CASA Secondment: Good practices from the

Veneto RegionFrancesca 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 systemPublic accreditated institutions 64

Local Health Authorities 21

Hospital Trust 2

Private accreditated institutions

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

Directorate of Social S

Directorate of Social S

FacilitiesHead of Department of Health

Department of Health and Social Services

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 serviceRequested 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 platformPatient’s

homeRegional eHealth Centre

5

32

4

SERVER

DATA TRANSMISSION

DATA ACCESS THROUGH HOME CARE PORTALALARM MANAGEMENT

ALARM MANAGEMENT

PATIENT

1

GATEWAYTELEMONITORING

DEVICES

REGIONAL CENTRE’S

OPERATOR

ALARMDEVICE

6

7

GENERAL PRACTITIONER

HOSPITAL ORLOCAL HEALTHDISTRICT

INTERVENTIONSERVICE

SOCIAL WORKER

FAMILY

Talking about numbers…

TelecareIn the period 2008-2012:• More than 45k true alarms managed• More than 10 mil scheduled phone calls (210k

call/month)

TeleHealthIn 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 centreUnique 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/needsDeferrable (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!