STUDY VISIT Veneto and Friuli Venezia Giulia Regions
Chronic diseases management
12 – 13.12.2013 Treviso and Pordenone, Italy
Partner contact details: LHA of Verona
Address: via Valverde 42, 37122 Verona, Italy
Telephone
Fax:
Email: leonardo.speri@ulss20.verona.it, gcentis@consorzioarsenal.it
Partner contact details: LHA Bassa Friulana
Address: Borgo Aquileia 2, 33057 Palmanova (UD), Italy
Telephone:
Fax:
Email: matteo.apuzzo@welfare.fvg.it
I. SUMMARY
The main theme of this joint study visit is chronic diseases management with
different focus on integration of health and social care in Veneto Region (day
1) and on ambient of life, domotics and accessibility in Friuli Venezia Giulia
Region (day 2).
The study visit was anticipated by the PSC meeting on 11 th December,
hosted in Arsenàl.IT premises and followed by an informal dinner in Treviso
city centre. Then the study visit took place on 12th-13th December 2013 and
had different locations. The first day was spent again in Treviso at Arsenàl.IT
premises and was dedicated to the presentation of the regional health and
social care system and the integration of some health and social policies in
the Veneto Region. Some examples of services addressed to chronic and frail
population were described also through videos and videoconference with
the health district centre of LHA 20 in the Verona area. The day was
completed with a site visit to SS. Giovanni Paolo hospital in Venice and the
final official dinner.
During the second day, the delegation was moved to Pordenone at the Polo
Tecnologico headquarter to attend the presentation of the FVG regional
strategy for innovation in the welfare sector, followed by the introduction of
some integrated initiatives involving public-private partnership for the
development of smart technologies for independent living.
II. DEBRIEFING ONSITE VISITS
The study visit was opened on 12th by the chairman of Arsenàl.IT, Veneto
research centre on eHealth innovation, who welcomed the delegation also
LHA 20 of Verona
Via Valverde, 42
37122 Verona
Italy
LHA 5 Bassa Friulana
Borgo Aquileia, 2
33057 Palmanova (UD)
Italy
www.casa-europe.eu
on behalf of the Veneto Region and the LHA 20 of Verona. Then the regional
health and social care system was introduced through a detailed
presentation covering the following topics:
- Demographic transition
- Chronicity and multimorbidity
- The Regional Health and Social System: integration, organization and
financial sustainability
- The new Health and Social Care Plan 2012-2016
- The ACG Project: population risk measurement
- Conclusions
Also as a part of the last Health and Social Care plan, the regional EHR
project was presented. Started in 2012, the program will get to the
implementation of the interoperability platform that, in the year of 2015,
will get to the re-organisation of health and social care processes by
transforming the already-existing local EHRs in a regional Health Information
Exchange network with the aim to reduce the fragmentation of information
and improve care coordination.
As a meaningful experience in chronic disease management, the European
project Renewing Health was presented, as well as some examples of
telemonitoring services addressed to patients with cardiovascular diseases,
COPD and diabetes. The role of the regional Telehealth and Telecare centre
was in-depth described through the presentation of telecare and telehealth
services provided and a video showing the daily activities within the centre.
The session was concluded with the reporting of the preliminary results of
Renewing Health project about the impact evaluation of telemonitoring
service in the Veneto Region.
During the afternoon the focus was moved on a couple of local solutions in
Verona area that represent a great experience of continuity of care. The first
one deals with the effective design of a protected discharge pathway for
patients that need an adequate assistance after having left the hospital. The
service presentation was followed by a videoconference with the health
district n.3 in Verona where the healthcare staff showed how the they use
the IT system to plan and manage the discharge pathway of frail patients by
intermediating between hospital wards and local care services. The second
presentation was dedicated to the ARCA project that has allowed defining in
Verona another care pathway for chronic patients living in nursing homes
that need to be hospitalised.
The day was concluded with a site visit at the SS Giovanni e Paolo hospital in
Venice and a brief introduction of the nurse monitoring service provided by
the LHA 12 of Venice to chronic population with limited mobility.
