ICT Strategy in The Catalan HealthCareand SocialCare

System

ICT Services

Table of contents

TicSalut Foundation

Catalan Healthcare System

Electronic Health Record in Primary Healthcare

iSIS.Cat. Integration Health and Social Care

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TicSalut: Technology, Innovation & Health

Founded in 2006, TicSalut Foundation is an agency within the Ministry of Health that works to promote the development and use of ICT in the health and social care domain, acts as a trends, innovations and emerging initiatives observatory, and provides services for the standardisation and accreditation of products.

The Catalan Healthcare System Health Plan

Current System The Catalan healthcare model is a multi-provider one integrated in a unique public network.

It enhances the autonomous management of each provider.

Providers are free to select their information systems; however 85% of the primary care centers have the same system (eCAP)

Interoperability among systems must be guaranteed.

Decentralized System

Catalan Healthcare System

Insurance Services

USE

R

CATALAN HEALTHCARE

SERVICE

CONTRACTED PROVIDERS

100%

DEPARTMENT OF HEALTH: Draws up Health Plan and Transfers economic resources Plans

Governance

The history of the Catalan healthcare system, made it highly fragmented at a healthcare supply level:

Around 80% of the specialized care and around the 20% of the primary care is provided by suppliers not belonging to the Department of Health

Inexistent common Information System for all the healthcare suppliers due to the healthcare system diversification

ICT’s Strategic component of the Healthcare System

20%

Supplementary Private Insurers

CATALAN INSTITUTE OF

HEALTH

Private Centres

20%

70%

10%

Goals and health programs

Chronic care patients orientation

Integrated care system

Quality and equitry in tertiary care

Focused in patients and families

Outcome-based commissioning

Clinical and professional knowledge management

System governance and participation

Shared information, transparency and evaluation

eHealth Plan

Citizen

centered

healthcare

HEALTH PLAN

97%

Hospitals

98%

Primary

Care

82%

Long-term

care

67%

Mental

health

Catalonia

Spain

USA

27 hospitals 6

EMRAM

2013

Current Situation. Some Figures

VIDEO

1.8m docs/month

23%

Current model

121.390 access/month

64%

New model

BPM

Rules

CDSS

IS

Web services

Care processes

Health intelligence

Messaging

platform

BI/visor

Future model: ISISS.cat Health and social integration

Healthcare

processes

integration

Integration Health Data

The Shared Medical Record – Look & Feel

Adding Value through ICT: From documents to cooperation

Adds “value” to

professionals

Enables continuity of

care

Sharing Documents

Images Publishing

Professionals share

knowledge

Serving continuity of care

Exchanging Information

ePrescripcion

Clinical practice is

connected with ALL the

agents demanding a

change in behaviour

Increase of quality of care

Collaborative Model

eHealth

Folder

Information

Digital certificate

Documents

Channel

Communication

Robust password

Services

CITIZENS ACCES TO DATA

Home Diagnosis ePrescription Vaccination Connect My controls Reports

Search by:

- Report type

- Date

- Center

Report search results: - Date - Report type - Diagnostic - Service - Health Center

PHC: Clinical reports

Active health

problem

Non active

health problem

Home Diagnosis ePrescription Vaccination Connect My controls Reports

PHC: Diagnosis control

Online: always updated

Printable

PHC: ePrescription – Available and printable

medication and chronic treatment

Home Diagnosis ePrescription Vaccination Connect My controls Reports

Reported from provider center

Reported from vaccination book

Reported verbally from patient

Duplicated

PHC: Vaccination – Reports vaccines supplied

Home Diagnosis ePrescription Vaccination Connect My controls Reports

o Blood donors

o Public procedures

desk

o Other reference

health centers

PHC: Connect

Home Diagnosis ePrescription Vaccination Connect My controls Reports

Telemonitoring

- Controlling of diabetic disease

- Preventive medicine (SISO)

PHC: My controls

Home Diagnosis ePrescription Vaccination Connect My controls Reports

Health care environment

Budget reduction + Increase chronicity

Guarantee the quality of the service

+ =

Challenge: manage efficiently the resources assigned to chronic patients

Information Technologies Process & Organization Current environment

• Systems oriented to the medical act.

• Low personalization of complex cases

• Low consensus level of agreement in the patient treatment

• High traditional units activity: A&E

• Reactive system

• Difficulties for the treatment adherence

• Low integration with palliatives units

• No patient centric vision

• Systems oriented to treat the pathology

not the patient (clinical pathways,

processes…)

• No case management role extended

• No transversal care plan treatment

• Low culture of homecare

• Low telemedicine processes

• No alternative units for A&E

treatments.

