eHealth addressing global
challenges through local actions
When Telemedicine does deliver!
Wednesday, 18th November 2010
Giancarlo Ruscitti MD
CEO - Fondazione Opera S. Camillo
Background of the experience of the Veneto Region
 Since 2004, the Veneto strategy of economic sustainability and
innovation has meant increasing financial contraints in Human
Resources, and developing policies for the allocation and most
efficient use of health care personnel, empowered by the
appropriate use of e-technologies;
 National budget constraints have forced the Region to reallocate
the health budget in order to guarantee the Essential Levels of
Health 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
• 4,8 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 2001 General Consensus
4
The Veneto Region:
Health Care Providers and Professionals
• 21 Local Health Authorities
• 2 Hospital Trusts
• 41.806 Medical & Nursing staff
• 11.702 Laboratory Technician
• 6.704 Administrative staff
• 117 Other Professionals
5
(* Veneto Regional Statistics Office data, 2008)
PUBLIC 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
The Veneto’s responsibility in policy-making
in the Health & Social Sector
Minister for Social
Policies
Minister for Health
Policies
Minister for Animal
Health
Regional Secretary for
Health & Social Services
21 Local Health
Authorities
2 University
Teaching
Hospitals
2 Scientific
Reseach
Hospitals
582
Municipalities in
the Veneto
Region
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 term
residents;
 Lack of health professionals (mainly pediatricians and
nurses);
 Restrictions imposed in public funding by commitments
towards maintaining EU stability treaties.
Telemedicine eHealth Projects:
Observatory
Source: “Observatory
and projects on
Telemedicine
applications
2009”,
Vol. 1/2009,
Arsenàl.IT
Number of Telemedicine projects
N.
progetti number of active Telemedicine projects
Cumulative
18
17
16
14
13
12
11
10
8
7
6
4
2
0
1
1
2
3
1
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
8
The Consortium Arsenàl.IT:
Veneto’s Research Center of eHealth Innovation
 Founded in 2005 as “Telemedicine
Consortium”, currently groups together
all the 23 Local Health Authorities of the
Veneto Region.
9
The Consortium Arsenàl.IT:
Veneto’s Research Center of eHealth Innovation
 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.
10
Telemedicine eHealth Projects:
ESCAPE
Citizens’ Clinical Document Sharing
Certification
Digital
Signature
Diagnostic Services
producing Clinical
Reports
Citizens
Home
PC
Storage
Mail
Service
Forwarding
GPs
Extraction
Hospital wards &
Internal Services
Example in a Local Health Authority
11
Territorial
Service
Providers
Telemedicine eHealth Projects:
Doge, General Practitioners Network
A Regional project to create a communication network
and connect general practioners and family doctors to the
hospital and Local Health Authority.
ACTORS:
 Regional information system
 Information system of Locl Health Authorities
 GP
 Citizens Personal EHR
SHARED INFORMATION:
 Population data and personal data
 E-prescription
 Clinical data, documents and reports
 Consents (privacy)
12
VENETO
REGION
Information
Citizens
System SERVICES (Personal EHR)
LHAs
GP
(Primary
Care)
Telemedicine eHealth Projects:
DREAMING & Telecare system
13
Telemedicine eHealth Projects:
HEALTH OPTIMUM
XDS Registry
Provincial area of
Vicenza
Provincial area of
Belluno
XDS
Repository
Provincial
area of
Padova
Provincial
area of
Treviso
Provincial
area of
Venezia
Provincial area of
Verona
14
Provincial area of
Rovigo
RENEWING HEALTH:
The Consortium
COMPETENCE CENTER
COUNTRY
Arsenàl.IT
Italy
Medcom International
Denmark
Center for Distance-spanning Healthcare
Sweden
Norwegian Center for Integrated Care and
Telemedicine
Catalan Agency for Health Technology
Assessment and Research (CAHTA)
VTT – Technical Research Center -
Norway
e-Trikala AE
Greece
TSB Innovationsagentur Berlin GmbH
Germany
ADVISORY BOARD
COUNTRY
Continua Health Alliance Private Stichting
(CHA)
Integrating the Healthcare Enterprice
(IHE)
Belgium
EUROPEAN ASSOCIATIONS
COUNTRY
European Patients’ Forum (EPF)
Luxembourg
European Health Telematics Association
(EHTEL)
Belgium
SWEDEN
FINLAND
NORWAY
Spain
DENMARK
Finland
GERMANY
AUSTRIA
Italy, Spain,
UK
ITALY
SPAIN
15
GREECE
RENEWING HEALTH:
The expected impacts
 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
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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 its
health care system;
 eHealth development is a way of empowering the
quality of human resources;
 The use of modern technologies in and out of
hospital should be understood as a way of
improving quality and safety for the benefit of
patients.
Thanking you for your kind attention!
amministratore.delegato@camilliani.net