eHealth addressing global

challenges through local actions

When Telemedicine does deliver!

Parallel Session PS 7

Tuesday 16 March, 2010,

14:00 – 15:15

Giancarlo Ruscitti MD

Secretary General for Health & Social Services

Veneto Region

Background of the experience of the Veneto Region

Since 2004, the Veneto strategy of economic sustainability andinnovation has meant increasing financial contraints in Human Resources, and developing policies for the allocation and mostefficient use of health care personnel, empowered by theappropriate use of e-technologies;

National budget constraints have forced the Region to reallocatethe health budget in order to guarantee the Essential Levels ofHealth Care provision (LEA) to all Veneto Citizens by:

1. rationalizing and renewing the hospital network;

2. re-organizing health services in the territory;

3. investing in innovation, ICT and eProcurement;

The Veneto Region: Territory and

Population

4

• 4,8 M inhabitants

• 18.391 km2 of land surface

Population Structure*

Members per family 2.6

Birth rate 9.3

Death rate 9.0

Natural growth rate 0.3

Total growth rate 5.6

% Elderly persons 135.7

% population > 65 years 18.5

% EU population>65 years 14.08

* As of the 2008 General Consensus

5

The Veneto Region:Health Care Providers and Professionals• 21 Local Health Authorities

• 2 Hospital TrustsPUBLIC ACCREDITED

INSTITUTIONS 64

IRCSS (SPECIALIST RESEARCH

INSTITUTES)1

Public health authority (Az. Osp.) 2

Hospital in the Provincial capital 6

Network hospital / strong integration 33

Integrating hospital of the network 8

Polyfunctional health centres 10

Management experimentation 4

PRIVATE ACCREDITED INSTITUTES 14

Care homes/ hospital 19

Classified hospital 4

IRCSS (SPECIALIST RESEARCH

INSTITUTES)1

• 41.806 Medical & Nursing staff• 11.702 Laboratory Technician

• 6.704 Administrative staff

• 117 Other Professionals

(* Veneto Regional Statistics Office data, 2008)

New challenges for Veneto Health Care

Increase in EU citizens expectations;

Ageing population

Home-care in rural and mountain areas;

Rising costs due to technological innovation;

Reduction of public health care expenditure;

Patient mobility: Tourists, Immigrants and Long termresidents;

Lack of health professionals (mainly pediatricians and nurses);

Restrictions imposed in public funding by commitments

towards maintaining EU stability treaties.

e-Health Priorities

From a technical perspective:

1. Enable the interoperability of Telemedicine services at the regional

level.

2. Build up standardized EHR systems at local level with a view to

establishing a single digital Patient Health Folder system at the regional

level.

3. Develop eHealth-based Disease Management models for the treatment

of outpatients.

4. Foster the interoperability of the above systems/services at the

National level.

5. Foster the interoperability of the above

systems/services at the European level

Telemedicine eHealth Projects:

Observatory

8

Number of Telemedicine projectsSource: “Observatory

and projects on

Telemedicine

applications

2009”,

Vol. 1/2009,

Arsenàl.IT

N. progetti

1 12

1

3

13

17

11

7

0

2

4

6

8

10

12

14

16

18

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

Cumulative number of active Telemedicine projects

E-Government services

TERREGOV

Paperless handling of

health documents

TeleMed-ESCAPE

Web-based booking of

health services

IESS

e-Learning for health

Growing-Together

Satellite-based

Second Opinion services

Near-To-Needs

Interoperability of health

smart cards

NETC@ARDS

Neurosurgical Tele-

counselling

HEALTH OPTIMUM

Patient Summary

& e-Prescription

Open e-Health Initiative

Personal Health System

and Telemonitoring

RENEWING HEALTH

e-Health Project Initiatives

63 European Projects – Themes: eHealth, Research,

Social Services and ICT

Overall budget: €50M

Telemedicine eHealth Projects:

ESCAPE

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Example in a Local Health Authority in Veneto

