and growing…… 12 19 CAT

22 EIP AHA INTEGRATED CARE 2013 From Chronic Care 2020 Integrated Care

23 CORE TOPICS INTEGRATED CARE ? YOUR IDEAS WAIT AND SEE EIP AHA ACTION AREAS

24 CHALLENGES TO THE SUCCESSFUL ADOPTION OF INTEGRATED CARE ? What kinds of PAYMENT SYSTEMS best incentivise IC ¿ Which ORGANISATIONAL SOLUTIONS are more effective challenges to the successful adoption of integrated care [1]. The focus of debate centred on four key systemic questions: what kinds of payment system best incentivise integrated care?; which organisational solutions are most effective?; how can care be better co- ordinated around people’s needs?; and what implementation strategies are likely to be most effective to stimulate change?

25 CHALLENGES TO THE SUCCESSFUL ADOPTION OF INTEGRATED CARE ? How can care be BETTER CO-ORDINTED around people’s needs ¿ What IMPLEMENTATION STRATEGIES are likely to be most effective to STIMULATE CHANGE

26 PERSONACTI VE AGEINGCIT IZENHEALTHY POLITICAL ADDED VALUE OF THE EIP AT A REGIONAL LEVEL Strategy EU Initi ave Op por tun ity Collaborative approach Sustainability Part ners hip Inn ova tion Predictive models ICT

27 European Innovation Partnership on Active and Healthy Ageing B3: INTEGRATED CARE COLLABORATIVE B3 DELTA QUESTIONNAIRE ANALYSIS

28 THE DELTA QUESTIONNAIRE Objective: Gain insights in the implementation of integrated care Who: - Regions / delivery organisations with B3 commitments - Candidate EIP Reference Sites What: – 27 European regions – Coverage of population of c. 54 million people – Spending of > €15 B per annum on care for people with chronic conditions.

29 27 REGIONS FROM EUROPE

30 KEY FINDINGS OF THE DELTA QUESTIONNAIRE

31 SHIFT TO PRIMARY/COMMUNITY BASED CARE

32 USE OF THE DELTA QUESTIONNAIRE Validating the Definition of Integrated Care for the Action Plan Validating and mapping of Action Areas Mapping activities Mapping gap s The work is on-going: Further insights to be gained through B3 activities in different Action Areas Lessons learnt

33 PERSONACTIV EAGEINGCITIZ ENHEALTHYA GEINGEUEIPA HAINTEGRATE DEBATE FOOD FOR THE DEBATE

34 PERSONACTI VEAGEINGCI TIZENHEALT HYAEIPAHAI organisational models risk stra tific tion care path ways dissemination financing chan ge mana geme nt workf orce devel opme nt patient/user empowerment ICT B3 ACTION AREAS

35 PERSONACTI VEAGEINGCI TIZENHEALT HYAEIPAHAI AA1 Organisational Models AA5 Risk Stratifiction AA4 Care Pathways AA9 Dissemination AA8 Financing AA2 Change Management AA3 Workforce Development AA6 P at ie nt /U s e r E mpowerment AA7 ICT B3 ACTION AREAS

36 Action Area  Change Management Action Area  Workforce Development Action Area  Risk Stratification Action Area  Care Pathways Action Area  Patient / User Empowermen t Action Area  Organisational Models Action Area  Finance/Funding Action Area  Dissemination Action Area  ICT Tools EIP AHA B3 Action Plan By 2015 Chronic Conditions’ Programmes available at least 10% of target population in at least 50 regions By 2015 Chronic Conditions’ Programmes available at least 10% of target population in at least 50 regions By 2015 - 2020 Integrated Care Programmes serving older people, supported by innovative tools and services, in at least 20 regions By 2015 - 2020 Integrated Care Programmes serving older people, supported by innovative tools and services, in at least 20 regions SIP TARGETS 2013 Monitoring impact and outcomes 2015 Toolkit Increase the average number of healthy life yrs by 2 in the EU by 2020 Health status and quality of life । Supporting the long term sustainability and efficiency of health and social systems । Enhancing competitiveness of EU industry Chronic ConditionsIntegrated Care Implementation and Scale Up of Chronic Care + Integrated Care Programmes Map of partnership models for implementation of Chronic and Integrated Care Programmes Map of best practice methodologies to support the implementation of Chronic and Integrated Care Map of reusable learning resources Stratification of the population Mapping Best Practices in the EU regions Map of coaching, education and support patient/user empowerment and adherence

37 4

38 STRATEGY Map ping How? Desktop search Method? Good Pratices Analysis From Commtments EU projects Analysis Other sources Analysis

39 STRATEGY Map ping Collecting info Analy sis How? Toolk it SCALE UP

40 European Innovation Partnership on Active and Healthy Ageing B3: INTEGRATED CARE COLLABORATIVE B3 GOOD PRACTICES

41 B3 GOOD PRACTICES Objective: to gather an initial map of current integrated care activities relating to the B3 Action Areas Who: All B3 members were invited to complete the B3 Good Practice template What: 37 regions / organisations completed the template by the end of April 2013

42 COLLECTION OF GOOD PRACTICES MARCH-APRIL 2013 37 good practices 29 organisations 16 regions 8 action areas … and the collection is still on-going SEPTEMBER 2013 > 50

43 THEMATIC COVERAGE OF THE GOOD PRACTICES B3 ACTION AREAS AA1 Organisational Models AA2 Change Management AA3 Workforce Development AA4 Risk Stratification AA5 Care Pathway AA6 Patient / user empowerment AA7 Electronic Care Records / ICT / Teleservices AA8 Finance, Funding

44 COVERAGE OF THE GOOD PRACTICES - Size of the target population varies from 50 patients to 7.5 million citizens - Total: over 13 million people

