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

1. eHealth addressing global challenges through local actionsWhen Telemedicine does deliver! Wednesday, 18th November 2010

2. Giancarlo Ruscitti MD CEO - Fondazione Opera S. Camillo

3. Background of the experience of the Veneto Region • Since 2004, the Veneto strategyofeconomicsustainabilityandinnovationhasmeantincreasingfinancialcontraints in Human Resources, anddevelopingpoliciesfortheallocationandmostefficientuseofhealthcarepersonnel, empoweredbytheappropriateuseof e-technologies; • National budgetconstraintshaveforcedthe Region toreallocatethehealthbudget in order toguarantee the EssentialLevelsofHealth Care provision (LEA) toall Veneto Citizensby: • rationalizingandrenewingthehospitalnetwork; • re-organizinghealthservices in the territory; • investing in innovation, ICT andeProcurement;

4. The Veneto Region: Territory and Population • 4,8 M inhabitants • 18.391km2 of land surface * As of the 2001 General Consensus 4

5. The Veneto Region:Health Care Providers and Professionals • 21 Local Health Authorities • 2 Hospital Trusts • 41.806 Medical & Nursing staff • 11.702 Laboratory Technician • 6.704 Administrative staff • 117 Other Professionals (* Veneto Regional Statistics Office data, 2008) 5

6. The Veneto’s responsibility in policy-making in the Health & Social Sector Ministerfor Social Policies MinisterforHealthPolicies MinisterforAnimalHealth 582 Municipalities in the Veneto Region RegionalSecretaryforHealth & Social Services 21LocalHealthAuthorities 2 University Teaching Hospitals 2 Scientific Reseach Hospitals

7. New challengesfor Veneto Health Care Increase in EU citizensexpectations; Ageingpopulation Home-care in rural and mountain areas; Risingcosts due totechnologicalinnovation; Reductionof public health care expenditure; Patientmobility: Tourists, Immigrants and Long termresidents; Lackofhealthprofessionals (mainlypediatricians and nurses); Restrictionsimposed in public fundingbycommitmentstowardsmaintaining EU stabilitytreaties.

8. Telemedicine eHealth Projects: Observatory Number of Telemedicine projects Cumulative number of active Telemedicine projects N. progetti 18 17 16 14 13 12 11 10 8 7 6 4 3 2 2 1 1 1 0 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Source: “Observatory and projects on Telemedicine applications 2009”, Vol. 1/2009, Arsenàl.IT 8

9. The ConsortiumArsenàl.IT:Veneto’s Research Center ofeHealthInnovation • Founded in 2005 as “Telemedicine Consortium”, currently groups together all the 23 Local Health Authorities of the Veneto Region. 9

10. 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. 10

11. Telemedicine eHealth Projects: ESCAPE Citizens Certification Home PC Digital Signature Storage Diagnostic Services producing Clinical Reports Mail Service Forwarding GPs Extraction Hospital wards & Internal Services Territorial Service Providers Example in aLocal Health Authority Citizens’ Clinical Document Sharing 11

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 • GP • Citizens Personal EHR • SHARED INFORMATION: • Population data and personal data • E-prescription • Clinical data, documents and reports • Consents (privacy) VENETO REGION SERVICES Information System LHAs Citizens (Personal EHR) GP (Primary Care) 12

13. Telemedicine eHealth Projects:DREAMING & Telecare system 13

14. Telemedicine eHealthProjects: HEALTH OPTIMUM Provincial area of Vicenza Provincial area of Belluno Provincial area of Padova Provincial area of Treviso Provincial area of Venezia Provincial area of Rovigo Provincial area of Verona XDS Registry XDS Repository 14

15. RENEWING HEALTH:The Consortium FINLAND SWEDEN NORWAY DENMARK GERMANY AUSTRIA ITALY SPAIN GREECE 15

16. 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-centeredeHealth service solution 16

17. Conclusions and challenges • The Veneto Region is actively involved in the area of innovation and health care reforms, with purchasing, payment systems and contracting as tools for restructuring, and in benchmarking itshealth care system; • eHealth development is a way of empowering the quality of human resources; • The useofmoderntechnologiesin and out of hospital shouldbeunderstoodas a way ofimprovingquality and safetyfor the benefit ofpatients.

18. Thanking you for your kind attention! amministratore.delegato@camilliani.net