eHealth addressing global challenges through ... - World of Health IT

eHealth addressing globalchallenges through local actionsWhen Telemedicine does deliver!Parallel Session PS 7Tuesday 16 March, 2010,14:00 – 15:15

Giancarlo Ruscitti MDSecretary General for Health & Social ServicesVeneto Region

Background of the experience of the Veneto Region• Since 2004, the Veneto strategy of economic sustainability andinnovation has meant increasing financial contraints in HumanResources, and developing policies for the allocation and mostefficient use of health care personnel, empowered by theappropriate use of e-technologies;• National budget constraints have forced the Region to reallocatethe health budget in order to guarantee the Essential Levels ofHealth Care provision (LEA) to all Veneto Citizens by:1. rationalizing and renewing the hospital network;2. re-organizing health services in the territory;3. investing in innovation, ICT and eProcurement;

The Veneto Region: Territory andPopulation• 4,8 M inhabitants• 18.391 km 2 of land surfacePopulation Structure*Members per family 2.6Birth rate 9.3Death rate 9.0Natural growth rate 0.3Total growth rate 5.6% Elderly persons 135.7% population > 65 years 18.5% EU population>65 years 14.08* As of the 2008 General Consensus4

The Veneto Region:Health Care Providers and Professionals• 21 Local Health Authorities• 2 Hospital TrustsPUBLIC ACCREDITEDINSTITUTIONS 64IRCSS (SPECIALIST RESEARCHINSTITUTES)Public health authority (Az. Osp.) 2Hospital in the Provincial capital 6Network hospital / strong integration 33Integrating hospital of the network 8Polyfunctional health centres 10Management experimentation 41• 41.806 Medical & Nursing staff• 11.702 Laboratory Technician• 6.704 Administrative staff• 117 Other ProfessionalsPRIVATE ACCREDITED INSTITUTES 14Care homes/ hospital 19Classified hospital 4IRCSS (SPECIALIST RESEARCHINSTITUTES)15(* Veneto Regional Statistics Office data, 2008)

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 termresidents; Lack of health professionals (mainly pediatricians andnurses); Restrictions imposed in public funding by commitmentstowards maintaining EU stability treaties.

e-Health PrioritiesFrom a technical perspective:1. Enable the interoperability of Telemedicine services at the regionallevel.2. Build up standardized EHR systems at local level with a view toestablishing a single digital Patient Health Folder system at the regionallevel.3. Develop eHealth-based Disease Management models for the treatmentof outpatients.4. Foster the interoperability of the above systems/services at theNational level.5. Foster the interoperability of the abovesystems/services at the European level

Telemedicine eHealth Projects:ObservatorySource: “Observatoryand projects onTelemedicineapplications2009”,Vol. 1/2009,Arsenàl.ITNumber of Telemedicine projectsN. Cumulative progetti number of active Telemedicine projects181716141312111087643221 1101998 1999 2000 2001 2002 2003 2004 2005 2006 2007 20088

e-Health Project InitiativesHEALTH OPTIMUMOpen e-Health InitiativeRENEWING HEALTHNeurosurgical TelecounsellingPatient Summary& e-PrescriptionPersonal Health Systemand TelemonitoringGrowing-TogetherNear-To-NeedsNETC@ARDSe-Learning for healthSatellite-basedSecond Opinion servicesInteroperability of healthsmart cardsTERREGOVTeleMed-ESCAPEIESSE-Government servicesPaperless handling ofhealth documentsWeb-based booking ofhealth services63 European Projects – Themes: eHealth, Research,Social Services and ICTOverall budget: €50M

Telemedicine eHealth Projects:ESCAPECitizens’ Clinical Document SharingCitizensDiagnostic Servicesproducing ClinicalReportsDigitalSignatureCertificationForwardingStorageHomePCMailServiceGPsHospital wards &Internal ServicesExtractionTerritorialServiceProvidersExample in a Local Health Authority inVeneto10

Telemedicine eHealth Projects:HEALTH OPTIMUMProvincial area ofVicenzaXDS RegistryProvincial area ofBellunoXDSRepositoryProvincialarea ofPadovaProvincialarea ofTrevisoProvincialarea ofVeneziaProvincial area ofVeronaProvincial area ofRovigo11

RENEWING HeALTHREgioNs of Europe WorkINg toGether for HeALTH• Programme: Competitiveness and Innovation Framework Programme CIP runs from2007-2013• Funding Scheme: Information and Communication Technologies Policy SupportProgramme ICT PSP; Funding Instruments: Pilot Type A• Principle Actor Involved: Regional Healthcare Authorities• Content of the 3 rd Call of Proposals in 2009• Theme: ICT for Health, ageing and inclusion• Objective: ICT for patient-centered health services• Budget: € 14 M - European Co-financing: € 7 M• Duration: 32 months• Starting date: 1 st February 2010Kick Off Meeting: 8 th February 2010, Venice

RENEWING HEALTH:The ConsortiumEUROPEAN ASSOCIATIONSEuropean Patients’Forum (EPF)European Health Telematics Association(EHTEL)COUNTRYLuxembourgBelgiumCOMPETENCE CENTERArsenàl.ITMedcom InternationalCenter for Distance-spanning HealthcareCOUNTRYItalyDenmarkSwedenSWEDENNORWAYFINLANDNorwegian Center for Integrated Care andTelemedicineCatalan Agency for Health TechnologyAssessment and Research (CAHTA)VTT – Technical Research Center -NorwaySpainFinlandDENMARKe-Trikala AETSB Innovationsagentur Berlin GmbHGreeceGermanyGERMANYADVISORY BOARDContinua Health Alliance PrivateStichting (CHA)Integrating the Healthcare Enterprice(IHE)COUNTRYBelgiumItaly,Spain,UKAUSTRIASPAINITALYGREECE13

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 anddemonstration of interoperability of the new solutions in regular healthcarepractice• Provide a convincing business case to be presented to National, Regionaland Local Health Authorities and to stimulate them to speed up thedeployment of patient-centered eHealth service solution14

The Consortium Arsenàl.IT:Veneto’s Research Center of eHealth Innovation• Has acted as Observatory byperforming systematic surveyson Telemedicine applicationsdeveloped over time by themember Health Authorities.• Has succeeded in highlightingthe critical issues ofinteroperability, standardizationand organizational impact asfactors for driving to the diffusionof Telemedicine applications incare delivery process.15

The DOGE ProjectThe General Practitioner NetworkA Regional project to create a communication network andconnect GP and Primary Care sites to the hospital and LocalHealth Authority (LHA).ACTORS:VENETO REGION• Regional information system• Information System of LHAs• GP• Personal EHRHIS HospitalInformation SystemGP andPRIMARY CARECITIZENEHRProject start: June 2009Doge Pilot Test is located in Adria Local Health Authorityn. 19 involving 70 GPs and SCCs

Conclusions and challenges• The Veneto Region is actively involved in the areaof innovation and health care reforms, withpurchasing, payment systems and contracting astools for restructuring, and in benchmarking itshealth care system;• eHealth development is a way of empowering thequality of human resources;• The use of modern technologies in and out ofhospital should be understood as a way ofimproving quality and safety for the benefit ofpatients.

Thanking you for your kind attention!giancarlo.ruscitti@regione.veneto.it