The 2nd day of the study visit was held in the premises of the Polo
Tecnologico (Technology Pole) of Pordenone, one of the technology and
research centres hosted in Friuli Venezia Giulia Region. This part of the study
visit was aimed at presenting the FVG Region innovation system and the
strategy in the welfare sector (integration between innovation, health and
social policies). The participants had an overview of the regional FVG as @
Lab, the Technology cluster for Ambient of Life, and specific projects have
been presented concerning home automation, domotics for independent
living and active ageing:
- The “Lack Project (Living for All Kitchen)”, that built a prototype of kitchen,
coordinated by Rino Snaidero Scientific Foundation, a research foundation
linked to Snaidero, one of the best known Italian private company in the
field of kitchen and furniture;
- “Re-freedom Project”, that promoted home automation and home quality
of life and has been coordinated by Friuli Innovazione Research and
Technology Transfer Centre in Udine;
- “Presto a Casa (Back Home), a social housing pilot project that integrated
innovation, domotics and social/health care, coordinated by AREA Science
Park in Trieste;
- “Help-Key Project”, that addressed home-care services integrating
innovation, wellbeing and social inclusion policies, coordinated by the Polo
Tecnologico in Pordenone.
At the end of the workshop session, the participants had the possibility to
visit the Polo and to receive information on the companies hosted there and
their most innovative activities and products. The study visit was concluded
by a light lunch after which the delegation was transferred to the closer
airports.
III LEARNING OUTCOMES FOR THE PARTNERSHIP
Area
(self- management /policy/ICT)
Veneto Region
Key characteristics
Learning
Outcome 1
Integration of telehealth and
telecare and continuity of care
for patients with chronic
diseases.
Veneto Region has a strong experience in
providing tele-care programs addressed
to older people. Tele-care is administered
by the Social Services of municipalities
since more than 25 years and it covers
now more than 25,000 citizens over 65
years with frail conditions in the whole
Region. The service is managed by a
regional operation centre that provides
24/7 assistance in case of emergency
situations occurring at home, such as
falls, deterioration of health conditions,
home intrusions, etc. Thanks to the
European project Renewing Health this
regional service was enriched with a
telehealth component for the
telemonitoring of patients with chronic
diseases. More than 700 patients, 7 Local
Health Authorities and 2 Hospital Trusts
have been involved in this pilot initiative
that is allowing to collect an impressive
set of data about the services impact.
The service is coordinated by the same
operation center that represents the key
intermediation point between the patient
and the main healthcare and social
players. Patients receive personalized
assistance that is not limited to
healthcare but involves also their daily
activities and contributes in this way to
reduce their social isolation and make
them feel safer, less worried and well
protected.
Learning
Outcome 2
Strong commitment to
chronicity and multimorbidity
policies and eHealth
implementation
The recent regional health and social care
plan pays particular attention to answer
to the changing needs of an ageing
population characterized by complex mix
of social conditions and multi-morbidity.
The regional strategy is to foster and
invest on intermediate care in order to
reach a solid integration between
hospital and primary care and finally with
patients’ homes. One of the priorities of
the regional government has been the
improvement of the method to measure
the case-mix (risk) n the population to
better predict health care needs and
future costs. An effective case-mix
measurement tool was developed during
the ACG (Adjusted Clinical Groups)
project for the classification of population
risk and correlation with resource
utilization.
The regional health and social care plan
put the strategic basis for the
implementation of the regional EHR, a
program that started at the end of 2012
and will get to the re-organisation of
health and social care services thanks to
the shared management of data and
processes at regional level.
Friuli Venezia Giulia Region
Learning
Outcome 1
Learning
Outcome 2
Policy level
Regional cluster made by a Public-Private
Partnership, that includes institutions,
organisations and companies coming
from Health, social, innovation, research
and education sectors.
ICT level
Domotics solutions for indipedent living
and active ageing at home
IV. IDENTIFICATION OF POTENTIAL BEST PRACTICES
1.Name of the Region
Potential Best Practice
Veneto Region
Integration of telehealth and telecare services
An efficient and virtuous organizational model that allows the
decentralization of chronic diseases management
Brief Characteristics
of
the Practice
Improved communication and collaboration collaboration among
different actors thanks to the strategic intermediation role played
by the regional telehealth and telcare center
Patient empowerment and social inclusion
Patients receive personalized assistance that includes also social
attention
2. Name of the Region
Potential Best Practice
Veneto Region
Case-mix measurement of population risk
The ACG project allowed to developed a sophisticated case-mix
measurement system for:
Brief Characteristics
of
the Practice



3.Name of the Region
Regional mapping of diseases and multi-morbidity
Tuning the intervention and resources according to the
actual patients needs
Including patients in appropriate case management
programs according to their risk and needs
Friuli Venezia Giulia Region
Presto a Casa (Back Homne)
Potential Best Practice
Brief Characteristics
of
the Practice
The project involves the Municipality of Trieste, the AREA Science
Park and ATER Trieste (Public housing institution) with the support
of the Province of Trieste. It is an experimental project committed
to develop innovative models for temporary domiciles devoted to
users with sub-acute physical and sensory disabilities.
