What does it take to make integrated care work? A ‘cookbook’ for large-scale deployment of coordinated care and telehealth

The Advancing Care Coordination & Telehealth Deployment (ACT) Programme is the first to explore the organisational and structural processes needed to successfully implement care coordination and telehealth (CC&TH) services on a large scale. A number of insights and conclusions were identified by the ACT programme. These will prove useful and valuable in supporting the large-scale deployment of CC&TH. Targeted at populations of chronic patients and elderly people, these insights and conclusions are a useful benchmark for implementing and exchanging best practices across the EU. Examples are: Perceptions between managers, frontline staff and patients do not always match; Organisational structure does influence the views and experiences of patients: a dedicated contact person is considered both important and helpful; Successful patient adherence happens when staff are engaged; There is a willingness by patients to participate in healthcare programmes; Patients overestimate their level of knowledge and adherence behaviour; The responsibility for adherence must be shared between patients and health care providers; Awareness of the adherence concept is an important factor for adherence promotion; The ability to track the use of resources is a useful feature of a stratification strategy, however, current regional case finding tools are difficult to benchmark and evaluate; Data availability and homogeneity are the biggest challenges when evaluating the performance of the programmes

Commercialisation of eHealth Innovations in the Market of UK Healthcare Sector: A Framework for Sustainable Business Model.

This is the peer reviewed version of the following article: Festus Oluseyi Oderanti, and Feng Li, ‘Commercialization of eHealth innovations in the market of the UK healthcare sector: A framework for a sustainable business model’, Psychology & Marketing, Vol. 35 (2): 120-137, February 2018, which has been published in final form at https://doi.org/10.1002/mar.21074. Under embargo until 10 January 2020. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.Demographic trends with extended life expectancy are placing increasing pressures on the UK state-funded healthcare budgets. eHealth innovations are expected to facilitate new avenues for cost-effective and safe methods of care, for enabling elderly people to live independently at their own homes and for assisting governments to cope with the demographic challenges. However, despite heavy investment in these innovations, large-scale deployment of eHealth continues to face significant obstacles, and lack of sustainable business models (BMs) is widely regarded as part of the greatest barriers. Through various empirical methods that include facilitated workshops, case studies of relevant organizations, and user groups, this paper investigates the reasons the private market of eHealth innovations has proved difficult to establish, and therefore it develops a framework for sustainable BMs that could elimiesnate barriers of eHealth innovation commercialization. Results of the study suggest that to achieve sustainable commercialization, BM frameworks and innovation diffusion characteristics should be considered complements but not substitutes.Peer reviewe

Increasing the Capacity of Primary Care Through Enabling Technology.

Primary care is the foundation of effective and high-quality health care. The role of primary care clinicians has expanded to encompass coordination of care across multiple providers and management of more patients with complex conditions. Enabling technology has the potential to expand the capacity for primary care clinicians to provide integrated, accessible care that channels expertise to the patient and brings specialty consultations into the primary care clinic. Furthermore, technology offers opportunities to engage patients in advancing their health through improved communication and enhanced self-management of chronic conditions. This paper describes enabling technologies in four domains (the body, the home, the community, and the primary care clinic) that can support the critical role primary care clinicians play in the health care system. It also identifies challenges to incorporating these technologies into primary care clinics, care processes, and workflow

Technology and Caregiving: Emerging Interventions and Directions for Research.

An array of technology-based interventions has increasingly become available to support family caregivers, primarily focusing on health and well-being, social isolation, financial, and psychological support. More recently the emergence of new technologies such as mobile and cloud, robotics, connected sensors, virtual/augmented/mixed reality, voice, and the evermore ubiquitous tools supported by advanced data analytics, coupled with the integration of multiple technologies through platform solutions, have opened a new era of technology-enabled interventions that can empower and support family caregivers. This paper proposes a conceptual framework for identifying and addressing the challenges that may need to be overcome to effectively apply technology-enabled solutions for family caregivers. The paper identifies a number of challenges that either moderate or mediate the full use of technologies for the benefit of caregivers. The challenges include issues related to equity, inclusion, and access; ethical concerns related to privacy and security; political and regulatory factors affecting interoperability and lack of standards; inclusive/human-centric design and issues; and inherent economic and distribution channel difficulties. The paper concludes with a summary of research questions and issues that form a framework for global research priorities

