FROFROMM

Pablo Rivero CorteSevilla. May 2006

TOTO

call center strategycall center strategy

a multichannel approach to the a multichannel approach to the citizencitizen

Directorate-General for Health Care Innovation,Systems and Directorate-General for Health Care Innovation,Systems and TechnologiesTechnologies

24 /7

health in andalusia

Personalised web areasSMS Services

Telephone helplines

Expectations and Participation

Multi-format audiovisual contents

€

Health Care Technological Platform in Andalusia

1,459 primary care 1,459 primary care centrescentres

The Public Health System has… The Public Health System has…

34 public hospitals34 public hospitals

91,000 healthcare91,000 healthcare professionalsprofessionals

The APHS is a key factor for growth and employmentThe APHS is a key factor for growth and employment

Budget: more thanBudget: more than7 billion €7 billion €

7.5% of the regional 7.5% of the regional GDPGDP

The AndalusianThe Andalusian Public Health System Public Health System in the framework of the renewed Lisbon Strategyin the framework of the renewed Lisbon Strategy

9,500 Diraya work 9,500 Diraya work stationsstations

i2010i2010

e-Health e-Health

20062006

A

C

T

I

O

N

L

I

N

E

S

FP7FP7 CIPCIPLLL LLL

20102010

ERDFERDF

ESFESF

HEALTHHEALTH

STRATEGYSTRATEGY

The APHS as a test bed for the development of EU policiesThe APHS as a test bed for the development of EU policies

LISBON STRATEGYLISBON STRATEGY

22ndnd

MODERNISATIOMODERNISATIONN

OfOf

ANDALUSIAANDALUSIA

The Andalusian Public Health System The Andalusian Public Health System in the framework of the renewed Lisbon Strategyin the framework of the renewed Lisbon Strategy

Projects

TechnologicalTechnological

platformplatform

CitizensCitizens

ProfessionalsProfessionals EnterprisesEnterprises

Quality and productivity in the APHS through intensive use of ICTs Quality and productivity in the APHS through intensive use of ICTs

Citizen Information and Citizen Information and Services CentreServices Centre

AAll the AAll the health informationhealth information on each citizen on each citizen

continuitycontinuity in the healthcare process in the healthcare process

IntegratedIntegrated and and

Available Available at any time or any placeat any time or any place

… … A centralised appointment system, A centralised appointment system,

an electronic prescription system …an electronic prescription system …

The Andalusian Public Health System The Andalusian Public Health System in the framework of the renewed Lisbon Strategyin the framework of the renewed Lisbon Strategy

Electronic Health Record

Electronic Health Record

Primary Care

Specialised Care

Telemedicine SystemTelemedicine SystemTelemedicine SystemTelemedicine System

INTEGRATED FRAMEWORK OF CITIZEN RELATIONSINTEGRATED FRAMEWORK OF CITIZEN RELATIONS

“The configuration of a new role and greater demand from public services means that Interaction with the citizen via multiple channels, the proactivity and interactivity of the system (especially in the area of promotion and prevention) and the personalisation of the service are all essential steps which must be taken in order to achieve proximity with the citizen.”

ICTS AND PROFESSIONAL FULFILLMENTICTS AND PROFESSIONAL FULFILLMENT

“The accumulated knowledge within the health system on the need for new IT systems as a support to clinical practice and the various management areas, together with the impressive development of ICTs, allows this knowledge to be converted into new and powerful technological tools that will facilitate and reinforce the fulfillment of the APHS professional.

ORGANISATIONAL INNOVATIONORGANISATIONAL INNOVATION

“The continuous learning which takes place in a complex system of continual interaction such as the public health system (in the case of Andalusia there are more than 80,000 professionals and 8 million users) facilitates transformation into more efficient forms of organisation”

