PowerPoint-presentatie

Report
CASA Secondment:
Good practices from the
Veneto Region
Francesca Vanzo, Arsenàl.IT
Poznan, 04th April 2014
The Veneto Region
• 4,9 M inhabitants
• 18.391 km2 of land surface
• 581 municipalities in 7 provinces
The Health and Social care System
Veneto Health system
Public accreditated institutions
64
Local Health Authorities
21
Hospital Trust
Private accreditated institutions
2
14
Medical & nursing staff
41.806
Laboratory technicians
11.702
Administrative staff
6.704
Other professionals
117
The Health and Social care System
Social
Services
Department
of Health
and Social
Services
Directorate
of Social S
Head of Department
of Health
Facilities
The secondment in the Veneto
Region - Topics
• The regional health and social care system
• Integration of telehealth and telecare services: the role of the
regional eHealth centre and the Renewing Health EU project
• Local coordination centre: the role of the centre CURA in
coordinating health and social services for elderly and frail patients
living in Treviso
• Telemonitoring services for patients with implantable cardiac devices
• Care provision for frail elderly patients: the ARCA Project
• Protected discharge pathway: integration between hospital facilities
and local care services in LHA of Verona
• Community hospital and health district care
The secondment in the Veneto
Region – Good practice
• The regional health and social care system
• Integration of telehealth and telecare services: the role of the
regional eHealth centre and the Renewing Health EU project
• Local coordination centre: the role of the centre CURA in
coordinating health and social services for elderly and frail patients
living in Treviso
• Telemonitoring services for patients with implantable cardiac devices
• Care provision for frail elderly patients: the ARCA Project
• Protected discharge pathway: integration between hospital facilities
and local care services in LHA of Verona
• Community hospital and health district care
Case Study 1
The role of the regional
eHealth centre
Telecare:
• Emergency Response Service plus Telecontrol
•
Domotic devices/Environmental monitoring (optional): fall sensors, water
sensor, LPG sensor, smoke sensor, etc.
Support to the Territorial Services:
•
Access to GP’s, Home Nursing Services, Specialist second opinion services
•
Access to secondary care: Front/Back Office & Call Center booking service
•
Informative Services and Technical Help Desk
Telehealth and Disease Management:
•
Telemonitoring of clinical parameters
•
Life Style Monitoring
Telecare services
Administered by the Social Services of 581 municipalities
since more than 25 years and effectively managed by the
regional eHealth centre.
It covers more than 24,000 citizens over 65 years old with frail
conditions in the whole Region with the following services:
• Emergency response: 24/7 detection of any potential critical
episode occurring at home, such as falls, deterioration of
symptoms and any other kind of inconvenience that can affect
the patient well-being everyday life conditions or needs and
educate patients to use the devices
• Telecontrol service: scheduled telephone contacts to monitor
the psychophysical state of the user and identify potential need
for further intervention
Telehealth service
Requested by the patient’s physician (GP or specialist)
and effectively managed by the same regional eHealth
centre.
In the context of the Renewing Health EU project a
group of telecare users with chronic diseases (COPD,
Heart Failure and Diabetes) were enrolled and provided
with also the telehealth service.
The regional eHealth staff is in charge of:
•Keeping patients’ clinical parameters under control
•Reminding patients of taking measurements according
to the scheduled plan
•Filtering false positive measurements
•Managing alarm situations according to their priority
and intermediating with the healthcare professionals (or
eventually emergency services)
Telecare and Telehealth platform
Patient’s
home
Regional eHealth Centre
PATIENT
TELEMONITORING
DEVICES
1
2
GENERAL
PRACTITIONER
SERVER
GATEWAY
7
3
HOSPITAL OR
LOCAL HEALTH
DISTRICT
4
6
5
ALARM
DEVICE
INTERVENTION
SERVICE
SOCIAL WORKER
REGIONAL
CENTRE’S
OPERATOR
DATA
TRANSMISSION
ALARM
MANAGEMENT
DATA ACCESS THROUGH HOME CARE
PORTAL
ALARM
MANAGEMENT
FAMILY
Talking about numbers…
Telecare
In the period 2008-2012:
• More than 45k true alarms managed
• More than 10 mil scheduled phone calls (210k call/month)
TeleHealth
In the period 2012-2013
• About 70k alarms received, 36% true alarms  eHealth
centre is an important preliminary filter
• Among true values, 76% are less severe alarms (green), 14%
medium alarms (yellow), 10% very severe alarms (red)
Case Study 2
Care coordination unique centre
Unique telephone number for all the elderly and frail patients
already in a home nursing program in the Treviso area.
•
Interchangeable staff management with resources with professionals
coming from the 4 health districts of LHA of Treviso (doctors, nurses,
administrative personnel, health and social care operators)
•
24/7 availability
•
Prioritization of requests and needs
(triage management)
•
Categorization of inbound requests
and management according to
standard procedures
Inbound requests/needs
Deferrable (answer within 150 min)
•Provision of drugs and medication material
•General information (front-end opening hours, remind of
appointment for blood test, etc.)
•Home visits (dates)
•Nurse services (blood infusions, enema administration, etc.)
•Notification of hospital admissions, discharges, death
No deferrable (answer within 90 minutes)
•PEG (bleeding, occlusion or dislocation of the feeding tube)
•Tracheotomy (dislocation of the tube, bronchoaspiration)
•Infusion (dislocation of the needle)
Thank you for your attention!

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