Telehealth and Care Coordination: What we did right and what we did wrong? Critical self-reflection

Telehealth and Care Coordination: What we did right and what we did wrong? Critical self-reflection WHINN, Odense 10th October 2017 ACT@Scale is funded by the European Union, in the framework of the Health Programme under grant agreement 709770

Advancing Care Coordination and Telehealth at Scale Cristina Bescos Philips Healthcare WHINN, 10th Oct 2017 ACT@Scale is funded by the European Union, in the framework of the Health Programme under grant agreement 709770

Population Health Vision Platform levels Activate patients Activation and engagement services Premium managed population Additional programs & services Chronic condition management Support and social care Prevention of chronic conditions Impact Navigate care for patients Care navigation services and capabilities Basic managed population Outreach campaign management Understand your population Value-based care platform Unmanaged population Health plan risk and performance management Regulatory reporting Transformation services and consulting 3

Health & Care Challenge Trends: Age related chronic conditions absorb the largest and fastest growing share of health and social care activities in high income countries Increasing complexity of people with multiple health and social care problems Need for health and social care grows with nr of conditions People with multiple needs are more likely to utilize health and long term services Current care systems are struggling to cope Episodic care, often in institutions Fragmentation and poor coordination of services Lack of ownership Poor communication (+ inability to share data) Duplication and gaps of care Primary and community care systems lack strength Mental and community care lack funding Slide adapted from understanding integrated care Nick Goodwin, CEO IFIC

Hypothesis Care coordination and telehealth can contribute to meet the Triple Aim goal in health systems Improving the user s experience Improving population health Better resource utilization Quadruple aim + 4 Improved care team experien

CC &TH: Many definitions & perspectives Integrated service delivery comprises the management and delivery of health and care services such that people receive a continuum of health promotion, health protection and disease prevention services, as well as diagnosis, treatment, long-term care, rehabilitation, and palliative care services through the different levels and sites of care within the health system and according to their needs - PAHO, 2011 (adapted)@philips:

ACT@Scale Northern Ireland South Denmar Groningen Basque Country Start March 2016 Catalonia Duration 36 months Project Budget 3.5 MEuros (60% funded) Consortium lead by Philips Healthcare (Germany)

ACT@Scale Consortium Philips Healthcare Germany (coordinator), Germany Osakidetza Basque Country Health System, Spain KRONIKGUNE Research Centre on Chronicity, Spain University Medical Center Groningen, the Netherlands Region of Southern Denmark, Denmark Agency for Health Quality and Assessment of Catalonia (AQuAS), Spain Centre for Connected Health and Social Care, Northern Ireland, Ireland Philips Electronics (Netherlands), the Netherlands Aristotle University of Thessaloniki, Greece City University London, School of Health Sciences, UK Universitätsklinikum Würzburg, Germany University of Hull, UK The Consorci Institut D Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Spain

ACT@Scale Aims Aim: scaling-up integrated care programs Structured methodology (PDSA) for assessment, benchmarking and exchange of good practices of scaling-up Transferability of good practices for scaling-up Topics: Stakeholder and change management. Achieve support and commitment Service selection. Appropriate level of distribution of health and care resources by dynamic needs of patients and populations Financial models and sustainability. Deliver at least equal quality of care at lower cost / better resources utilization Citizen empowerment. Total engagement of users / citizens to make the strategy self-sustaining Evidence. Collecting and measuring experience, status, progress and success of scalingup

9 Target Population / Programs (14) Chronic conditions CAT Chronic care CAT Complex case management CAT Physical activity 3 Region 2016 2019 South Denmark 430 2000 Catalonia 5000 15500 Northern 18500 35200 Netherlands Basque Country 6350 18400 Northern Ireland 2000 4200 TOTAL 32280 75300 Respiratory NNL Asthma / COPD NIRE COPD telemonitoring 2 Diabetes NIRE Diabetes telemonitoring 1 Cardiac BAS telemonitoring NNL Effective cardio 2 Multimorbid BAS Multimorbid integration 1 3 Independent living CAT Nursing homes CAT Frail older adults NNL Embrace 1 Pregnancy NIRE Weight management telemonitoring 1 Mental health RSD Telepsychiatry

Collaborative methodology The collaborative approach requires groups to come together periodically to learn change ideas and quality methods, and to exchange their experiences with making changes. Stimulates rapid improvement Disseminate good ideas Boost learning skills Key elements Topic selection Measurement and evaluation Purpose and expectations Actions periods Expert recruitment Learning sessions Enrollment of participating teams

Telehealth and Care Coordination: What we did right and what we did wrong? Critical self-reflection WHINN, Odense 10th October 2017 ACT@Scale is funded by the European Union, in the framework of the Health Programme under grant agreement 709770

ACT@Scale Objectives Demonstrate how the benefits of CC & TH can be successfully deployed at scale in real world healthcare settings From small pilots to routine practice Healthcare regions are investigating how best to incorporate CC & TH services into care delivery, and how to scale up and incorporate to standard practice. Reaching large scale Scaling-up encompasses making the services sustainable, providing them to entire populations, and engaging patients and practitioners. Transfer knowledge among key EU decision makers Develop, test, consolidate CC & TH best practices that can be exchanged and leveraged by healthcare regions to expedite deployment of services at scale. Promote European thought leadership at EU policy level and showing payers, practitioners and providers how patient care can be improved under restricted budgets. 13

ACT@Scale Process ACT@Scale Transferability Event 10 th October, Odense WHINN 2017: Week of Health and Innovation Proposal Baseline: M6 Learning Cycle: T.E. M18Coaching Cycle: M30 Dissemination Selection of Good Practices to scale-up Mapping current situation Identify critical factors for scaling up Agree on KPIs Improveme nt interventio n on the critical factor Mapping updated situation Identify critical factors for scaling-up Improvement intervention on the cirtical factor Transfer from the good practice experience Mappin g update d situatio n Lessons Learne d 1 Data Collection & Analytics 2 Data Collection & Analytics 3 Data Collection & Analytics

Engage with us: Collaborating partners Engagement as observer Access to programme results and participation in project meetings Learn from the others good practice and experiences Provide opportunities for collaboration leading to efficiently (re-) design and validate innovative care services and expand the services to larger population - with the same level of investment Enlarge your visibility at international level Enable local industry to see a larger market, beyond the local border Engage political/industrial support Engagement as evaluation site in addition, Access to the ACT evaluation engine and fully participate in the evaluation process and best practice selection Get evidence and benchmarking of your solution under the review of the key international experts Combine evidence with all the evaluation sites

Questions? Thank you! https://www.act-at-scale.eu/ Cristina.Bescos@philips.com