45 THEMES 50% of the good practices target one or more chronic disease (cardiovascular diseases, COPD, diabetes, etc) Numerous examples of comprehensive regional programmes for chronicity Wide range of issues, incl. insurance, social security, housing, independent living, volunteering, impact on competitiveness Innovation in technologies, delivery of services and organisation Patient-centered Strong focus on implementation SEMEHT

46 AND ….. A FEW EXAMPLES ParkinsonNet, Radboud University Nijmegen Medical Centre Successfully improved Parkinson care in the Netherlands by: 1.Developing regional networks of primary and secondary Parkinson care around general hospitals 2.Selecting and training physiotherapists to work according to evidence-based guidelines 3.Boosting patient volumes per therapist by stimulating selective referral to ParkinsonNet therapists 4.Supporting these networks with online tools to enhance information exchange and communication and therefore collaboration between allied health professionals, neurologists, and empowered patients. The model demonstrates: 1.An improvement in the quality of care for those patients 2.Prevention of disease complications (including a 50% reduction in hip fractures) 3.A reduction in hospitalization 4.A substantial cost reduction (€20 million annually in the Netherlands alone) SUSTAINABILITY

47 GOOD PRACTICE IN AA7 ICT AND TELESERVICES NHS24, Scotland: ICT for prediction of risk improves planning healthcare and better address of resources. Puglia, Italy: Telecardiology - Over 550.000 ECG performed, significant reduction of avoidable death, 60% underwent appropriate treatment and no hospitalization unless urgent (only 11%) Lombardia, Italy: Homebase telesurveillance programme COPD patients. 60% of patients didn’t occur hospitalization. Fondazione B.Kessler Trentino, Italy: Access to personal HER a key element for empowerment. Best practice in the field of Public-Private partnership for e-health procurement

48 NHS24 Scotland: ICT to support learning network – to share knowledge and foster peer to peer review. Catalonia NEXES Project: ICT Platform for health information sharing, Patient self-management, Electronic Health Record. Basque Country TelBil: ICT telemonitoring resulted in significant reduction in hospital admissions for patients with Heart Failure and COPD Saxony, Germany: ICT for Diabetic patients, management of patients data, networking among stakeholders, real time monitoring of related costs Lombardia Fondazione Maugeri, Italy: Telesurveillance programme for Heart Failure patients demonstrated reduction of hospitalisation and improved access to appropriate care SIPE, Emilia Romagna, Italy: R.A. financed Industrial District, creating partnership between enterprises and Universities to foster R&D processes followed by technology transfer GOOD PRACTICE IN AA7 ICT AND TELESERVICES

49 NEXT STEPS... An analysis of good practices will be undertaken to determine: – Success factors – why initiative worked well – Lessons learned – what didn’t work / what could be done better / differently – Transferability to other regions / organisations – to promote scale up of integrated care Will inform the development of the B3 toolkits

50 European Innovation Partnership on Active and Healthy Ageing B3: Integrated Care Collaborative Action Area 7: ICT and Teleservices

51 B3 ACTION AREA 7 ICT AND TELESERVICES  Objectives/activities Highlight the potential of ICT/teleservices to underpin the delivery of integrated care and to realise service efficiencies/cost-effectiveness (Action Plan, 2012) Improve the effectiveness of health and social care ICT systems and data sharing by identifying solutions which improve interoperability between record systems and data sharing (Action Plan, 2012)

52 B3 ACTION AREA 7 DELIVERABLES Mapping of ICT solutions Electronic care records Personal health records Aligning existing projects (epSOS, Calliope) Common security processes (identification, authentification, authorization and patient consent) Teleservices Increased levels of integration of clinical and social data Increased implementation of electronic consent and share record capabilities Availability of functionality in Electronic Health/Care Record Toolkit for Electronic Care Records/ICT/Teleservices: Approaches to managing regulatory issues, security, privacy, liability, confidentiality and interoperability Reductions of risk and time to market costs for industry Model business cases to support implementation and scale up European Initiative Service Specification for the development of personal digital health records Increased implementation of teleservices as part of Integrated Care Programmes

53 B3 ACTION AREA 7 WORK PLAN FOR 2013  Work package description WP7-1 Map of ICT solutions focusing on how services for chronic disease management or integrated care are being supported by common eHealth infrastructure  Task Description T7-1  T7-1-1 Definition of services for integrated care and chronic disease management T7-1-2 Analyse the compatibility of services with the outcomes of other existing European projects (e.g. epSOS, Calliope) T7-1-3 Validate the outcomes of T7-1-2 through the practical workshop T7-1-4 Develop indicators for ICT solutions T7-1-5 Evaluate models of ICT solutions supported by common eHealth infrastructure

54 TIME TO GET INVOLVED!  How can we better utilise ICT / Teleservices to support and promote the scale up of integrated care in Europe?  How could EIP and the B3 Action Group help?

55 TIME TO GET INVOLVED!  Are you currently working on the projects where the outcomes of which can help to achieve the objectives of AA7, or AA1, AA2, AA3, AA4, AA5, AA6, AA8 ?

56 TIME TO GET INVOLVED!  In your opinion, what are the services necessary to support and stimulate the delivery of integrated care ?

57 PERSONACTI VE AGEINGCIT IZENHEALTHY Thanks from Jean Mag da Don na Orsi Brian Este ban Cris tina George Andrea Loukianos Bart Joana To ni Francesca

58 European Innovation Partnership on Active and Healthy Ageing thank you B3 Action Group on Integrated Care Dr. Toni Dedeu tdedeu@gencat.cat https://webgate.ec.europa.eu/eipaha/actiongroup/index/b3


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