hope
The challenge of integrated care in Europe
ICT4Life, a Horizon 2020 EU-funded initiative contributing to the challenge of integrated care for patients suffering from Parkinson’ s disease, Alzheimer’ s disease and other dementias is discussed
Isabella Notarangelo HOPE
With the contribution of the ICT4Life consortium
The 20th century was characterised by an enhancement of well-being and better economic conditions bringing modifications in lifestyle. Such improvements also led to new risk-factors that could be controlled but not cured, causing an increase in chronic conditions. Health systems, once mainly focused on acute episodes, are now working on the implementation of countrytailored solutions aimed at better responses to the burden of( multiple) chronic conditions.
In recent years, Europe faced important demographic changes affecting the ageing population. As a result, there are almost 10 million Europeans affected by Parkinson’ s, Alzheimer’ s and other dementias, and the number is forecast to double by 2030, making them a major health challenge. Those people want to live in their own homes but, because of their symptoms, they face difficulties in daily life, both in managing their own care and in living independently.
Increased chronic conditions, multi-morbidity and an ageing population of both the workforce and patients has led to the development of a new integrated care model at the European and national levels. This model is supported by the development and deployment of innovative information and communication technology( ICT) tools to improve and facilitate the quality and delivery of care in all health settings.
At Member States’ level, most health systems have already moved from a traditional hospitalcentric and doctor-centric pattern of care to integrated care in which hospitals work closely with primary care, community care and homecare. Almost all European countries have made efforts in modifying their hospital provision patterns: delivering better services, increasing quality, improving efficiency and productivity. Further actions are directed towards the creation of multi-professional networks and to the involvement of the patient in the pattern of care.
As the literature shows, the presence of a strong ICT system connecting either professionals or professionals and patients is a successful factor for transition from hospital-focused health systems to continuum care-focused health systems. Such factors are crucial to ensure quality of care, especially in times of financial constraints.
Integrated care models address how care services could be coordinated and delivered to deal with people’ s continuous care in a more efficient way while considering all stakeholders’ needs and perspectives. To do so, there are several
8 HHE 2018 | hospitalhealthcare. com levels of integration. The Triple Integration, 1 stated by Simon Stevens, described the different levels needed to address integrated care services depending on the care services and stakeholders involved. That is:
• integration between primary and specialist services to provide health services closer to the
patient;
• integration between physical and mental health services to fight against the stigma on mental
health;
• integration of health and social services to coordinate the efforts of the different services
that support patients.
The participation of patients, care-givers and the community within the care processes has to be added to the dimensions mentioned above, to adopt a people-centred approach also based on their own perspectives and needs as stated in the World Health Organization strategy.
The concept of integrated care is not limited to health services. The rising burden of chronic diseases and of the number of people with complex care needs requires delivery systems that bring together a range of professionals and skills from both the cure( healthcare) and care( long-term and social care) sectors. The concept of integrated care seems particularly important for service provision to the elderly, as elderly patients are often chronically ill and subject to co-morbidities. Thus, patients suffering from Parkinson’ s, Alzheimer’ s and other dementias could be included in these targets.
In January 2017, HOPE adopted a position paper on integrated care, providing not only an overview of the current situation in Europe but also highlighting the challenges faced by European health systems as well as their differences. In Europe, the situation varies considerably across countries not only because of the demographic differences but also because of health and social systems rooted in different histories and cultures. European health systems are moving away( but not at the same pace) from the‘ treat and cure of acute conditions’ culture to face the challenges posed by the transition to an ageing demographic. Strategies that deal with organisational, financial, delivery and eHealth technology aspects have been adopted at the country or regional level.
This is the context in which the ICT4Life project intends to provide its contribution, and will be discussed below.