European Hospital Survey: Benchmarking deployment of e-Health services (2012–2013) Synthesis of Outcomes

A widespread uptake of eHealth technologies is likely to benefit European Healthcare systems both in terms of quality of care and financial sustainability and European society at large. This is why eHealth has been on the European Commission policy agenda for more than a decade. The objectives of the latest eHealth action plan developed in 2012 are in line with those of the Europe 2020 Strategy and the Digital Agenda for Europe. This report, based on the analysis of the data from the "European Hospital Survey: Benchmarking deployment of e-Health services (2012–2013)" project, presents policy relevant results and findings in this field. The results highlighted here are based on the analysis of the survey descriptive results as well as two composite indicators on eHealth deployment and eHealth availability and use that were developed based on the survey's data. Although they are closely interrelated, these results have been grouped in four sections. They are presented in detail in this document and briefly summarised below.JRC.J.3-Information Societ

European Hospital Survey: Benchmarking deployment of e-Health services (2012–2013) Composite Indicators on eHealth Deployment and on Availability & Use of eHealth functionalities.

eHealth has been on the European Commission Information Society's policy agenda for more than a decade, from the eEurope initiative(European Commission 1999) to the i2010 Strategy(European Commission 2005), and most recently the Digital Agenda for Europe (DAE)(European Commission 2010), eHealth was also one of the Lead Market Initiatives in 2007. Today it is the focus of one of the two first pilots under the EU2020 Strategy and its Innovation Union flagship initiative – the European Innovation Partnership on Active and Healthy Ageing. The key strategic orientations of the European Commission eHealth policy are defined in the eHealth Action Plan 2012-2020 where eHealth is referred to as "the application of information and communications technologies across the whole range of functions that affect the health sector and including products, systems and services that go beyond simply Internet-based applications"(European Commission 2004).JRC.J.3-Information Societ

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

Protocol for the OUTREACH trial: a randomised trial comparing delivery of cancer systemic therapy in three different settings: patient's home, GP surgery and hospital day unit.

BACKGROUND: The national Cancer Reform Strategy recommends delivering care closer to home whenever possible. Cancer drug treatment has traditionally been administered to patients in specialist hospital-based facilities. Technological developments mean that nowadays, most treatment can be delivered in the out-patient setting. Increasing demand, care quality improvements and patient choice have stimulated interest in delivering some treatment to patients in the community, however, formal evaluation of delivering cancer treatment in different community settings is lacking. This randomised trial compares delivery of cancer treatment in the hospital with delivery in two different community settings: the patient's home and general practice (GP) surgeries. METHODS/DESIGN: Patients due to receive a minimum 12 week course of standard intravenous cancer treatment at two hospitals in the Anglia Cancer Network are randomised on a 1:1:1 basis to receive treatment in the hospital day unit (control arm), or their own home, or their choice of one of three neighbouring GP surgeries. Overall patient care, treatment prescribing and clinical review is undertaken according to standard local practice. All treatment is dispensed by the local hospital pharmacy and treatment is delivered by the hospital chemotherapy nurses. At four time points during the 12 week study period, information is collected from patients, nursing staff, primary and secondary care teams to address the primary end point, patient-perceived benefits (using the emotional function domain of the EORTC QLQC30 patient questionnaire), as well as secondary end points: patient satisfaction, safety and health economics. DISCUSSION: The Outreach trial is the first randomised controlled trial conducted which compares delivery of out-patient based intravenous cancer treatment in two different community settings with standard hospital based treatment. Results of this study may better inform all key stakeholders regarding potential costs and benefits of transferring clinical services from hospital to the community. TRIAL REGISTRATION NUMBER: ISRCTN: ISRCTN66219681.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

A pilot randomised controlled trial of personalised care for depressed patients with symptomatic coronary heart disease in South London general practices: the UPBEAT-UK RCT protocol and recruitment.

