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”
321
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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0
5
10
15
20
25
Megetuenig
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Re
sp
on
de
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
on
de
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
sp
on
de
nts
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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