Healthcare delivery Optimisation through telemedicine

Acronym of the case:

HEALTH OPTIMUM

Web address of the case:

http://www.healthoptimum.info

Country of the case:

Denmark , Italy , Spain , Sweden , Romania

City/region:

Regione Veneto, AragÃ³n, Syddanmark, Uppsala, Timis

Posting Date:

18 March 2008

Last Edited Date:

09 October 2008

Author:

Silvia Giovannetti (Azienda ULSS 9 Treviso)

Telemedicine | e-Health | ICT

Type of initiative

Network
Strategic initiative

Case Abstract

Health Optimum, acronym for delivery OPTIMisation throUgh teleMedicine, is a project approved by the European Commission in the eTEN program. The objective of the project is to ensure the healthcare services through virtual medical assistance for a wide range of medical specialties: hematology, nephrology, dermatology, oncology, radiology, endocrinology, cardiology, endocrinology, orthopedics, plastic surgery, neurosurgery, psychiatry, alcoholism recuperation, home monitorization for old people and general healthcare. During the market validation phase, HEALTH OPTIMUM has market validated a comprehensive suite of telemedicine services able to improve the perceived quality of the healthcare services provided and, at the same time, to enable a reduction in the costs related to their production and delivery. The Project has also evaluated the usersâ€™ acceptance of the services and validated a business model on which the HEALTH OPTIMUM Initial Market Deployment phase is based. The expected outcome of the ongoing second phase of the project is an operational system which is up and running in all the Regions and which is financially self-standing because it pays for itself through the savings that it releases in the routine delivery of healthcare. Thanks to HEALTH OPTIMUM, Doctors are saving time, Public Healthcare Systems are saving money and patients are receiving better coordinated and better quality care.

Description of the case

Domain

eHealth

Topic

Regional/national Health Information Networks | Telemedicine services

Sector

Healthcare | Social Services

Date

June 2007 to May 2009

Target Users

Target Users Description

The services tested and deployed are: Neurosurgical Tele-counselling and Tele-laboratory service in homecare; Tele-laboratory service in Haematology; Tele-counselling, Tele-laboratory and Shared medical record service for Radiology (service available for Uppsala); Tele-counselling for Haematology, Oncology and Nephrology; Tele-counselling, Electronic referral and Tele-laboratory for Neurophysiology (service available for Uppsala); Tele-referral for Cardiology; Tele-referral for endocrinology; Tele-counselling and Shared medical record for Plastic Surgery (Uppsala); Tele-dialysis; Tele-thrombolysis; Tele-alcohol Rehabilitation; Tele-counselling, Electronic referral, Shared medical record for Dermatology (Uppsala); Tele-counselling, Tele-laboratory and Shared medical record for Discharge teleconference (Uppsala); Tele-counselling and Shared medical record for Oral and Maxillofacial Surgery (Uppsala); Tele-coronary Arteriography.

Scope

International

Status

Pilot

Language(s)

Policy Context and Legal Framework

HEALTH OPTIMUM is a Telemedicine project approved and co-funded by the European Community within the eTEN programme.

The â€œmarket validation phaseâ€ officially began in May 2004 and ended in January 2006. In this phase the countries participating were: Italy (Regione Veneto), Spain (Aragon) and Denmark (Funen). The phase tested some telemedicine services trying to assess them in a first operational field. In the present phase, called â€œInitial Deploymentâ€, the existing services and new ones will be deployed in five countries: Italy (Regione Veneto, as coordinator); Spain (AragÃ³n); Denmark (Syddanmark); Sweden (Uppsala); Romania (Timis). The project will last two years, from June 2007 to May 2009.

Project Size and Implementation

Type of initiative

Other

Overall Implementation approach

Partnerships between administration and/or private sector and/or non-profit sector

Technology choice

Standards-based technology

Funding source

Public funding EU | Public funding national | Public funding regional | Private sector

Project size

Implementation: Larger than €10,000,000

Yearly cost:

€5,000,000-10,000,000

Implementation and Management Approach

The project management structure has to co-ordinate and ensure co-operation among the various partners involved throughout the life cycle of the Phase. The project management structure will be responsible for: producing the Project Plan; controlling the execution of the Project plan; keeping the overall Project on schedule, by applying the appropriate corrective actions in case of shift in relation to the project plan; guaranteeing that the appropriate standards of project management and quality assurance are applied; applying all the regulatory prescriptions in terms of data confidentiality and integrity; discussing Project objectives and results with the Steering Committee.

