Project outline and status Marco d'angelantonio A i th I t f T l di i Assessing the Impact of Telemedicine 6 April 2011, Luxembourg
Table of Content RENEWING HEALTH in a nutshell Objectives Consortium Clusters Current status 2
RENEWING HEALTH in a nutshell RENEWING HEALTH is the second Pilot Type A ehealth project funded under the new European Union ICT-PSP (Information and Communications Technologies Policy Support Programme) Project start date: 1 st of February 2010 Project duration: 32 months Total budget: 14.000.000 Euros EU contribution: 7.000.000 Euros 21 pilot sites, grouped in 9 clusters and distributed over 9 EU regions 3
Size RENEWING HEALTH in a nutshell 20 partners + 5 Competence Centres 7.900 patients in the Intervention Group 72 person-years of work 27 FTE Multicultural character Partners come from 11 different EU countries nicely covering Northern, Central and Southern Europe Evaluation methodology 4 Randomised Controlled Trials MAST
Population covered Region RENEWING HEALTH in a nutshell Population Regione del Veneto 4.800.000 Region Syddanmark 1.200.000 Norrbotten County 250.000 North Norway 462.000 Catalunya 7.000.000 South Karelia 135.000 Thessaly & Central Greece 1.500.000 000 Land Kärnten 560.000 Land Berlin 4.900.000 Total 20.807.000 5
Clinical objectives 6 Explicit objectives improving the quality of life of chronic patients who, for just the three chronic diseases addressed in the Project, account for well over 15% of the EU adult population by removing anxiety about health conditions reducing the need for the patient to use emergency services and/or hospital stays avoiding and/or slowing down the worsening of their disease and the insurgence of complications providing clinical evidence that, at least for certain chronic diseases, a telemedicine-based delivery network can supply healthcare services at least of the same clinical quality and reliability as those supplied through a traditional a healthcare e delivery network
Explicit objectives Patient/user perspective objectives providing coherent clinical services through ICT that take into proper consideration patients and professional users needs, capabilities, risks and benefits implementing solutions that support the empowerment of the patients and increase patients satisfaction demonstrating that the implementation of telemedicine services improves the professional satisfaction of the involved healthcare professionals. measuring patients, relatives, informal caregivers and healthcare professionals satisfaction (through questionnaires) 7
Economic objectives Explicit objectives containing the cost of care for chronic patients to maintain the health system sustainable in spite of the demographic changes reducing the reliance of chronic patients on the most expensive care facilities and replacing them with more affordable homecare 8
Organisational objectives 9 Explicit objectives cutting across the traditional fences among different levels of care creating an organisational model for telemedicine services that ensures a safe, clear and efficient pathway for patients in their journey through the healthcare system promoting active participation of the patients in the organisational model measuring the organisational impact of telemedicine in both a qualitative and quantitative manner
Implicit objectives Providing Healthcare budgetary Authorities with a rock-solid argument to adopt PHS and rethink the way they deliver care thanks to these Reaching in each of the pilot sites the critical mass of patients which will make the move towards the deployment depoy e of PHS unstoppable oppabe 10
Consortium It comprises all the relevant stakeholders Regional Health Authorities Regional Healthcare Providers Competence Centres in Telemedicine Patient and professional (through their associations) Industrial companies (through their associations) 11
Consortium Regione del Veneto Region Syddanmark Norrbottens Läns Landsting (County Council of Norrbotten) Lulea Tekniska Universitet - Centre for Distance-spanning spanning Healthcare Helse Nord RHF - Northern Norway Regional Health Authority Universitetssykehuset Nord-Norge Norge HF (Norwegian Centre for Integrated Care and Telemedicine) Ministerio de Salut - Generalitat de Catalunya Agència d'avaluació de Tecnologia i Recerca Mèdiques (Catalan Agency for Health Technology Assessment and Research) Etelä-Karjalan sosiaali- ja terveydenhuollon kuntayhtymä (South Karelia Social and Health Care District) Anaptyxiaki Diadimotiki Eteria Psifiakes Polis Kentrikis Elladas AE OTA (Intermunicipal Development Company Digital Cities of Central Greece S.A.) Anaptyxiaki Etaireia Dimou Trikkaion Anaptyxiaki Anonymi Etaireia OTA (e-trikala AE) Italy Denmark Sweden Sweden Norway Norway Spain Spain Finland Greece Greece 12
Consortium Municipality of Trikala Diikisi 5th Ygionomikis Periferias D.Y.P.E. Thessalias kai Stereas Ellados (Regional Health Authority of Sterea & Thessaly) European Patient s Forum European Health Telematics Association Continua Health Alliance Private Stichting Fundació TicSalut Krankenanstalten Betriebsgesellschft Land Kärnten Pflegewerk Managementgesellschaft Greece Greece Luxembourg Belgium Belgium Spain Austria Austria Germany 13
Consortium Regione Veneto Surface:18.391 km² Inhabitants: 4,8 million Municipalities: 580 Population density: 263/km². 14
Consortium Norrbotten County 15 Surface: 98.911 km² Inhabitants: 258.094 Municipalities:14 Population density: 2,6/km².