Through the creation of houses equipped with information and
automation technologies, which are a new major resource to obtain
autonomy at home for the disabled, the project is primarily aimed
at promoting the key role of users.
More specifically, two flats belonging to ATER will be equipped with
automation technologies, technical furniture and special design
and building solutions so as to facilitate access and make all spaces
usable also to those whose autonomy is suddenly limited to a
major or minor extent.
The use of “training” houses is mainly aimed at young and adult
people with physical and/or sensory disabilities (usually after
serious traumas), who will experiment tools, devices and facilities
that can help them, managing and monitoring their activities,
house functionalities and interactions with the outside world while
fully complying with their requirements in terms of personal safety,
environment and house comfort.
This experimentation is required to understand what could be
actually useful to users and to realise the changes to be made to
their houses, as well as to select economically viable and technically
feasible solutions so that they can face life in a more serene
manner when they get back home.
“Back Home” falls within the broader context of the regional
strategic project called “Domotica FVG”.
4.Name of the Region
Friuli Venezia Giulia Region
Re-Freedom Project
Potential Best Practice
Brief Characteristics
of
the Practice
Project funded by the Regional Law 26/2005 Art. 22 “innovation in
social-health services” (Lead partner: Municipality of Udine; Project
partners: Rino Snaidero Scientific Foundation; Friuli Innovazione).
ICT networking of two apartments in the town of Udine, structured
to host new technologies research and validation. Testing of an
organizational model for the provision of innovative services using
advanced technologies. The project aim is to develop guidelines
and tools for planning the refurbishment of housing units and also
the integrated services in urban areas.
FINAL REMARKS
LIST OF PARTICIPANTS OF STUDY VISIT
NAME
SURNAME
PARTNER
ORGANISATION
EMAIL
Tina
Norrköping
Minicipality
kristina.allerth@norrkoping.se
Allerth
Karen Vibeke
Training department,
Nyborg Kommune
kva@nyborg.dk
Andersen
Apuzzo
ASS 5 Bassa Friulana
matteo.apuzzo@welfare.fvg.it
k.j.barbour@soton.ac.uk
Barbour
Wessex
Health
Network
lotte.beck@rsyd.dk
Beck
Health
Innovation
Centre of Southern
Denmark
massimiliano.bertetti@polo.pn.it
Massimiliano
Bertetti
Polo Tecnologio
Pordenone
Sarie
Bongers
Freelance Consultant
anam.carriazo@juntadeandalucia.es
Ana
Carriazo
Ministry of Equality,
Health and Social
Policies
Giorgia
Centis
Arsenàl.IT
gcentis@consorzioarsenal.it
Sarah
Collins
Kent County Council
sarah.collins@kent.gov.uk
jccontel@gencat.cat
Joan Carles
Contel
Department of Health,
Government
of
Catalonia
Pietro
Crosilla
Ass 5 "Bassa Friulana"
pietro.crosilla@welfare.fvg.it
Richard
Curry
SEHTA
richard.curry@sehta.co.uk
De Jong
Healthcare
Network
Midden-Brabant
marjolein@dijkjong.demon.nl
Marjolein
Dedeu
Ministry of Health of
Catalonia
tdedeu@gencat.cat
Toni
Deja
Regional Centre of
Social Policy in Poznan
radoslaw.deja@rops.poznan.pl
Radosław
Patricia
Díaz SanchezCortés
TicSalut Foundation
Fabian
Dominguez
Flemish Government
fabian.dominguez@wvg.vlaanderen.be
cathy.dorrian@nhs.net
Cathy
Dorrian
The Scottish Centre for
Telehealth
&
Telecare/NHS 24
Christina
Ederberg
Region Halland
christina.ederberg@regionhalland.se
estela.perez@juntadeandalucia.es
Mariano
Flores
Caballero
Ministry of Equality,
Health and Social
Policies
Jill
Frankland
Kent County Council
jill.frankland@kent.gov.uk
Ignasi
Garcia-Milà
Vidal
TicSalut Foundation
Matteo
Katherine
Lotte
Bianca
Miruna
Academic
Science
di
sariebongers@gmail.com
pdiaz@ticsalut.cat
igarciamila@ticsalut.cat
gavrilitab@yahoo.com
Gavrilita
Timis County Council
Federica
Giampieretti
ASS n.