Types of InnovationTypes of Innovation

CITIZENSCITIZENS

New World of New World of the Starsthe Stars

New World of New World of the Starsthe Stars

New WebsiteNew WebsiteNew WebsiteNew Website

TransparencyTransparencyTransparencyTransparency

Health Info.Health Info.Assesment Assesment

CentreCentre

Health Info.Health Info.Assesment Assesment

CentreCentre

Audiovisual Audiovisual Multimedia Multimedia

PlatformPlatform

Audiovisual Audiovisual Multimedia Multimedia

PlatformPlatform

ExpectationsExpectationsBankBank

ExpectationsExpectationsBankBank

Health ResposeContact Center

Health ResposeContact Center

e-Administratione-Administratione-Administratione-Administration

Initiatives Initiatives MapMap

Initiatives Initiatives MapMap

SMSSMSSMSSMS

Telephone Telephone EnquiriesEnquiries

Telephone Telephone EnquiriesEnquiries

TelemedicineTelemedicineTelemedicineTelemedicine

Educates (3-16 years)Entertains (3-16 years)

UsabilityPersonalised

Assesses and divulges Information on Helath

TeleassistanceTelemonitoringMobile Units

EducatesInformsEntertains Healthcare info.

Health advice

Info. on pathologies,Citizen´s rights

Collection of expectetions to promote participationand information

Information on Qualityin Health Centres

AccesibilidadVentanilla Única

New Services for the CitizenNew Services for the Citizen

SALUD RESPONDEContact center

RECETA XXIElectronic prescription

MTIInformation Treatment

Modules

OCAMprofessionals

UDBusers

STRUCTUREresources

CENTRALIZED APPOINTMENT HEALTH RECORD

Diraya

Presential

Telephone

Users

CEISCEIS

eMail

Web

Data WarehouseOthers channels

Back Office

Diraya.Health Response

Centralized appointment

B D U

APPOINTMENT CENTRAL MODULEAPPOINTMENT CENTRAL MODULE

for

Diraya. Corporate appointment

Primary Care

Specialized Care

Diagnostics Tests

Clinical modules

Emergency

Specialist consultation

Primary Care

Destiny

Laboratories

Specialists

RIS

PACSPACS

Appointment

Requests

Results reports

Cross consultation

Laboratory

Functional tests

Radiological tests

Requests agents

Corporate catalogues

Diraya. Corporate appointment

•Usuario

OCAM

Diraya. Corporate appointment

0

10

20

30

40

50

60

70

80

ANDALUCIA 47,2 48,2 43,8 40,8 39,9 36,7

DISTRITO JAÉN 33,5 39 34,1 42,1 36,9 74,4

1999 2000 2001 2002 2003 2004

Evolucion de la satisfacción con la comunicación telefónica, desde el exterior, con el centro de salud. Andalucia y Distrito Jaén. 1999 - 2004

% de personas satisfechas(fácil + muy fácil)

Las pregunta que se formula es: "¿Cómo de fácil le resulta hablar por teléfono con su centro cuando lo necesita? Opciones de respuesta: Muy difícil / Difícil / Ni fácil ni difícil / Fácil / Muy fácil /NS/NC.Fuente: Encuestas de satisfacción a usuarios de atención primaria. SAS

Diraya. Health Response

SMS Operating SystemSMS Operating System

Health information, prevention and promotion campaignsHealth information, prevention and promotion campaigns

The APHS adapts to modern society by using new technologies for communicating with the citizen.

The APHS adapts to modern society by using new technologies

for communicating with the citizen.

.The citizen can now choose how to receive

required information

SMS messages provide the citizen with

immediate, personalised information

Tobacco addictionPollen count by provinceHeatwave prevention plan, etc

Metabolopathy programmesAdult vaccinations (Anti-influenza and Anti-tetanus).

Incorporation into the health care activity

“CHOOSE YOUR MEANS OF CONTACT” With a closer, more accessible system.“CHOOSE YOUR MEANS OF CONTACT” With a closer, more accessible system.

Much more than a Contact Center.

The citizen can now choose how to receive required information

APHSAPHSAIDSAIDSHealth cardHealth cardOral Hygiene Health ProgrammeOral Hygiene Health ProgrammeLiving Will DeclarationLiving Will Declaration

Community liaison nursing.

Monitoring of post-hospital discharge

patients due to fragility or climatic conditions

Primary Care programmed appointments in APHS Health Primary Care programmed appointments in APHS Health CentresCentresFree choice of hospital for surgical operationsFree choice of hospital for surgical operationsSecond medical opinionSecond medical opinion

• More services

• More channels

• Stepwise development

• A response for every need

• Personalised information

• Interactive and pro-active service

• HealthResponse is available 24/7

health in andalusia 24/7 aims to develop new services and boost current services available through HealthResponse:

Mission

To offer our citizens a new service for healthcare and health

information, 24 hours a day 365 days a year, accessible through different communication channels, providing immediate and personalised response that is adapted to the needs of each individual.

