1. Example of the way new technology is used in the field of health (E-Health) Elena Vio - Arsenàl.IT Veneto’s Research Centre for eHealth Innovation

2. Moving to ehealth Healthcare Telemedicine Store&Forward Telehomecare Telesurgery eHealth

3. E-health Plan in Europe 2012-2020 CHALLANGES:  to improve chronic disease and multimorbidity  to increase sustainability and efficiency of health systems by unlocking innovation,enhancing patient/citizen-centric care and citizen empowerment and encouraging organisational changes;  to foster cross-border healthcare, health security, solidarity, universality and equity;  to improve legal and market conditions for developing eHealth products and services

4. Do you need only technical innovation?

5. We need a HTA approach Technology Clinical efficacy efficency Economy User Perception Organization Etical Legal E-Health

6. ICT applied to Health TelemedicineTelemedicine TelehealthTelehealth e-Healthe-Health m-Healthm-Health ConsultazioneConsultazione DiagnosiDiagnosi monitoringmonitoring Remote assistance Health education Health&epidemiologyHealth&epidemiology Environment and industrial health Health policy EHREHR Health data Decision support Order entry Clinical support Clinicians support Remote data collection ICT applied to health TelemedicineTelemedicine consultationconsultation diagnosisdiagnosis networknetwork

7. Health in Veneto Region: 7 21 Local Health Authorities Healthcare assistance (Hospitals) Territorial assistance and social issues (GPs, outpatients’ clinics, elderly care, in-home assistance, mental health, disability, drug addiction, ecc…) Prevention department 2 Hospital Trusts University education and research High-specialty services 4,9 M inhabitants (2013 data) 18.391 km2 of land surface

8. The Consortium Arsenàl.IT: Veneto’s Research Center for eHealth Innovation Founded in 2005 as “Telemedicine Consortium”, currently groups all the 23 Local Health Authorities afferent to the Veneto Region. Has succeeded in highlighting the critical issues of interoperability, standardization and organizational impact as key factors for driving Telemedicine applications to the mainstream of the care delivery process.

9. eHealth service in Veneto Region:  HEALTH OPTIMUM European Project – European Telemedicine Project aimed to diffuse and pilot-test some telemedicine services for neurosurgical telecounselling (2007-2009)  VENETO ESCAPE - giving to patient and to healthcare professional the possibility to obtain digitally signed electronic medical reports (2009-2012)  Doge: the GPs Network - Regional project aimed to set up a network of services for information and document exchange between GPs, Hospitals and LHAs (2009-2010)  SUSTATINS: European Project - study and implement services that permit direct access online by citizens to their personal healthcare data and other service so as to improve their empowerment and administrative management (2012-2015).  RENEWING HEALTH - validation in real life settings and with a common assessment methodology of the use of Personal Health Systems for innovative Telemedicine services (2009-2012)

10. NEUROSURGICAL TELECOUNSELLING ICT allows to sharing information and CT images between peripheral hospital and central hospital with Neurosurgeon - in all hospitals of Veneto region and in 4 european regions Central hospital Peripheral Hospital Form for request+images Form for response Emergency room Neurosurgery Neuroradiology X

11. NEUROSURGICAL TELECOUNSELLING ICT allows to sharing information and CT images between peripheral hospital and central hospital with Neurosurgeon - in all hospitals of Veneto region and in 4 european regions Results: Equity of treatment Saved time and unnecessary transfers of patient and physicians (75%) Legal value of remote consultation 3200 telecounselling/year – over 1000 clinical users

12. Digitalization and Management of clinical reports ICT allows to eliminate paper for clinical report, guaranteed legal validity (signature, certification, storage, distribution, extraction, conservation, delivery via on line) – in all Veneto region Results: Less trips: 120 M€/years saved for citizens Reuse of human resource (33) Opportunity to process or share data in order to better treat the patient 60% of downloaded clinical reports

13. MANAGEMENT OF E-PRESCRIPTION ICT allows to manage electronic prescriptions and referrals: from the production of document to the dispensation of it – in all Veneto region Results: Better use of common resources Better identification of citizen To avoid errors Use of decision support system for prescription

14. ON LINE SERVICES FOR CITIZENS Access to their health data online, online payment, online booking, access to waiting lists, digital consensus management, communication between citizens and specialists. Focus group Results: Authonomy of citizens Self-management Empowerment of citizens

15. TELEMONITORING OF CHRONIC PATIENTS ICT allows to physician to manage the chronic patient (COPD, Diabetes, CVD) in remote way Patient’s homeRegional eHealth Centre 5 32 4 GENERAL PRACTITIONER SERVER DATA TRANSMISSIONDATA ACCESS THROUGH HOME CARE PORTAL CONTACT WITH PATIENTALARM MANAGEMENT PATIENT 1 GATEWAY ALARM DEVICE HOSPITAL OR LOCAL HEALTH DISTRICT INTERVENTION SERVICE SOCIAL WORKER FAMILY 6 7 TELEMONITORING DEVICES REGIONAL CENTRE’S OPERATOR

16. GREECE FINLAND SPAIN NORWAY DENMARK ITALY AUSTRIA GERMANY SWEDEN TELEMONITORING OF CHRONIC PATIENTS 3,332 enrolled patients in Veneto Region Over 7,000 enrolled patients at european level 10 involved LHA in Veneto Region Clinical Staff involved: Cardiologists Electrophysiologists Pulmonologists Diabetologists Nurses GPs Evaluation Clinical aspects Organizational aspects Economical aspects User and patients perceptions Social aspects

17. Tools to support the healthcare processes Bottom-up model: to involve 1000 operators for the realization

18. Thank you for your attention evio@consorzioarsenal.it www.consorzioarsenal.it @Consorz_Arsenal MRCLIC Veneto ESCAPE www.youtube.com/user/consorzioarsenal www.youtube.com/user/RENEWINGHEALTH www.linkedin.com/company/arsen-l.it consorzioarsenal_it