• No integration with social services

• No integration with intermediate care

attention

• Systems with low level of

integration

• No 360º vision of patient

• No proactive systems for given support to the professionals.

• No clinical pathways implemented in all healthcare levels (partial implementation).

• Difficulties to measure the KPIs

• No mobiles development solutions

i-SISS.Cat

Strategic plan for the implementation and deployment of the platform for the management of

healthcare and social Processes in Catalonia

BENEFITS

Gestió del coneixement

Models de predicció

Anàlisi impacte pacient

Mesura de resultats en termes de salut

Analítica Avançada

Model de Interoperabilitat i regles de negoci

Model de gestió de processos clínics integrats

Gestió de processos

Guies clíniquesMonitorització del serveiGestió d’acords de servei

Integració Publicació catàleg de serveis d’informació pacientMissatgeria entre proveïdorsEstàndards del sector i de país (HL7, WIFIS)

Gestió de regles

Ruta al territoriEvents del pacientProtocols

GovernVisió programes Gestió oferta – demandaControl econòmic/consum

ProfessionalsVisió 360Gestió del procésEntorn de col·laboració / educacióAlarmes

Pacients – Canal de SalutInteracció amb el sistema sanitariEducacióPacient expert

Gestió d’informacióHCE Continguts

iSALUT

Motor tràmits

Access informació clínica personal

Accés a apps.

Telemonitorització

Model de col·laboració amb el ciutadà -Canal de Salut

AQuAS - VISC • Distribution and source of

information with different level of detail

• Evaluation of care processes • Prediction Model • International projects. Pilots

Citizen • Proactivity • Non-face-care Model • CPS – follow-up of the process • Co-responsability

• APPs • Personalized medicine

Department • Comply with the

objectives of the health care plan

• Getting health policies to citizens

• Integration with other departments

Professionals • Continuum of care • Vision and process monitoring • mhealth • Collaborative model • Proactive and predictive medicine

Supplier • Integrations into their systems of

information • Common Model • Process management • Interconsultes • Definition of rules of derivation –

supply & emand control systems for clinical decision support

• Facilitate the adaptiation to the new billing models among other introduceds

DGORS • Integration with the

history of the Center • Accreditations. Quality

management of the Center

• Patient collaborative environments

CatSalut • Model Government • Common Model Standardization • Information on line

• Monitoring of regional healthcare processes

• Proactivity. Have data, don’t ask for them • Demand control • Adjustment of payment models • Proforma Invoice: identification of clinical

processes • Integration with 061CatSalut Respon

Public Health • Suitability of prevention

programmes • Integration with SSII asistencials • Prescribe health tips • Library of Consells de Salut and

mobility • Integrl vision of citizen

information • Epidemic predictive models

DG Planning • Decisions on-line • Design stage based on

activity • Alliance Planning • Training material linked

with clinical processes • Telemedicine and

telemonitoring • PPAC and Pacient Expert

Governance of the program

Holistic view of the

patient

Integral vision of healthcare

processes

Integral vision of

the citizen

Government programs:

Summary of Processes Governance i-SISS.Cat

•Creation of programs and tracking key performance indicators (KPIs). •Allocation of KPIs for each program. •Display of results for program and service provider.

360 °view of the patient: • Access to the broad view of the patient and the process (the supplier can decide to use this functionality or not). • Environments of collaboration between professionals.

Healthcare process integration:

• Social and health-related information sharing of the patient by the definition of integral processes. • Unique file generation and healthcare.

Integral vision of the citizen:

• Platform that will allow us to expand

the coverage to other social benefits and giving coverage to the unique social, labour and health record.

360 °view of the patient: • Access to the broad view of the patient and the process (the supplier can decide to use this functionality or not). • Environments of collaboration between professionals.

Integració procés sociosanitari:

• 306º view of the patient. • collaborative environment of professionals.

• Management the different clinical processes included in the Healthcare Plan

• Govern the health model in terms of efficiency and direct towards processes

• Facilitate the adoption of new models for health care providers billing

• Fit the new models of purchase without adding complexity to the supplier

• Self-management. Customized of the clinic processes to the reality of each of the

territories and suppliers..

• Integrate suppliers at different levels: processes, information and management tool at

the discretion of the level of evolution that they have their systems of information

• Make interoperability between different providers, unifying the model of integration

and sharing of information

• Measure the relevant indicators established within the Health Plan

• Co-responsible for the patient in the management of their health and the health

system itself

The solution i-SISS.Cat should allow

Thank you

Jordi Martínez

Chief Innovation Officer, TicSalut Foundation