24 hrs

saludandalucía24 hrs24 hrs

saludandalucíasaludandalucía

Specific aims 24 hrs

saludandalucía24 hrs24 hrs

saludandalucíasaludandalucía

Provide information and advice 24 hours a day (365 days a year) in line with particular health problems

Give information on services, resources and help available personally, immediately and directly

Meet the information needs of our citizens providing quality information, swiftly and efficiently

Provide integrated and consistent response from different services

Ensure multichannel formats to improve accessibility to the healthcare system for citizens

Bring health and services closer to people

In particular, to support patients and their families facing greater difficulties in accessing healthcare services and greater need for care (dependent persons, chronic patients, family carers...)

Provide help for the professional throughout the process of providing information to patients

Generate trust in the APHS, devising strategies from the user’s standpoint capable of meeting his/her expectations

24 hrs

saludandalucía24 hrs24 hrs

saludandalucíasaludandalucíaCharacteristicsInformation via different channels: telephone, web, mobiles, email, DTT...

Information on demand: a citizen (or professional) seeks and finds information on different channels

Responses are adapted to the different members of the public (men and women, youth, the elderly, different ethnic groups...

Quality information (AHQA), that is evidence-based and backed by accessible guides from any GP practice or user information unit

Up-to-date information available when needed by the enquirer

Pro-active information, via the most appropriate channel in line with the target population and profile of needs

Using set referral criteria when required

Link with healthcare services (helplines at health centres, 24-hour helplines within integrated plans, 061, emergency services, primary care consultation, liaison nurse)

• The mission for the Healthcare information management Centre (Healthresponse, keeps you informed...) is to provide our citizens with accessible, easy-to-understand, quality information with full APHS guarantees.

• The various initiatives that are currently under development on this topic in different areas of the APHS will be integrated and strengthened (A network centre, with different, fully coordinated, syngergistic nodes).

• The Expectations and Participation Bank (Healthresponse, listens to you...), will compile information on the expectations, needs, suggestions and proposals from patients and citizens for improvements in healthcare provision.

• The different channels for participation will be implemented through the “”WEB face” of the Bank (Expectations and Participation Web).

health in andalusia 24/7 is backed by the Healthcare Information Management Centre and the Expectations and Participation Bank:

EXPECTATIONS AND PARTICIPATION BANKEXPECTATIONS AND PARTICIPATION BANK

WEBWEB TEL

In person

(New channels for participation)

7 tools for participation:Focal groupsCitizen panels

Specific reportsSegmented Webfor professionals

Segmented Web for citizens

Information Assessment

System

AHTAAComplaints/Claims

(Single model)Quantitative and

Qualitiative surveys1)Theme-based forums

2)Electronic questionnaires

3)Working desktop for correspondents

4)Area for access to citizen expectations

5)Area for participation by associations

6)Citizen Panels

7)Area for Participation Resources

Healthcare information management Centre

Generates quality, up-to-date, accessible information through different channels

Content production for different formats and channels

Updated, accredited, useful and easy-to-read information

WEB Tele-phone

Health Response

Health in Andalusia 24/7

Multi-channel healthcare and health information

Content production for different formats and channels

Updated, accredited, useful and easy-to-read information

3G Mobile

SMS DTT E- mail RadioVideo

Printed

materials

Information on expectations GENERATED IN DIFFERENT AREAS OF THE APHS.

Integration and management of scattered information through the Bank

Information COMPILED DIRECTLY THROUGH the EXPECTATIONS and PARTICIPATION WEB (forums and other channels for

participation). (Healthresponse, listens to

you...)

Information for the citizen

Information

for profession

als

Information for

managers.