Friulana"
5
Laura
Giorgi
LHA of Verona
internazionali@ulss20.verona.it
Holtmaat
Healthcare
Network
Midden-Brabant
v.holtmaat@zmbr.nl
Veronique
Kristina
Isaksson
Region Halland
kristina.isaksson@laholm.se
Sonja
Johansson
Linköpings Kommun
sonja.johansson2@linkoping.se
Kaag
Province
Brabant
AKaag@brabant.nl
Astrid
Mikael
Kahlin
Laholm Municipality
mikael.kahlin@laholm.se
Kools
Care Innovation Center
WB
kools.sprundel@home.nl
Kees
KrzymińskaSiemaszko
Poznan University of
Medical Sciences
romakrzyminska@interia.pl
Roma
James
Lampert
Kent County Council
james.lampert@kent.gov.uk
Malin
Larsson
Region Halland
malin.larsson@regionhalland.se
Yorgos
Lazariotis
LHA of Verona
ylazariotis@ulss20.verona.it
Lee
Kent
Community
Health NHS Trust
kim.lee2@nhs.net
Kim
sharonlee2@nhs.net
Sharon
Lee
Kent
Community
Health NHS Trust
Macleod
Renfrewshire
Social Work
peter.macleod@renfrewshire.gsx.gov.uk
Peter
Silvia
Mancin
Arsenal.IT
smancin@consorzioarsenal.it
Ron
Meldrum
Kent county
ronmeldrum@yahoo.co.uk
Edwin
Mermans
Province
Brabant
Francesc
Moya Olvera
TicSalut Foundation
fmoya@ticsalut.cat
Mirta
Mordakhai
LHA 20 of Verona
mirta.mordakhai@ulss20.verona.it
Hayley.Mullan@kentcht.nhs.uk
Hayley
Mullan
Kent
Community
Health NHS Trust
Bart
Neels
Sirris
bart.neels@sirris.be
emilie.nielsen@rsyd.dk
Emilie
Nielsen
Health
Innovation
Centre of Southern
Denmark
Andrea
Oliani
LHA of Verona
andrea.oliani@ulss20.verona.it
Glyn
Pallister
Kent County Council
Glyn.Pallister@kent.gov.uk
David
Parry
SEHTA
david.parry@sehta.co.uk
of
of
"Bassa
Noord-
Council
Noord-
federica.giampieretti@welfare.fvg.it
emermans@brabant.nl
Michael
Pealsson
New tools for Health
michael.peolsson@halsansnyaverktyg.se
Peter
Raeymaekers
Flemish Government
peter.raeymaekers@wvg.vlaanderen.be
Raus
Knowledge
Social Europe
herman.raus@kcse.eu
Herman
Mick
Roberts
Kent County Council
Michael.Roberts@kent.gov.uk
Stefania
Romano
ASS. 5 "Bassa Friulana"
stefania.romano@welfare.fvg.it
Rommel
Knowledge
Social Europe
an.rommel@kcse.eu
An
Elena
Rosu
Timis County Council
Ester
Sarquella
Casellas
Mancomunitat la Plana
Center
Center
elena.rosu@cjtimis.ro
ester.sarquella@mancoplana.cat
MirelaCarina
Sinca
Timis County Council
Sommer
Healthsekretarie
Svendborg Kommune
tove.sommer@svendborg.dk
Tove
Leonardo
Speri
LHA 20 of Verona
leonardo.speri@ulss20.verona.it
Marielle
Swinkels
Zorgtechnoservice
m.swinkels@zorgtechnoservice.nl
Szewczyczak
Poznan University of
Medical Sciences
mszewczyczak@wp.pl
Marlena
hilde@zorganderstv.be
Taillieu
Ablecare
(ZorgAndersTv/ZORG
Magazine)
michael@zorganderstv.be
Michael
Van
Buggenhout
Ablecare
(ZorgAndersTv - ZORG
Magazine)
Care Innovation Center
WB
chantal@cic-westbrabant.nl
Chantal
Van
Spaendonck
Ingrid
Von Sydow
Linköpings Kommun
ingrid.von.sydow@linkoping.se
Kathy
Vuillaume
EPM
kathyvuillaume@epmconsultancy.eu
Eveline
Wouters
Fontys
e.wouters@fontys.nl
Hilde
mirela_carina@yahoo.com