Taking IT Artifacts Seriously: Developing a Mixed Determinants Model of Assimilation of Telehealth Systems

A number of healthcare authorities are considering the adoption of telehealth into mainstream clinical care, bringing telehealth technology out of experimental settings into real life settings. To fully reap the benefits from a technological innovation, the innovation must be assimilated into the organization\u27s work system. As most literature on telehealth adoption to date has focused on its evaluation (e.g., user acceptance), more work is warranted to understand how telehealth can be integrated into administrative and clinical practices and to identify factors that may impinge onto telehealth integration. Borrowing from institutional, structuration and organizational learning theories, we propose a research framework* to address limitations of past work and to guide research and managerial actions while integrating telehealth in the workplace

Marshfield Clinic: Health Information Technology Paves the Way for Population Health Management

Highlights Fund-defined attributes of an ideal care delivery system and best practices, including an internal electronic health record, primary care teams, physician quality metrics and mentors, and standardized care processes for chronic care management

Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS3) - TDP (United Kingdom) Case Study Report

The Telecare Development Programme (TDP) case in Scotland (UK) is a patient-centred Integrated Care management process targeting the 65+ population in the country. It particularly addresses vulnerable subgroups of patients and patients with complex illnesses within the 32 communities across Scotland. The TDP case is a funding initiative developed between 2006 and 2011 by the Scottish Government in order to encourage the adoption of the telecare by health and social care services. It sought to demonstrate how telecare could contribute to support the safety and quality of life of older people and enable them to live at home longer, while significantly reducing the cost of health and social care services provisioning. During the period of 2006-2011, no less than 51 telecare projects were operating within all 32 Communities, covering the whole population of Scotland. The starting point of the TDP case was a change in the policy context that required a shift from a healthcare system oriented towards hospital-based treatment to a system based on preventive care to manage long-term conditions. TDP enables vertical integration within the Communities of Health Partnerships (CHPs), but should also promote full integration in a short to medium-term perspective, especially as the new legislative framework coming into force in March-April 2015 aims to integrate health and social care units, as a consequence of a recent health care spending review.JRC.J.3-Information Societ

Telehealth in the Amazon Region in Latin America: an Overview

Purpose: This paper describes the current status of telehealth in the Latin American Amazon and displays the result of a distance course on malaria, focused on physicians and healthcare professionals from nine countries of the Amazon region. Methods: Data were collected on telehealth implementation and course participation for the following countries in the Amazon region: Brazil, Colombia, Ecuador, Peru, Venezuela and Bolivia. Results: There are 808 Municipalities in the Amazon region. Over half (51.9%) of the Municipalities have implemented or are implementing telehealth projects in the region. Among these 6 countries, Brazil has the highest percentage of municipalities with telehealth projects implemented (498 of 808, 61,6%;), Venezuela  (38 of 91, 41.7%) and  following by Bolívia  (5 of 39; 12,8%). Participation in the distance course on malaria has included 868 students: Brazil, 291 participants (33.5%); Bolivia, 28 (3.2%); Colombia, 104 (12.0%); Ecuador, 52 (6.0%); Guyana, 2 (0.2%); Paraguay 1 (0.1%), 270 Peru (31,1%); 102 Venezuela (11.8%) and others (2.1%). Nearly all (99.1%) of learners would recommend the course to colleagues. Conclusion: Shared action between countries is an important framework that can lead to incorporation of telehealth resources and training for a common, remote setting, as exemplified by international activities in the Amazon region

Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS3) - Operational Guidelines for ICT-supported Integrated Care and Independent Living

The guidelines in this report have been developed as part of the Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS3) project. Twenty-four ICT-supported integrated care initiatives in the EU were identified which supported integrated care and/or independent living and were either deployed or promising large scale pilots. The aim of this report is to define a set of recommendations to guide the process of developing and implementing ICT-supported integrated care and independent living, based on the experiences made in these 24 initiatives. The intended audience for this guidance document are those who work on the development and implementation of initiatives at an operational level, such as professionals, managers in healthcare organisations, regional managers of health or social care, health insurers, professionals’ organisations, etc.JRC.J.3-Information Societ