european innovation partnership on active and healthy ageing eip aha action group b3 integrated care...
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European Innovation Partnership on Active and Healthy Ageing
EIP AHA Action Group B3Integrated Care
Dr. Toni DedeuSenior International Officer
Ministry of Health of Catalonia
Istanbul, 10th September 2013
Chair - EUREGHA European Regional and Local Health Authrities Association
European Innovation Partnership on Active and Healthy Ageing
B3 ACTION GROUP ON INTEGRATED CARE
EFPC – ISTANBUL 10 SEPTEMBER 2013
European Innovation Partnership on Active and Healthy Ageing
How many of you have ever heard about EIP AHA?
Are your organisations involved in any EIP Action Group?
European Innovation Partnership on Active and Healthy Ageing
B3: INTEGRATED CARE COLLABORATIVE
AN OVERVIEW
Ageing society
Chronic conditions
Lack of health professionals
Financial challenges
Health inequalities
HLY vs LE
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
ResourceEfficiency
• 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
EUROPEAN INNOVATION PARTNERSHIP ON
ACTIVE AND HEALTHY AGEING
health & quality of life of European
citizens
growth & expansion of EU industry
Sustainable & efficient care
systems
+2 Healthy Life Years by 2020Triple 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
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
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)
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
PERSONACTIVEAGEINGCITIZENHEALTHY
POLITICAL ADDED VALUE OF THE EIP AT A REGIONAL LEVEL
euIn
itia
tive
Com
mit
mm
ent
s
Refe
rence
si
tes
regi
onm
inis
trie
s
smes
Prov
ider
s
acad
emia
OPPORTUNITY
CATALONIAEUROPEAN
COMMISSION
2013
14
EIP AHA
A1 A2 A3 B3 C2 D4
C
RS
OM
STRATEGIC IMPLEMENTATION PLAN FOR
AHA
Commitment / Reference Site / Market Place
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
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
A1 Prescr
iption and Adhere
nce
A2 Falls
preve
ntion
A3 Preve
ntion of Functi
onal Declin
e and Fr
ailty
B3 Inte
grate
d Care
C2 Inte
roperab
le Independent L
iving
D4 Age-Fr
iendly En
vironments
020406080
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European Innovation Partnership on Active and Healthy Ageing
B3 Action Group
‘Replicating and tutoring integrated care forchronic diseases, including remote
monitoring at regional level’
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.
WHAT SOME ‘BRAINS’ SAY ABOUTINTEGRATED CARE
System Integration
Organisation Integration
Financial Integration
Professional Integration
Service Integration
Personal
Integration
Population Based
Person Focused
Care
Micro Level Meso Level Macro Level
NormativeIntegration
Personal Integration
+2 HEALTHY LIFE YEARS by 2020A triple win for Europe
+2 HEALTHY LIFE YEARS by 2020A 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 solutionssynergies
Regions, delivery organisations, patient / carers organisations, academia, industry
B3 ACTION GROUPMEMBERSHIP
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
EIP AHAINTEGRATED CARE
2013From Chronic Care
2020IntegratedCare
CORE TOPICSINTEGRATED CARE
?YOUR IDEAS
WAITAND SEE
EIP AHAACTION AREAS
CHALLENGES TO THE SUCCESSFUL ADOPTION OF
INTEGRATED CARE
?What kinds of PAYMENT SYSTEMSbest incentivise IC
¿ Which ORGANISATIONAL
SOLUTIONS are more effective
CHALLENGES TO THE SUCCESSFUL ADOPTION OF
INTEGRATED CARE
?How can care beBETTER CO-ORDINTEDaround people’s needs
¿ What IMPLEMENTATION STRATEGIES are likely
to be most effective to STIMULATE CHANGE
PERSONACTIVEAGEINGCITIZENHEALTHY
POLITICAL ADDED VALUE OF THE EIP AT A REGIONAL LEVEL
Strategy
EU Initiave
Opportunity
Collaborative approach Sust
ain
ab
ility
Partnership
Innovation
Predictive models
ICT
European Innovation Partnership on Active and Healthy Ageing
B3: INTEGRATED CARE COLLABORATIVE
B3 DELTA QUESTIONNAIRE ANALYSIS
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.
