jakob sylvest nielsen's presentation from the healthcare denmark ambassador summit

M U N I C I P A L I T Y O F L Y N G B Y - T A A R B Æ K

HEALTH

Healthcare Denmark 27 – 28. Oktober 2014

Lyngby-Taarbæk Municipality

• Lyngby-Taarbæk: A municipality with approx. 53.000 Citizens – an avarage size municipality i DK.

• App. 3.800 citizens are estimated to suffer from COPD in the Municipality – only 50 pct. Diagnozed.

• Epital Health is a Citizen-centric COPD-telemedicineproject aimed at tackling the challenges facing the healthcare sector

• Project initiated i november 2011 – 52 active COPD-citizens active today – target 2015: 150 citizens.

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A Citizen-centric approach to a sector

neutral health care system focused at;

• Self monitoring of key health indicators

• Citizen Empowerment through health promoting service offers

• Supervision from a call-center and proactive measures towards criticalpatient value measurements

• 24-Hour on-call doctor to support Call Center nurses – LEON

• Full IT-based support system for processes og documentation

The Vision

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1. Better quality-of-life for citizens and reduced mortality rates

2. Diminishing health care expenditure through fewer acutehospitalisations and ambulant treatments

3. Diminshing expenditure on home care for citizens

4. Competency development of employees, aiming to support the effortsto digitalise the public welfare services

The Goals

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The actors in Epital Health

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Citizen Pharmacy

Subacute unit

Epital TechnicalService team

GeneralPractitioner

Epital ClinicalService team

Epital HealthCoach

Physiotherapist Dietician

Municipality

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”The Funnel”

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Reduction

of

admissions

Admissionat hospital

Self managed

Support 1

Support 2

Managed

Controlled

30%10-15%

10%10%

10%

25-30%Measures

Activity

Empowerment

IT-Support

Self treatment

Asyncronous TM

Epi Call Center

Synchronous TMResponse teams

Intensified

observationEmpowerment

Healthy Lifestyle

Insight to own health

Network/Communities

Increase comptences

Symptom understanding

Self treatment plan

IT-based decsionsupport

Link to ECC

Rapid response

Professional support

Optional services

Care/coaching

Coordination

Monitoring

Sparring

1. Clinically supportedcare

2. Outgioing specialisedClinical Service Team

”Admitted” at home

Admitted at

Subacute unit atMunicipality

Intensified

observation and care

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Citizen - Summer 2014

Medical box – rescue medication

e-health navigator

e-health monitoring devices

CallCenter, Lyngby-Taarbæk, – Summer 2014

Instant acces to core clinical data

1

2

3

Real-time communication while having access to updated clinical data

Results?

Results I - Economics

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Activities of 28 citizens in Epitalet

Periode 01.10.2013-31.03.2013 01.10.2014-31.03.2014 Pct. Change

Number of hospitalizations 10 5 -50%

Number of days in the hospital 70 15 -79%

Total cost of hospitalization (DDK, DRG-value) 1.149.560 129.090 -89%

Municipality direct payment of hospitalization (DDK) 97.112 43.890 -55%

Number of outpatiens visits 26 14 -46%

Total cost of outpatiens visits (DDK) 73.066 39.239 -46%

Visits general practitioner 239 250 5%

Results II – Quality of life

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5

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Megetuenig

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Re

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nts

27. It means a lot to me that I can make measurements to check my health conditions, whenever I need that (n = 22)

AgreeDisagree

Results II – Quality of life

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0

5

10

15

20

25

Megetuenig

2 3 4 5 6 7 8 9 Meget enig

Re

sp

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nts

22. After I joined the Epital, I have had less need to contact the emergency/ 1813, when I feel bad (n = 15)

Disagree Agree

Results II – Quality of life

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0

5

10

15

20

25

Meget uenig 2 3 4 5 6 7 8 9 Meget enig

Re

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34. I am completely comfortable with giving The health staff the needed information through Epital in order to help me (n = 22)

Disagree Agree

1. Expanding the number of citizens in the project – 150 in 2015 (and more) including citizens from surronding municipalities: Getting more data for studies.

2. Considerations of expansion af project to other groups of cronicdiseases - The Epital is a generic system : positive business case ?

3. Scrutinize the national strategic targets and political agenda: municipalities and regions should go in the same direction.

Perspectives

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