EXPECTATIONEXPECTATIONS AND S AND

PARTICIPATIOPARTICIPATION WEBN WEB

Centro de evaluación de información sanitaria

Genera información de calidad, actualizada y accesible en distintos canales

Producción de contenidos para distintos formatos y canales

Información actualizada, acreditada, útil y legible

WEB Teléfono

Salud Responde

Salud Andalucía 24 horas

Atención e información sanitaria, multicanal

Producción de contenidos para distintos formatos y canales

Información actualizada, acreditada, útil y legible

Móvil 3G SMS TDT E-mail RadioVídeo

Material impreso

Healthcare information managementCentre

Generates quality, up-to-date and accessibleinformation via different channels

Content production for different formats and channels

Updated, accredited, useful,easy-to-read information

WEB Tele-phone

Health Response

Health in Andalusia 24/7

Healthcare and health information, multichannel

Content production for different formats and channels

Updated, accredited, useful, easy-to-read information

3G mobile SMS DTT E-mail RadioVideoPrintedmaterials

Healthresponse, keeps you informed...

1) General information for the citizen on services and resources

2) Health information open to all citizens

3) Personalised information on major health problems

4) Information on how to tackle healthcare emergencies

4 levels of information

24 hrs

saludandalucía24 hrs24 hrs

saludandalucíasaludandalucía

The citizen receives information

Digital television

Mobile

Smoking

AIDS

Healthy eating

Cardiovascular disease prevention

Accident prevention

Avoiding unwanted pregnancy

Alcohol and drugs, etc.

2.-Health Information

The citizenneeds (requests)

information

Telephone

WEB

E-Mail

Telephone

WEB

E-Mail

In person

(at the surgery,

at the UIS)

Protocol-based informationguidelines

Frequently asked questionsand answers

24 hrs

saludandalucía24 hrs24 hrs

saludandalucíasaludandalucía

Digital t

elevision

Mobile

In person

(at the surgery,

at the UIS)

Information on the most common health problems

Progressive implementation:

Medical problems

Adults: allergies, cardiovascular and respiratory

Children: allergies, otitis, ...

Surgiocal problems

Adults: AMS (Cataracts, GI tract (copro))

Children: Tonsillectomy

24 hrs

saludandalucía24 hrs24 hrs

saludandalucíasaludandalucía

Available on the WEB

Accessible by telephone

If protocol-based problems are pinpointed, referral to healthcare personnel

(similar to follow-up for frail patients)

The citizen seeks information

The citizen receives information

Through the WEB: interactive tutorials, information adapted to different profiles, most common questions and answers, videos, links, etc.

Through subscription email

Through telephone operators at HR responding to the most common previously protocol-based questions

When problems are detected, assistance is provided by healthcare personnel or the case is referred to the 061 helpline or emergency services

Protocol-based information guides

Most common questions and

answers

Call is referred to healthcare centre if available.

Access from healthcare centre to the same information guides

(consistent information throughout the APHS)

Enquirer accessesHealth in Andalusia 24/7

via WEB

Enquirer accessesHealth in Andalusia 24/7

by TELEPHONE

Finds information onhis/her health problem

Information is insufficentand he/she calls Operator attends call and

resolves doubt or problem with protocol-based

information

Operator attends call andgives appointment for

primary care, liaison nurse or specialist

consultation (only for cases matching protocols)

Operator receives call and refers to

A healthcare professional by phoneTo Primary Care Consultation

To Emergency Service

Referred to seek further information

on the WEB

ReferralHealth centre

Resolves

Refers

WEB CHANNEL TELEPHONE CHANNEL

IN PERSON CHANNEL

CONCLUSIONS and STRONG POINTS

•Modernisation over the past 5 years (BDU, scheduled appointments, Webs, ...) has led to a major leap in quality towards a Multi-service, Multi-channel Information Centre

• The “natural” strategic development of HealthResponse tends towards this model

•Technology convergence (Web+TF+Mobile+Audiovisual) in 2006-2007

•A challenge and a great opportunity to shape Health in Andalusia 24/7

•The new model for HealthResponse is not a “substitute” for already existing services and info lines (Web, Tel, AHTAA, ...), rather it boosts and strengthens the overall approach

FROFROMM

Pablo Rivero CorteSevilla. May 2006

TOTO

call center strategycall center strategy

a multichannel approach to the a multichannel approach to the citizencitizen

Directorate-General for Health Care Innovation,Systems and Directorate-General for Health Care Innovation,Systems and TechnologiesTechnologies

¡Muchas gracias por su atención!¡Muchas gracias por su atención!Nous vous remercions pour votre attention! Nous vous remercions pour votre attention!

Thank you for your kind attention!Thank you for your kind attention!