27 REGIONSFROM EUROPE
KEY FINDINGS OF THE DELTA QUESTIONNAIRE
SHIFT TO PRIMARY/COMMUNITY BASED CARE
USE OF THE DELTA QUESTIONNAIRE
• Validating the Definition of Integrated Care for the Action Plan
• Validating and mapping of Action Areas • Mapping activities• Mapping gaps
The work is on-going: • Further insights to be gained through B3 activities in
different Action Areas• Lessons learnt
PERSONACTIVEAGEINGCITIZENHEALTHYAGEINGEUEIPAHAINTEGRATE
DEBATE
FOOD FOR THE DEBATE
PERSONACTIVEAGEINGCITIZENHEALTHYAEIPAHAI
organisational models
risk stratifiction
care pathways
dissemination
financi
ng
change management
workforce development
patient/user empowerment
ICT
B3 ACTION AREAS
PERSONACTIVEAGEINGCITIZENHEALTHYAEIPAHAI
AA1 Organisational Models
AA5 Risk StratifictionAA4 Care Pathways
AA9 DisseminationAA8 Financing
AA2 Change ManagementAA3 Workforce Development
AA6 Patient/User EmpowermentAA7 ICT
B3 ACTION AREAS
Action Area
Change
Management
Action Area
Workforce
Development
Action Area
Risk Stratification
Action Area
Care Pathways
Action Area
Patient / User Empowerment
Action Area
Organisational
Models
Act
ion
Are
a
Fi
nanc
e/Fu
ndin
g
Acti
on A
rea
Dis
sem
inati
on
Act
ion
Are
a
IC
T T
oo
ls
EIP AHA B3 Action Plan
By 2015Chronic Conditions’ Programmes available at least 10% of target population in at least 50
regions
By 2015 - 2020Integrated 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 Toolkit Toolkit
Tool
kit
Tool
kit
Toolkit Toolkit Toolkit
Increase the average number of healthy life yrs by 2 in the EU by 2020Health status and quality of life । Supporting the long term sustainability and efficiency of health and social systems । Enhancing competitiveness of EU industry
Chronic Conditions Integrated 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
4
STRATEGYMapping
• How?
Desktop search
• Method?
Good Pratices
• Analysis From Commtments
EU projects • Analysis
Other sources • Analysis
STRATEGYMapping
• Collecting info
Analysis
• How?
Toolkit
• SCALE UP
European Innovation Partnership on Active and Healthy Ageing
B3: INTEGRATED CARE COLLABORATIVE
B3 GOOD PRACTICES
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
COLLECTION OF GOOD PRACTICESMARCH-APRIL 2013
• 37 good practices
• 29 organisations• 16 regions• 8 action areas
… and the collectionis still on-going
SEPTEMBER 2013 > 50
THEMATIC COVERAGE OF THE GOOD PRACTICES B3 ACTION AREAS
AA1 AA2 AA3 AA4 AA5 AA6 AA7 AA80
2
4
6
8
10
12
14
11
8
7
3
13
11
14
3Rele
vant
goo
d pr
actic
es
AA1 Organisational ModelsAA2 Change ManagementAA3 Workforce DevelopmentAA4 Risk Stratification
AA5 Care PathwayAA6 Patient / user empowermentAA7 Electronic Care Records / ICT / TeleservicesAA8 Finance, Funding
COVERAGE OF THE GOOD PRACTICES
under 10,000 10,000-50,000 50,000-1000000 over 1,000,000 N/A0
2
4
6
8
10
12
14
- Size of the target population varies from 50 patients to 7.5 million citizens
- Total: over 13 million people
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 implementationSEMEHT
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
therapists4. 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:5. An improvement in the quality of care for those patients6. Prevention of disease complications (including a 50% reduction in hip fractures) 7. A reduction in hospitalization8. A substantial cost reduction (€20 million annually in the Netherlands alone)
SUSTAINABILITY
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
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 costsLombardia Fondazione Maugeri, Italy: Telesurveillance programme for Heart Failure patients demonstrated reduction of hospitalisation and improved access to appropriate careSIPE, 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
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
European Innovation Partnership on Active and Healthy Ageing
B3: Integrated Care Collaborative
Action Area 7: ICT and Teleservices
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)
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 industryModel 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
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
TIME TO GETINVOLVED! 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?
TIME TO GETINVOLVED! 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
?
TIME TO GETINVOLVED! In your opinion, what are the services
necessary to support and stimulate the delivery of integrated care
?
PERSONACTIVEAGEINGCITIZENHEALTHY
Thanks from
Jean
Magda
Donna
Orsi
Bri
an
EstebanCristina
George
Andre
aLoukianos
Bart
Joana
Toni
Francesca
European Innovation Partnership on Active and Healthy Ageing
thank youB3 Action Group on
Integrated Care Dr. Toni Dedeu
https://webgate.ec.europa.eu/eipaha/actiongroup/index/b3