www.epital.org

Introduction to the Epital

“Moving  Health Care to Your Fingertip”

Klaus Phanareth – MD, PHD, President – Danish Society for Clinical Telemedicine

Ageing population Demografic bomb

“The  Silver  Tsunami”

Boom of chronic conditions (>70% of budget)

Popular demand: •Continuity •Availability •Dignity •Quality

Increase of demand •Fewer resources •Decreasing workforce

Globalisation •Increased competition •Migration of services

Evermore expensive forms of treatment • Increase in supply

Stagnated culture Unchanged > 50 years

The Health Care Sector

A burning platform

Transformation af sundhedsydelser

Hospital

GP

Hospital

Hospital

Lost in the Bermuda triangle

Nursing home/ municipal healthcare

Healthcare center

The helpless patient with a chronic

condition

3 sectors, multiple legislations, 3 systems of reimbursement, 3 cultures

Citizen centered health care system

The empowered citisen with chronic condition

Health care center

Hospital

GP Pharmacy

Social services

Nursing home/ municipal healthcare

What is Epital Health?

Evolution – not revolution www.president.ee/images/stories/pdf/ehtf-report2012.pdf

A research-based re-design of the healthcare sector, based upon: • empowerment • service transformation • coordination • telehealth and telecare • common sense

Health service transformation

patient citizen diagnose clinical pathway fragmented coherent and coordinated disease condition plan responsibility empowerment treatment service/prophylaxis/procrastination admitted outmitted ”scheduled” ”on  demand“  (available) segmented inclusive – sector neutral centralized close to citizen

Healthcare sector – 2012 The Epital

A research-based re-design of the healthcare sector, based upon: • empowerment • service transformation • coordination • telehealth and telecare • common sense

Empowerment  is…

To enable people to act on their own, and thereby gain control over their lives.. ……especially control over the critical and crucial factors that keep people stuck in oppression or powerlessness, where they have no control

General Practitioner Municipality

Epi-callcenter

Citizen’s  epital

Hospital Empowerment

Coordination of clinical pathways Emergency calls Outmitting Second opinion Population monitoring

Diagnostics Initiating treatment Outpatient visits Rehabilitation (COPD level 3)

Diagnostics Initiating treatment Outpatient visits

Nursing Rehabilitation (COPD level 2+3) Nursing efforts Citizen services

Mobile unit

Communities Education Lifestyle changes

Home calls System installation and -support Services Blood sampling On-site diagnostics and treatment

Organisation and services

EPITALEPITAL

EPITALEPITAL

EPITALEPITAL EPITALEPITAL EPITALEPITAL EPITALEPITAL

EPITALEPITAL

EPITALEPITAL

Health Coach

Empowerment services Condition monitor

Skype

Epi-plan

The Entry: Citizen - Epital

Lung monitor

Pulse-oximeter

Thermometer

Epitalet

Why are the municipality involved in the Epital?

1. History: Structural reform of local government i 2007 gives

direct financial responsibility of health cost in the hospitals => search for new ways to reduce the increasing cost to health services.

2. Windows of opportunity: Financial crisis and reduces local community budget calls for new ideas and new solutions => The idea of a project involving cross-sectorial cooperation and citizen empowerment (in combination) using new technology had a strong political impact.

The critical issues

1. Creating sufficient knowledge and technical competence in the front-personal

2. Establishing robust standard procedures that fit the tasks and objectives of the existing organization  and  “gives  comfort”  to  the  colleagues    

3. Organizing the relevant services of the municipality so that the services can be directed to the citizens through the call-center.

Perspectives seen from the municipality

1. Extending the epital-concept to other citizen groups (other chronics, mentally ill citizens, socially vulnerable families)

2. Providing better and a higher quality health services to the citizens through a coherent and coordinated effort

3. Discus partnerships with neighboring municipalities.