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Professor George Crooks Medical Director, NHS 24, UK

The European Innovation Partnership for Healthy and Active Ageing B3 Action Group on Integrated Care. Professor George Crooks Medical Director, NHS 24, UK 13th International Conference on Integrated Care Berlin, 11 April 2013. Ageing society. Lack of health professionals.

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Professor George Crooks Medical Director, NHS 24, UK

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  1. The European Innovation Partnership for Healthy and Active Ageing B3 Action Group on Integrated Care Professor George Crooks Medical Director, NHS 24, UK 13th International Conference on Integrated Care Berlin, 11 April 2013

  2. Ageing society Lack of health professionals Chronic conditions Financial challenges HLY vs LE Health inequalities

  3. Keep itS I M P L E

  4. Future Service Model

  5. We need a new way….

  6. EUROPEAN INNOVATION PARTNERSHIPon Active and Healthy Ageing – An Overview Orsi Nagy Innovation for Health and Consumers European Commission, DG SANCO

  7. +2 Healthy Life Years by 2020 Triple win for Europe Action Groups Reference Sites

  8. Europe 2020 flagships for smart, sustainable and inclusive growth New Industrial Policy Platform against Poverty Innovation Union New Skills and New Jobs Digital Agenda Youth on the Move Resource Efficiency European Innovation Partnership on Active and Healthy Ageing Health in Europe 2020

  9. Political added value of the EIP Joint Action on Chronic Diseases and Healthy Ageing (28 countries + 5 networks) inspire for policy action support from the ground High level conferences (e-health, Gastein Forum, Conference of Partners, Frailty and Adherence Conferences) identify good practices working in real life EC: facilitator & supporter Alignment of priorities in Horizon 2020, CIP 2013, PHP 2013 etc. develop policy on active & healthy ageing align policy priorities with funding mobilise efforts & resources Reflection process of the MS: Towards modern, responsive and sustainable health systems

  10. 1 billion euro mobilised 30 mio citizens, >2 mio patients Marketplace >30,000 visits >650 registered users > 500 commitments 1,000 regions & municipalities 3,000 partners Building up EIP scale and critical mass

  11. Invitation For Commitments 2013 Closed: 28 February 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

  12. EUROPEAN INNOVATION PARTNERSHIPon Active and Healthy Ageing – B3 Action Group Donna Henderson Scottish Centre for Telehealth and Telecare NHS 24

  13. B3 Integrated Care Collaborative Regions, delivery organisations, patient / carers organisations, academia, industry collect experience, evidence to support policy-making provide input – expertise, best practice iterative, flexible process inspiration scale up innovative solutions synergies +2 HEALTHY LIFE YEARS by 2020 A triple win for Europe

  14. Current B3 Action Group Membership • 67 EIP commitments received from: • Regions • Delivery organisations • Patient / carer representative organisations • Academia • Industry • 199 stakeholders from committed regions / organisations and growing……

  15. Action Area v Change Management Action Area w Workforce Development Action Area x Risk Stratification Action Area y Care Pathways Action Area z Patient / User Empowerment Action Area u Organisational Models Map of reusable learning resources Stratification of the population Toolkit Toolkit Toolkit Toolkit Toolkit Toolkit Mapping Best Practices in the EU regions Map of partnership models for implementation of Chronic and Integrated Care Programme Action Area | Finance/Funding Map of best practice methodologies to support the implementation of Chronic and Integrated Care Increase the average number of healthy life yrs by 2 in the EU by 2020 Health status and quality of life । Supporting the long term sustainability and efficiency of health and social systems । Enhancing competitiveness of EU industry Action Area { ICT Tools Map of coaching, education and support patient/user empowerment and adherence 2013 Monitoring impact and outcomes 2015 Toolkit Toolkit Action Area } Dissemination By 2015 Chronic Conditions’ Programmes available at least 10% of target population in at least 50 regions By 2015 - 2020 Integrated Care Programmes serving older people, supported by innovative tools and services, in at least20 regions SIP TARGETS EIP AHA B3 Action Plan Chronic Conditions Integrated Care Implementation and Scale Up of Chronic Care + Integrated Care Programmes

