eHealth addressing global challenges through local actions When Telemedicine does deliver!

Wednesday, 18 th November 2010

Giancarlo Ruscitti MD

CEO - Fondazione Opera S. Camillo

Background of the experience of the Veneto Region  Since 2004, the Veneto strategy of economic sustainability and innovation has meant increasing financial contraints in Human Resources, and developing policies for the allocation and most efficient use of health care personnel, empowered by the appropriate use of e-technologies;  National budget constraints have forced the Region to reallocate the health budget in order to guarantee the Essential Levels of Health Care provision (LEA) to all Veneto Citizens by: 1.

2.

3.

rationalizing and renewing the hospital network; re-organizing health services in the territory; investing in innovation, ICT and eProcurement;

4

The Veneto Region: Territory and Population

• 4,8 M inhabitants • 18.391 km

2 of land surface

Population Structure * Members per family Birth rate Death rate Natural growth rate Total growth rate % Elderly persons % population > 65 years % EU population>65 years 2.6

9.3

9.0

0.3

5.6

135.7

18.5

14.08

* As of the 2001 General Consensus

The Veneto Region:

Health Care Providers and Professionals

• 21 Local Health Authorities • 2 Hospital Trusts PUBLIC ACCREDITED INSTITUTIONS IRCSS (SPECIALIST RESEARCH INSTITUTES) Public health authority (Az. Osp.) Hospital in the Provincial capital Network hospital / strong integration Integrating hospital of the network Polyfunctional health centres Management experimentation 5 • • • •

41.806 Medical & Nursing staff 11.702 Laboratory Technician 6.704 Administrative staff 117 Other Professionals

(* Veneto Regional Statistics Office data, 2008 )

PRIVATE ACCREDITED INSTITUTES Care homes/ hospital Classified hospital IRCSS (SPECIALIST RESEARCH INSTITUTES )

14 19 4 1 64 1 2 6 33 8 10 4

The Veneto’s responsibility in policy-making in the Health & Social Sector

Minister for Social Policies Minister for Health Policies Minister for Animal Health 21 Local Health Authorities Regional Secretary for Health & Social Services 2 University Teaching Hospitals 2 Scientific Reseach Hospitals 582 Municipalities in the Veneto Region

New challenges for Veneto Health Care

      Increase in EU citizens expectations; Ageing population Home-care in rural and mountain areas; Rising costs due to technological innovation; Reduction of public health care expenditure; Patient mobility: Tourists, Immigrants and Long term residents;  Lack of health professionals (mainly pediatricians and nurses);  Restrictions imposed in public funding by commitments towards maintaining EU stability treaties.

Telemedicine eHealth Projects: Observatory

Source: “Observatory and projects on Telemedicine applications 2009”, Vol. 1/2009, Arsenàl.IT

Number of Telemedicine projects

8

18 16 2 0 6 4 14 12 10 8 1 1 2 1 3 13 17 11 7 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

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The Consortium Arsenàl.IT

:

Veneto’s Research Center of eHealth Innovation

 Founded in 2005 as “Telemedicine Consortium”, currently groups together all the 23 Local Health Authorities of the Veneto Region.

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The Consortium Arsenàl.IT:

Veneto’s Research Center of eHealth Innovation

 Has acted as Observatory by performing systematic surveys on Telemedicine applications developed over time by the member Health Authorities.

 Has succeeded in highlighting the critical issues of

interoperability, standardization

and organizational impact as factors for driving to the diffusion of Telemedicine applications in care delivery process.

Telemedicine eHealth Projects:

ESCAPE

Citizens

Citizens’ Clinical Document Sharing

Certification

Home PC

Digital Signature Storage

Mail Service Diagnostic Services producing Clinical Reports

Forwarding

GPs 11

Extraction

Hospital wards & Internal Services Example in a Local Health Authority Territorial Service Providers

12

Telemedicine eHealth Projects:

Doge, General Practitioners Network

       

A Regional project to create a communication network and connect general practioners and family doctors to the hospital and Local Health Authority.

ACTORS :

Regional information system Information system of Locl Health Authorities

VENETO REGION

GP Citizens Personal EHR

Information System LHAs SERVICES Citizens (Personal EHR)

SHARED INFORMATION:

Population data and personal data E-prescription

GP (Primary Care)

Clinical data, documents and reports Consents (privacy)

13

Telemedicine eHealth Projects: DREAMING & Telecare system

14

Telemedicine eHealth Projects: HEALTH OPTIMUM

Provincial area of Vicenza XDS Registry Provincial area of Belluno Provincial area of Padova XDS Repository Provincial area of Treviso Provincial area of Verona Provincial area of Venezia Provincial area of Rovigo

15

RENEWING HEALTH:

The Consortium EUROPEAN ASSOCIATIONS

European Patients’ Forum (EPF) European Health Telematics Association (EHTEL)

COMPETENCE CENTER

Arsenàl.IT

Medcom International Center for Distance-spanning Healthcare

COUNTRY

Italy Denmark Sweden Norwegian Center for Integrated Care and Telemedicine Catalan Agency for Health Technology Assessment and Research (CAHTA) VTT – Technical Research Center e-Trikala AE TSB Innovationsagentur Berlin GmbH Norway Spain Finland Greece Germany

ADVISORY BOARD COUNTRY

Continua Health Alliance Private Stichting (CHA) Integrating the Healthcare Enterprice (IHE) Belgium Italy, Spain, UK

COUNTRY

Luxembourg Belgium

NORWAY SWEDEN FINLAND DENMARK GERMANY AUSTRIA ITALY SPAIN GREECE

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RENEWING HEALTH: The expected impacts



Reduce hospitalisation

and improve disease management  Increased links and interaction between

patients and health professionals

, facilitating more active

participation of patients

in care processes 

Improvement of quality

of life for patients suffering form chronic conditions  Increased use of

existing or commonly agreed standards

and demonstration of interoperability of the new solutions in regular healthcare practice  Provide

a convincing business case

to be presented to National, Regional and Local Health Authorities and to stimulate them to speed up the deployment of patient-centered eHealth service solution

Conclusions and challenges

 The

Veneto Region

is actively involved in the area of

innovation

and

health care reforms

purchasing, payment systems and contracting as tools for restructuring, and in , with

benchmarking

its health care system;  eHealth development is a way of empowering the quality of human resources;  The use of modern technologies in and out of hospital should be understood as a way of improving quality and safety for the benefit of patients.

Thanking you for your kind attention!

[email protected]