ABSTRACT: Background: Community studies reveal people with coronary heart disease (CHD) are twice as likely to be depressed as the general population and that this co-morbidity negatively affects the course and outcome of both conditions. There is evidence for the efficacy of collaborative care and case management for depression treatment, and whilst NICE guidelines recommend these approaches only where depression has not responded to psychological, pharmacological, or combined treatments, these care approaches may be particularly relevant to the needs of people with CHD and depression in the earlier stages of stepped care in primary care settings. Methods: This pilot randomised controlled trial will evaluate whether a simple intervention involving a personalised care plan, elements of case management and regular telephone review is a feasible and acceptable intervention that leads to better mental and physical health outcomes for these patients. The comparator group will be usual general practitioner (GP) care. 81 participants have been recruited from CHD registers of 15 South London general practices. Eligible participants have probable major depression identified by a score of ≥8 on the Hospital Anxiety and Depression Scale depression subscale (HADS-D) together with symptomatic CHD identified using the Modified Rose Angina Questionnaire. Consenting participants are randomly allocated to usual care or the personalised care intervention which involves a comprehensive assessment of each participant’s physical and mental health needs which are documented in a care plan, followed by regular telephone reviews by the case manager over a 6-month period. At each review, the intervention participant’s mood, function and identified problems are reviewed and the case manager uses evidence based behaviour change techniques to facilitate achievement of goals specified by the patient with the aim of increasing the patient’s self efficacy to solve their problems. Depressive symptoms measured by HADS score will be collected at baseline and 1, 6- and 12 months post randomisation. Other outcomes include CHD symptoms, quality of life, wellbeing and health service utilisation. Discussion: This practical and patient-focused intervention is potentially an effective and accessible approach to the health and social care needs of people with depression and CHD in primary care. Trial registration: ISRCTN21615909

Long-Term Impact of War on Healthcare Costs: An Eight-Country Study

PMCID: PMC3251588This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS3) - ACTION (Sweden) Case Study Report

ACTION (Assisting Carers using Telematics Interventions to meet Older Person’s Needs) is a self-care and family care support service provided through ICT installed at patients' homes. The main target of the service are older carers living with aged spouses who require help with the activities of daily living as a consequence of chronic illness. The ACTION service consists of 4 integrated components: multimedia educational programmes, a call centre with video-telephony, a computer with videophone placed in the older person’s home and training and supervision programmes. ACTION is currently running as a mainstream service in the Borås municipality in Western Sweden, where it was first piloted and implemented in 1997, with around 100 users (status July 2014). Back in 2011, around 350 people were using the service as there were pilot projects in twenty municipalities across Sweden.JRC.J.3-Information Societ

European Hospital Survey: Benchmarking deployment of e-Health services (2012–2013) Country Reports

A widespread uptake of eHealth technologies is likely to benefit European Healthcare systems both in terms of quality of care and financial sustainability and European society at large. This is why eHealth has been on the European Commission policy agenda for more than a decade. The objectives of the latest eHealth action plan developed in 2012 are in line with those of the Europe 2020 Strategy and the Digital Agenda for Europe. This report, based on the analysis of the data from the "European Hospital Survey: Benchmarking deployment of e-Health services (2012–2013)" project, presents policy relevant results and findings for each of the 28 EU Member States as well as Iceland and Norway. The results highlighted here are based on the analysis of the survey descriptive results as well as two composite indicators on eHealth deployment and eHealth availability and use that were developed based on the survey's dataJRC.J.3-Information Societ

Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS3) - DREAMING (Spain) Case Study Report

DREAMING (ElDeRly-friEndly Alarm handling and MonitorING) was a large-scale pilot project that took place in 6 sites over a period of around 4 years, starting in 2008. It aimed to demonstrate new services that could help elderly people live independently in their home environment as long for as their physical and mental conditions allow. The technologies deployed were a combination of health and environmental monitoring systems. The data collected was processed by a decision support system and handled by a call centre. None of the 6 DREAMING sites developed further or integrated the services into the package of health and social care benefits offered to the population covered. Nevertheless, the innovation Unit of Barbastro Health Care Area (Spain) relied on the lessons and experiences from DREAMING and previous projects to design and test the implementation of telemonitoring services with a stronger integrated care approach.JRC.J.3-Information Societ