The upper level of management is responsible for the overall supervision of the Project, and it is represented by the Project Steering Committee composed of senior representatives of the Partners, by the Project Co-ordinator.

The requirement of application interoperability was fundamental, together with the technological management of the patient documentation produced within the project (reports, opinions, images, lab results). The project has carried out a trial of an Electronic Health Record (EHR) technical framework in which all data converge to make easier the exchange of information on advanced consultancy, and to help the search for surgery rooms and bed availability.

Technology solution

Technology solutions are different, depending on the specific telemedicine application, but they all meet the interoperability requirements complying with IHE guidelines.

Impact, innovation and results

Impact

In Italy, the project representatives for Neurosurgical Tele-counselling and Tele-laboratory have worked first on the functional and technical architecture assessment. For Neurosurgical Tele-counselling they defined the reorganisation of the workflow using a telemedicine approach. A scientific work group defined the basic clinical data set necessary for counselling between peripheral hospitals and the main neurosurgical centre. In the Deployment phase the redefinition of processes and the application of Telemedicine services will be extended to the whole Region

In Spain, in the Deployment phase Tele-counselling will be applied to the following specialties: Oncology, Nephrology, Radiology, Ophthalmology, Haematology, Emergencies or Neurology, already trialled during the Market Validation phase.

In Denmark (Syddanmark) it has also been decided to adopt in the Deployment phase of the Project some of the HEALTH OPTIMUM services that were market validated in the other countries, in addition to those already validated in Funen. The two market validated services, Tele-cardiology and Tele-endocrinology, will be deployed.

Sweden (Uppsala) aims to extend and develop the following clinical areas, all belonging to the Plastic Surgery field: Wound Treatment, Burn Treatment and Breast Reconstruction. The most natural market is represented by the counties closest to Uppsala Hub structure today has agreements in place with all of them and this opens an easy way for the deployment of the HEALTH OPTIMUM services in the whole area covered by these four counties.

In the earlier stages of the Initial Deployment phase, Romania (Timis) will focus on implementing the Tele-counselling for Neurosurgery and Radiology. These are totally new services for Romania and represent a major challenge. In further stages of the Initial Deployment phase, Tele-counselling in Neurosurgery could be extended applying it both to other hospitals in the Timis County and to other clinical specialities.

The results are:
- decreasing mortality and morbidity by reducing transfer time and by improving the appropriateness of patient transfer;
- avoiding unnecessary transfer and reducing risks for patients requiring surgical intervention or sophisticated monitoring;
- improving the ability to rapidly diagnose serious injury for patients without transferring them to another hospital centre;
- rationalising the use of human and technological resources;
- establishing uniform levels of trauma care through the use of standardised protocols;
- guaranteeing equality of treatment to all citizens victim of a trauma, irrespective of where they live;
- improving communication between Primary and Secondary Care;
- releasing financial resources

Track record of sharing

At the end of the Market Validation Phase the Project was elected Project of the Year 2005 in the ambit of e-TEN Project.

Lessons learnt

By proving the benefits of telemedicine solutions and deploying them in pioneering trials, the HEALTH OPTIMUM project has acted as a catalyst for the rollout of services to meet the challenges that public healthcare system are facing: the ageing population will increase demand for healthcare in the future meanwhile lower tax revenues due to a relative decline of the number of young people joining the workforce leads to budget cuts.

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Anomymous

HEALTH OPTIMUM at AER eHEALTH meeting

10 April 2008 | 2324 Visits | Rating: No votes

The HEALTH OPTIMUM Project attends the AER eHealth meeting, taking place in Wien (A) on 11 April 2008, as best practice for Regione Veneto strategy.

More info at:
http://www.a-e-r.org/events/health-social-affairs-committee/2008/ehealth...