  16. 4

  17. Good Practice in Integrated CareAction Area 6 –Patient / User Empowerment:‘Expert Patient Programme from Catalonia’ Dr Toni Dedeu Ministry of Health of Catalonia 18

  18. Good Practice in Integrated Care Expert Patient Programme from Catalonia [Ministry of Health of Catalonia] [Spain] [Catalonia][7,560,000] [Target population: 2,210,000] Description • The Expert Patient Programme of Catalonia™ (EPPC™) is a: • multidisciplinary initiative • based on patient-healthcare professional collaboration • and team work • In the EPPC it is the Expert Patient (EP) who: • leads the process • transmits knowledge about his or her disease to other patients who suffer from the same health problem • The healthcare professional: • becomes an observer, • and only intervenes if it becomes necessary • The Expert Patient is a person: • suffering from a chronic disease • who is able to take responsibility for his or her disease and self-care, • identifying symptoms, • and acquiring the skills to manage the physical, emotional and social aspects of the disease 19

  19. Good Practice in Integrated Care Expert Patient Programme from Catalonia Objectives • General Objective • To promote change in daily life habits which will improve quality of patient life, with the exchange and transference of knowledge and experiences between the Expert Patient and other patients • Specific objectives • Patient involvement • Evaluate degree of patient satisfaction • Improve perceived quality of life of the patients • Improve patients’ understanding of their disease • Improve level of self-care in order to better manage the disease • Improve treatment management • Reduce the number of encounters with Primary care nurses and GPs • Reduce hospital admissions and hospital emergency visits 20

  20. Good Practice in Integrated Care Expert Patient Programme from Catalonia Highlights: Innovation, Impactand Outcomes Innovation Involvement of patients in the self-management of chronic conditions with the support of multidisciplinary teams, with an innovative learning methodology specifically designed for the programme. 21

  21. Good Practice in Integrated Care Expert Patient Programme from Catalonia Methodology • The EPPC consists of: 22

  22. Good Practice in Integrated Care Expert Patient Programme from Catalonia Target Population 23

  23. Good Practice in Integrated Care Expert Patient Programme from Catalonia Highlights: Innovation, Impact and Outcomes • Impact • Example of result of healthcare service utilisation in groups of patients suffering from COPD • Total Participants: 140 24

  24. Key change management elements the EEPC has brought: Key change management elements the EEPC has brought: Good Practice in Integrated Care Expert Patient Programme from Catalonia 25

  25. Key change management elements the EEPC has brought: Key change management elements the EEPC has brought: Good Practice in Integrated Care Expert Patient Programme from Catalonia 26

  26. Key change management elements the EEPC has brought: Key change management elements the EEPC has brought: Good Practice in Integrated Care Expert Patient Programme from Catalonia 27

  27. Key change management elements the EEPC has brought: Key change management elements the EEPC has brought: Good Practice in Integrated Care Expert Patient Programme from Catalonia ❶From a paternalistic approach to healthcare from the professional point of view to a participative process with the patient ❷ An informed and co-responsible patient makes better and more efficient use of the healthcare services ❸ Patient knows betterwhat to do and when to ask for the support of a healthcare professional or when to go to a healthcare centre ❹ Reduce burden on resources and the use of services such as the number of visits to primary health centres, emergency units or hospital admissions due to worsening of the disease ❺ Increase to the sustainability of the Health System ❻ Results obtained to date, comparable with other similar International programmes, shows that this is a cost-effective intervention 28

  28. Key change management elements the EEPC has brought: Key change management elements the EEPC has brought: Good Practice in Integrated Care Expert Patient Programme from Catalonia 29

  29. Good Practice in Integrated CareAction Area 7–ICT / Teleservices’Telecardiology in Puglia' Francesca Avolio Regional Healthcare Agency, Puglia 18

  30. TELECARDIOLOGY applied to APULIA REGIONAL PUBLIC HEALTH CARE NETWORK ……..a good practice in Puglia Francesca Avolio Regional Healthcare Agency

