Continuity of Patient Care

Chronic diseases:A Challenge for eHealth

http://www.euro/who/int

Chronic diseases: A challenge for eHealthRelevance of Chronic Conditions

Mortality• 60% worldwide• 66% in Canada

Health Budget• 78% in USA• 70% in Australia

Chronic diseases: A challenge for eHealthRelevance of Chronic Conditions

http://www.calgaryhealthregion.ca/cdmhttp://nurseweb.ucsf.edu/iha

http://www.health.gov.au

Spain:- 18 million people report a Chronic disease

UK:- 60% of adults report a Chronic health problem- 80% of GP Consultations- 60% of Hospital bed days

Chronic diseases: A challenge for eHealthRelevance of Chronic Conditions: Europe

http://www.natpact.nhs.ukhttp://www.ine.es

Chronic diseases: A challenge for eHealthCDM: Worldwide experiences: Florida State

Afifi AA et al. Preventive Medicine 2007

Patients paticipating in DM:

Lower rate of:- Inpatient hospital stays- Inpatient days- Emergency room visits- Outpatient visits

http://www.floridahealthy.org

Chronic diseases: A challenge for eHealthCDM: Worldwide experiences: Castlefields

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Non-fatal MisIHD Deaths

Castlefields Health Centre Cardiac events

http://www.natpact.nhs.uk/cms/328.phpLyon D et al. J Integ Care 2006;14:7-12

Chronic diseases: A challenge for eHealthCDM: Situation in Andalusia, Spain

Chronic Diseases in Andalusia

Cause of Death: - Cardiovascular diseases 38%- Cancer 24%

471,000 diabetic patientsMental disorders: 42% peopleOlder people with CD: >75%

Chronic diseases: A challenge for eHealthThird Health Plan of Andalusia 2003-2008

http://www.juntadeandalucia.es/salud

Chronic diseases: A challenge for eHealthAndalusian Public Healthcare System: Quick facts

1,500 Primary care centres41 Public Hospitals

90,000 Healthcare professionals8,700 M € Health Budget

http://www.juntadeandalucia.es/servicioandaluzdesalud

Chronic diseases: A challenge for eHealthPerson centred care in chronic conditions

Chronic diseases: A challenge for eHealthRole of eHealth in CDM progarms

http://www.bmj.com

Telemonitoring or structured telephone support programmes for patients with chronic hearth failure: systematic review and meta-analysisRobyn A. Clark, Sally C. Inglis, Finlay A. McAlister, John G.F. Cleland, Simon Stewart

RESEARCH

BMJ, doi:10.1136/bmj.39156.536968.55 (published 10 April 2007)

Chronic diseases: A challenge for eHealtheHealth in Andalusia: “Diraya” Platform

Health Care Information and Management Integrated System Health Care Information and Management Integrated System

Chronic diseases: A challenge for eHealtheHealth in Andalusia: “Salud Responde”

Telephone appointment

Internet appointment

Centralised appointment

Second Medical Opinion

Living wills

Smart cards

Virtual Office (InterS@S)

HealthRespondsInformation and Services Centre Information

Waiting lists

Electronic prescription

Chronic diseases: A challenge for eHealtheHealth in Andalusia: “Salud Andalucía 24h”

EducationInformationentertainement

Healthcare InformationHealth Advices

Information on Quality in Health Centres

Tobeinformed .is healthTelephone enquiriesSecond medical opinionIiving willsHealth cardWaiting listsTelephone appointmentHealthcare informationHealth advicesDischarge telephone surveyAIDS, Tobacco, bird flu...

SMS servicesExpectations bank

Transparency

e-Administration

Individual assessment andinformation on Health

24 hrhealth andalusia

Collection of Expectationsto promote participationand information

WebTV/DTVMobile

Living willsSmart card

HealthResponds

Chronic diseases: A challenge for eHealthElectronic prescription

62.763

48.753

0

10000

20000

30000

40000

50000

60000

70000

SEP-05 SEP-06

-22.32%

GP consultations before and after electronic prescription

Chronic diseases: A challenge for eHealthHealth Wave Plan: Telephone follow-up

People at risk

Weather forecast

Daily alert level

Emergency Coordination Centre

Heath Wave Response Plan

Hospital Emergency Room

People at risk: 5,821Total Calls: 42,964

HealthResponds

Family nurse

Chronic diseases: A challenge for eHealthDigital Retinography in diabetic patients

Vaccines AppointmentsWarningsAdvices

Users: 6,720Total SMS: 112,192

Chronic diseases: A challenge for eHealthDigital Retinography in diabetic patients

People studied: 13,892With retinopathy: 4,306

Chronic diseases: A challenge for eHealthImproving the management of Chronic diseases

Proactive Healthcare System

EffectiveSelf-managementSupport

Chronic diseases: A challenge for eHealthICT applications in Chronic diseases

http://www.opimec.es