Consortium Region Syddanmark Surface: 12.191 191 km² Inhabitants: 1.194.659 Municipalities: 22 Population density: 98/km². 16
Consortium North Norway 17 Surface: 112.951 km² Inhabitants: 462.908 Municipalities: 20 Population density: 4,1/km².
Consortium South Karelia Surface: 7.236 km² Inhabitants: 135.000 Municipalities: 11 Population density:18,7/km². 18
Consortium Catalonia Surface: 32.114 km² Inhabitants: 7.504.881 Municipalities: 946 Population density: 233,7/km². 19
Consortium Carinthia Surface: 9.536 km² Inhabitants: 559.981 Municipalities: 132 Population density: 58,7/km². 20
Consortium Central Greece Surface: 32.448,72 km² Inhabitants: 1.000.000 Municipalities: 11 Population density: 47,03/km². 24/06/2011 21
Consortium Berlin Surface: 892 km² Inhabitants: 3.443.570 Population density: 3.861,3/km². 22
Consortium The Competence Centres 23
Consortium The patients, industrial and ehealth Associations 24
Why clusters The concept of clusters has been introduced for: grouping existing telemedicine services, although using heterogeneous technological platforms, according to their aim, timing and duration of the intervention increasing the statistical power of the trials by aggregating data from the various pilots of a same cluster promoting close collaboration and sharing of experience among teams which have never worked together before RENEWING HEALTH 25
Cluster table Pilot site Type of service PATHOL LOGY VENETO 1 & 2 VENEZIA & OVEST VICENT TINO VENETO 3 & 4 PADOVA VERONA VENET TO 5 TREVI SO VENET TO 6 PIEVE DI SOLIGO SYDDANM MARK 1 NORRBO OTTEN ERN WAY NORTH NORW CATALO ONIA SOUTH KA ARELIA THESS SALY CARINT THIA BERL LIN patients ved Number of involv Cluster 1 Medium-term health coaching and life-long l monitoring Cluster 2 Life-long monitoring Cluster 3 Ulcer monitoring Cluster 4 Short term follow-up after hospital discharge Cluster 5 Life-long monitoring DIABETES COPD X X X X 900 X X 400 X 500 x X 800 X X X X X 900 26 Cluster 6 Medium-term health coaching and life-long monitoring X X 300 Cluster 7 Remote monitoring of X X X X X 310 Congestive Heart Failure Cluster 8 Remote monitoring of implantable cardiac devices X X X X 1.850 (ICD & PM) Cluster 9 Remote monitoring of Oral Anticoagulant Therapy X X X X 1.940 (OAT) CVD diseas ses Total 7.900
Minimum requirements for a cluster All pilots belonging g to a same cluster have to share a common set of primary indicators Each cluster of pilots have to operate as a multi-centre clinical trial (aggregation g of data) For each cluster a Scientific Trial Protocol has been elaborated that includes, a.o., a detailed description of objectives, design, methodology, outcomes, statistical considerations 27
Current status 28 We have completed the Grant Agreement negotiation with the Commission We have brought order to the chaos We have organised 21 heterogeneous pilots into 9 rather homogeneous clusters We have defined a common dataset to collect demographic, health related quality of life and patients perception We agreed to use a common outcome for all the clusters (SF-36 v2 questionnaire) i
Current status We have finalised the Trial Protocols for 7 of the 9 clusters We have completed the User Requirements and the Technical Recommendations for Project Implementation We are almost in line with the Project Plan which was particularly ambitious because of the number of partners and the complexity of the matter 29
Current status We have attracted attention from other regions and organisations which have expressed an interest in joining the Project... and even more important than all the other achievements: we have learnt to work together as a team in spite of the fact that we barely knew each other at the beginning of the Project 30
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