1. Happy people – Good investments
I am the project manager of the European project SmartCare in the Region of Southern Denmark and my focus is on implementing IT and making sure that the systems match the users needs. I have worked as a project manager in hospitals, the private sector, the municipality and now the region, so I have a good sense of the different actors surrounding the patients and their challenges. One of my main tasks over the years has been to understand userneeds and converting them into IT solutions.
I represent the Region of Southern Denmark, which is responsible for managing the hospitals and making sure that the different sectors communicate to ensure good medical care to the citizens of Denmark.
Happy people – Good investments
A case of Shared Care

2. Presentation
My focus today will be on the Shared Care platform, which we have developed in collaboration with IBM because we believe that this platform is a very good investment that leads to happy people.
The Shared Care platform is also the core element for our participation in the European SmartCare project.

3. Agenda Cross-sectional communication today
Agreements and standardized messsages
Limitations
The role of the Shared Care platform
Setting information free
The look and content of the platform
How does it work?
Development and implementation
Keys to succesful use of IT
First I will give a brief overview of the communication between sectors that exists today as a backdrop for why we have developed the Shared Care platform.
We think that the best ICT solutions set information free, so that it is available to as many involved parties as possible at any given time.
I also want to show you how the platform works and what it includes.
Lastly I want to point out that even the best ICT solution needs to be followed by smart and involving implementation.

4. Setting the stage Division of labour
GP, Hospital, Municipality
National standards of communication
MedCom messages
Health agreements
Care pathways for chronic diseases
So just to set the stage, the Danish Healthcare Sector consists of three major contributors; general practitioners that are the main contact and gatekeeper for the patients, the hospitals mangaged by the regions, that are responsible for specialised treatment and the municipalities, that are responsible for prevention, daily life and social aspects of the citizens.
The electronic communication between these three organizations consists mainly of national medcom standards for messaging. These messages are sent automatically between the major systems after a set of agreed rules depending on the length and nature of the patients admission to the hospital. These standards were first developed in 1995 and are now widely implented in Denmark.
Furthermore communication between sectors is based on Health agreements which are made every 4 years, with the current one running untill In the current agreement special emphasis has been made on elderly and patients with a chronic condition. Patients with a chronic condition are categorized in 4 categories according to the complexity of their disease as well as their self care ability. These categories have different care pathways where specific responsibility has been divided for the caregivers.

5. Referral to a preventive acitivity in the municipality
So this means that there are a large number of different electronic messages being sent from the major systems today such as;
Referral to a preventive acitivity in the municipality
Admission to a hospital
Information to the municipality that a citizent has been admitted
Additional information on the patient
Information on the treatment
Request for change of medication
Electronic prescription
Referal to a specialist
This system works! – however it also has some limitations:
Only the most neccessary information is shared and only between a few systems (actually there are a lot more systems especially in the municipality. You could say that it is the municipality’s responsibility to distribute relevant information within their own organisation, however that is not always the case today)
- The patient and their possible informal carers such as relatives are not included in these systems of communication. This is a problem for both the patients with a low and high selfcare ability. The patients with low selfcare ability have a wide range of professionals involved in their medical and social issues – and these different professionals all just have a fragment of information. This means that the patient is the key to provide additional relevant information – a patient that typically already has a lot of problems to deal with. There is also a group of patients demanding more knowledge regarding their own condition and they wish to play an active role in their treatment – this is also what society is expecting of these citizens. In order to enable them to do this they need easier access to relevant data.

6. So this means that today each actor has a piece of information in the puzzle of information and we bring that together with the Shared Care platform.

7. Again w belive that the best ICT solutions sets information free…
We cannot predict everything and people cannot be precisely categorized – therefore we aim to make as much information available to as many relevant people as possible at any given time.
The Shared Care platform is developed as a supplement to the existing messaging system and to support the care pathways developed for the patients with a chronic condition – heart disease as an example. So where the messages are the main highway – the shared care platform is the scenic route.

8. So the Shared Care platform is designed based on the care pathways as well as workshops with participation from the major actors to get input on what information is relevant to share. It is mainly focused on integration with the existing systems and national databases – so that information is not redundant or not correctly updated.
I would like to show you the system and briefly explain the main components (start screen-cast)

9. Mobile access
We have also developed a mobile access, which is even more simpel and user friendly for the patient groups, that are not accustomed to using a pc but might be able to use a tablet or smartphone.
As an example we can ask patients to enter measurements or answer questionnaires with this userinterface.

10. Making ICT work Legislation needs to be re-evaluated
Involving end-users from the beginning
Supporting healthcare professionals
Making sure the system is available
Finally I just want to emphasize the importance of aspects surrounding the system itself, which are very important when implementing ICT solutions.
Right now there are issues regarding the legal framework – it simply has not followed the technical advancements
As always it is important to involve end-users in designing the system – both patients and professionals
In many projects it is the care professionals that have to manage and implement the project in addition to their clinical work. We believe it is crucial that they are supported by professional project managers as facilitators.
Finally systems have to be available – this means enough pc’s, a minimum of break-downs and sufficient education.
All of this will help the good investment make people happy 

11. Contact Thank you for listening! Maria Hardt-Madsen
Project Manager of SmartCare
Southern Denmark Health Innovation E: M:
So feel free to contact me for further information…