03.02. Detalle

LINKCARE will focus, not only on the suitability of the platforms, from the technical point of view - interoperability, security, standards and regulations -, but also on the needs and requirements that are specific for the care of patients with chronic health problems - coordination of professionals across time, centred on the patient, and collaboration among different levels of care.

Despite increased investment in health and social care, many of the traditional difficulties continue to exist and are common to healthcare services in Europe. Many of these issues concern the processes that underpin and support the delivery of services in specific contexts of non-acute care provision such as Mental Health, Elderly Care, Child Care, and the administration and management of home treatments. For too long the care of patients with chronic conditions has taken place in a compartmentalized fashion.

Furthermore, pushed by the need to maximize population coverage in an increasingly resource limited environment; new models of care delivery are emerging. These models have a common focus on collaboration among professionals with diverse profiles, located in the same or different institutions, linked to different providers and supplying different types of services.

Finally, the interoperability between different components of the system is also a critical issue for successful system implementation in an organisation. At the moment the healthcare systems lack interoperability and standardization both concerning storage, interface to database, system documentation and interfaces to other systems.

In this context, the LINKCARE services, based on a standard architecture with interoperability concerns, are designed to contribute to the change in the way care is delivered to chronic patients to overcome the problems associated to fragmentation of care and validate a convergent model of care centred in their treatment.

The main idea for the business case of Linkcare is the provision of services that:

• Facilitate the establishment of an European convergent healthcare system that is centred on the chronic patients, coordinated across different levels of the health and community services;
• Facilitate ubiquitous and mobile new working practices for health professionals with a multiplicity of working profiles that, in turn, require interoperability with existing information resources.

LINKCARE will focus, not only on the suitability of the platforms, from the technical point of view - interoperability, security, standards and regulations -, but also on the needs and requirements that are specific for the care of patients with chronic health problems - coordination of professionals across time, centred on the patient, and collaboration among different levels of care.

In the framework of the market validation, the consortium will run pilot installations, will establish the requirements to integrate the services in the existing operational/legacy systems, will set up the training plan to successfully validate the platform and will elaborate the deployment strategy on the basis of the outcome of the market and business analysis and the conclusions from the pilots validation.

The 3 test sites, used for the evaluation provide common services for patients with chronic conditions. They are: Hospital Clinic I Provincial in Spain, Central Norway Regional Health Authority in Norway, and LITO Hospital in Cyprus.

The final objective of the LINKCARE project is to validate the market concerning the deployment of LINKCARE services which introduce new means for quality long term health care management. The consortium already possesses the research and development framework, as well as individual applications, as a result of previously RTD projects. It is expected that LINKCARE will set the base for successful exploitation, through the creation of a sound deployment plan supported by the results of the validation trials of the LINKCARE services.

Today there is no a straight and comprehensive service available in Europe for patients with chronic conditions. There are various systems, services and applications available, which allow users to monitor their health status and transmit some type of vital signal information to remotely located medical personnel, or to professionals to manage and work in a cooperative environment. Linkcare aims at offering a viable, innovative, integrated health care service for chronic patients, to support health professional in their activity and to pave the way for the implementation of new models of care. In order to do that, the project will validate the precise conditions to be fulfilled and the gaps to bridge for a real deployment.

Due to the innovative character of the service, and the fact that the health care market elements do not offer sufficient ground in order to extract the right conclusions, the consortium consider that the work that will be developed in Linkcare as for the positioning and the viability of the service, will ensure a truthful business plan and will fulfil the growing demand in the health service market to provide health services to chronic patients, with an efficient use of the resources.

The success of Linkcare will be measured on the following areas:

• acceptance by the health workforce of the use of the Linkcare platform
• increase in the collaboration among the health care workforce: reduction of the clerical work increase of the information sharing, reduction of the “repeated” work
• patient adherence to care plans, reduce morbidity, and improve quality of life
• efficacy of patient use of vital tele monitoring facilities to early detect patient worsening of a condition
• cost / saving analysis: cost of the service / savings in health care costs
• capacity of generating revenues from the private sector (private health services, pharmaceutical companies, other service / assets providers)

In order to maximize the result of the validation, Linkcare partners will be applying a set of harmonised and well established success indicators based on the experience of the partners in the evaluation of the impact of ICT in health.

The overall services for the Spanish Site are:

• Infrastructure at the hospital: Care Management Centre (CMC): The CMC environment consists of the following basic functional elements:
  • A Call Centre Service, including two main modules: teleoperator application (support for handling incoming calls) and a Voice Response Unit or automatic telephony service (automatic handling of calls out of hours)
  • A web-based Patient Management Module (PMM) that provides the professionals in the Chronic environment (nurses, doctors, physiotherapists, other health care professionals, managers and administrators) with access to the information regarding patients and other aspects of the project they may need to carry out their tasks. It can be used from anywhere, provided that there is a navigator and Internet connection available, and that the appropriate security requirements are followed.
  • DB service that performs back-office activities i.e. contains the patient and professional personnel database, access rules, etc. The database contains the information related to the patient, including past history and plan of care. It does also contain information about the professionals working in chronic environment and other data needed to implement the system"s functionality.
  • Inter-application message management module, that enables the sharing of information among all the software modules in the system.
• Infrastructure to support home visits: the Home Visit Unit is designed to be used by the professionals during their work at the patient homes. These units consist of a small size portable PC with a PCMCIA allowing GPRS / UMTS connection and a software application. They enable the professional to connect to the centre and receive information about their visits agenda for the day, access to updated patient information, and any other relevant data coming from the HER. This unit also allows recording all the parameters introduced during the visit into the central.

The overall services of the Norwegian Site are:

• CSCW – supporting sharing of documents, messaging (internal e-mail), instant messaging and discussion board.
• Library with info resources – health care providers has access to an electronic medical handbook that are used to give the patient extensive information about her disease and that gives the caregiver decision support at the point of care.
• Agenda – planning of patient activities in relation to all care providers. The individual patient plan is the most central service in the Norwegian pilot. Important information in relation to the patient plan is the objectives of the plan and evaluation of the patient at different stages.
• Profile management – management of users is based on a roles and access rights related to the roles. Caregivers can have different roles related to different patients.
• Patient management module – it supports simple management of the patient profile. The patient management module is not connected to the PAS at the hospital.

The overall services of the Cyprus Site are:

The LINKCARE platform for the trials in Cyprus will be based on the DITIS system, currently in operation supporting home care for cancer patients. It will be customized and parameterized for the needs of the cardiac trials to be performed by LITO Polyclinic.

DITIS is an Internet (web) based Group Collaboration system with fixed and GSM/GPRS/UMTS mobile connectivity. It employs Web Databases and Database Connectivity for storage and processing of information, including Patient Information, in accordance with National and International standards (e.g. WHO ICD-10, ICD-O, HL7), role–based intelligent interface for uniform access to the common database, security features, and the Group Collaboration software from both fixed and mobile computing units. DITIS also supports the integration of new technologies in Telemedicine and the home care service for patients through the use of Mobile Computing Units (e.g. Smart Phones, Pocket PC, PDAs, Handheld PCs, Tablet PC)..

Participantes

Contacto

Dr. Josep Roca
Hospital Clínic i Provincial de Barcelona
Hospital Clínic i Provincial de Barcelona Servei de Neumología Villarroel 170, Barcelona
Tfno.: +34 932275747
Fax: +34 932275455
E-mail: jroca@clinic.ub.es
Web: http://www.hospitalclinic.org