Extraction

Hospital wards &

Internal Services

Digital Signature

Forwarding

Storage

Certification

Diagnostic Services

producing Clinical

Reports

Mail

Service

GPs

Home

PC

Territorial

Service

Providers

Citizens

Citizens’ Clinical Document Sharing

Telemedicine eHealth Projects:

HEALTH OPTIMUM

11

Provincial area of Vicenza

Provincial area of Belluno

Provincial area of Treviso

Provincial area of Venezia

Provincial area of Rovigo

Provincial area of Verona

Provincial area of Padova

XDS Repository

XDS Registry

Programme: Competitiveness and Innovation Framework Programme CIP runs from

2007-2013

Funding Scheme: Information and Communication Technologies Policy Support

Programme ICT PSP; Funding Instruments: Pilot Type A

Principle Actor Involved: Regional Healthcare Authorities

Content of the 3rd Call of Proposals in 2009

Theme: ICT for Health, ageing and inclusion

Objective: ICT for patient-centered health services

Budget: € 14 M - European Co-financing: € 7 M

Duration: 32 months

Starting date: 1st February 2010

Kick Off Meeting: 8th February 2010, Venice

RENEWING HeALTHREgioNs of Europe WorkINg toGether for HeALTH

RENEWING HEALTH:The Consortium

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GREECE

FINLAND

SPAIN

NORWAY

DENMARK

ITALY

AUSTRIA

GERMANY

SWEDEN

EUROPEAN ASSOCIATIONS COUNTRY

European Patients’Forum (EPF) Luxembourg

European Health Telematics Association

(EHTEL)

Belgium

COMPETENCE CENTER COUNTRY

Arsenàl.IT Italy

Medcom International Denmark

Center for Distance-spanning Healthcare Sweden

Norwegian Center for Integrated Care and

Telemedicine

Norway

Catalan Agency for Health Technology

Assessment and Research (CAHTA)

Spain

VTT – Technical Research Center - Finland

e-Trikala AE Greece

TSB Innovationsagentur Berlin GmbH Germany

ADVISORY BOARD COUNTRY

Continua Health Alliance Private

Stichting (CHA)

Belgium

Integrating the Healthcare Enterprice

(IHE)

Italy,Spain,

UK

RENEWING HEALTH:The expected impacts

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Reduce hospitalisation and improve disease management

Increased links and interaction between patients and health professionals,

facilitating more active participation of patients in care processes

Improvement of quality of life for patients suffering form chronic conditions

Increased use of existing or commonly agreed standards and

demonstration of interoperability of the new solutions in regular healthcare

practice

Provide a convincing business case to be presented to National, Regional

and Local Health Authorities and to stimulate them to speed up the

deployment of patient-centered eHealth service solution

The Consortium Arsenàl.IT:Veneto’s Research Center of eHealth Innovation

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Has acted as Observatory by

performing systematic surveys

on Telemedicine applications

developed over time by the

member Health Authorities.

Has succeeded in highlighting

the critical issues of

interoperability, standardization

and organizational impact as

factors for driving to the diffusion

of Telemedicine applications in

care delivery process.

The DOGE ProjectThe General Practitioner Network

A Regional project to create a communication network and

connect GP and Primary Care sites to the hospital and Local

Health Authority (LHA).

ACTORS:

Regional information system

Information System of LHAs

GP

Personal EHR

VENETO REGION

CITIZEN

EHR

GP and

PRIMARY CARE

HIS Hospital Information System

Project start: June 2009

Doge Pilot Test is located in Adria Local Health Authority

n. 19 involving 70 GPs and SCCs

Conclusions and challenges

The Veneto Region is actively involved in the area of innovation and health care reforms, with purchasing, payment systems and contracting as tools for restructuring, and in benchmarking itshealth care system;

eHealth development is a way of empowering the quality of human resources;

The use of modern technologies in and out ofhospital should be understood as a way ofimproving quality and safety for the benefit ofpatients.

Thanking you for your kind attention!

giancarlo.ruscitti@regione.veneto.it