  31. TARANTO FOGGIA LECCE BAT BARI BRINDISI 183 Ambulances 118 6 First Territorial Aid Points 21 Medicars 2 Inflated boat 1 Water Scooter 42 First Aid Points 2 Hydroambulances 35 Summer First Aid Points 1 3 5 2 2 3 1 6 8 20 41 2 35 10 34 14 1 6 3 17 39 5 2 2 14 16 UPDATE MARCH 2013 292 Clients in Apulia

  32. 4. The operator,through CardioVox P12 e CardioLink record the ECG of the patient in 50 seconds. 5. The operator, in 50 seconds, trasmit by Telephone, an ECG at Central Telecardiology Cardio On Line Europe. 6. Thespecialist receive, analyze, and report, in real-time, the ECG; he provides a specialist referral. 7. Reported electrocardiogram with a legal medical validity, is sent through fax (maximum within 3 minutes) to the operational Centre of 118, then it is made available in internet through the access to HRS - NET on www.cardioonlineeurope.com. • 3. A Central Telecardiology,run by a team of Cardiology Specialists Operating 24 hours on 24, 365 days per year, ready at all times to receive and report a real-time 12-lead ECG standard. 2. A landline or mobile phone. Scope of Service The service allows you to perform an electrocardiogram checks electronically through the combined use of: 1. 12 derivations standard mod. CardioVox P12 e CardioLink, supplied to users of the services.

  33. 551.010 ECG REPORT IN REAL TIME CARDIOLOGY WITH ADVICE ON LINE TELECARDIOLOGYapplied to APULIA REGIONAL PUBLIC HEALTH CARE NETWORK Activity to 11th October 2004 - 31st March 2013 ECG referted in March 2013: 9.218

  34. TELECARDIOLOGYapplied to APULIA REGIONAL PUBLIC HEALTH CARE NETWORK Activity to 11th October 2004 - 31st March 551.010 ECG REPORTED

  35. TELECARDIOLOGYapplied to APULIA REGIONAL PUBLIC HEALTH CARE NETWORK Activity to 11th October 2004 - 31st March 551.010 ECG REPORTED Breakdown by Range Hourly Breakdown for Sex

  36. 12.452 21.618 36.749 54.977 66.324 82.024 125.570 120.988 30.308 TELECARDIOLOGYapplied to APULIA REGIONAL PUBLIC HEALTH CARE NETWORK Activity to 11th October 2004 - 31st March CALL/AGE REPORT AGE DECADE CALL NUMBER

  37. TELECARDIOLOGYapplied to APULIA REGIONAL PUBLIC HEALTH CARE NETWORK Activity to 11th October 2004 - 31st March 551.010 ECG REPORTED

  38. TELECARDIOLOGYapplied to APULIA REGIONAL PUBLIC HEALTH CARE NETWORK Activity to 11th October 2004 - 31st March 212.643 ECG PATHOLOGICAL Distribution Disorders

  39. Without Shelter Urgent Hospitalization TELECARDIOLOGYapplied to APULIA REGIONAL 118 PUBLIC HEALTH CARE NETWORK Activity to 11th October 2004 - 31st March 551.010 ECG REPORTED

  40. TELECARDIOLOGYapplied to APULIA REGIONAL PUBLIC HEALTH CARE NETWORK • Conclusions……. • Rapid intervention time (…diagnosis network and at home) • Appropriatness (….less hospitalization..) • Equity(….widespread easy open access .. despite sex,age,time, soc/econ fcts) • Transferability (…devices, phone conections, networking … • ……organizational model….)

  41. Reduction of inappropriate hospital stay And savings in operating costs Guarantee widespread And more effective Service Intervention: Provide education and support Reduction of Hospitalization and healthcare costs Improve lifestyles and Health behaviour Perform services in the right setting Introduce telemedicine Increase point of access to healthcare Improve Clinical Outcomes Reduction of Acute events TELECARDIOLOGYapplied to APULIA REGIONAL PUBLIC HEALTH CARE and CRONICITY Sustainability of RHS Equity in Health

  42. alexandra 2012 Thank you from …….Puglia f.avolio@arespuglia.it

  43. European Innovation Partnership on Active and Healthy AgeingAction Group B3 - Integrated Care Thank you https://webgate.ec.europa.eu/eipaha/ 30

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