1. Continuity of Patient Care
Chronic diseases:
A Challenge for eHealth

2. Chronic diseases: A challenge for eHealth
Relevance of Chronic Conditions
http://www.euro/who/int

3. Chronic diseases: A challenge for eHealth
Relevance of Chronic Conditions
Mortality
• 60% worldwide
• 66% in Canada
Health Budget
• 78% in USA
• 70% in Australia
http://nurseweb.ucsf.edu/iha
http://www.calgaryhealthregion.ca/cdm
http://www.health.gov.au

4. Chronic diseases: A challenge for eHealth
Relevance of Chronic Conditions: Europe
Spain:
- 18 million people report a
Chronic disease
UK:
- 60% of adults report a Chronic
health problem
- 80% of GP Consultations
- 60% of Hospital bed days
http://www.ine.es
http://www.natpact.nhs.uk

5. Chronic diseases: A challenge for eHealth
CDM: Worldwide experiences: Florida State
Patients paticipating in DM:
Lower rate of:
- Inpatient hospital stays
- Inpatient days
- Emergency room visits
- Outpatient visits
http://www.floridahealthy.org
Afifi AA et al. Preventive Medicine 2007

6. Chronic diseases: A challenge for eHealth
CDM: Worldwide experiences: Castlefields
Castlefields Health Centre
Cardiac events
60
50
40
Non-fatal Mis
30
IHD Deaths
20
10
0
02
3
4
5
6
7
8
9
0
1
/9
/9
/9
/9
/9
/9
/9
/0
/0
1/
92
93
94
95
96
97
98
99
00
'0
http://www.natpact.nhs.uk/cms/328.php
Lyon D et al. J Integ Care 2006;14:7-12

7. Chronic diseases: A challenge for eHealth
CDM: Situation in Andalusia, Spain
Chronic Diseases in Andalusia
Cause of Death:
- Cardiovascular diseases 38%
- Cancer 24%
471,000 diabetic patients
Mental disorders: 42% people
Older people with CD: >75%

8. Chronic diseases: A challenge for eHealth
Third Health Plan of Andalusia 2003-2008
http://www.juntadeandalucia.es/salud

9. Chronic diseases: A challenge for eHealth
Andalusian Public Healthcare System: Quick facts
1,500 Primary care centres
41 Public Hospitals
90,000 Healthcare professionals
8,700 M € Health Budget
http://www.juntadeandalucia.es/servicioandaluzdesalud

10. Chronic diseases: A challenge for eHealth
Person centred care in chronic conditions

11. Chronic diseases: A challenge for eHealth
Role of eHealth in CDM progarms
BMJ, doi:10.1136/bmj.39156.536968.55 (published 10 April 2007)
RESEARCH
Telemonitoring or structured telephone support
programmes for patients with chronic hearth failure:
systematic review and meta-analysis
Robyn A. Clark, Sally C. Inglis, Finlay A. McAlister, John G.F. Cleland,
Simon Stewart
http://www.bmj.com

12. Chronic diseases: A challenge for eHealth
eHealth in Andalusia: “Diraya” Platform
Health Care Information and
Management Integrated System

13. Chronic diseases: A challenge for eHealth
eHealth in Andalusia: “Salud Responde”
Living
wills
Second
Medical
Opinion Centralised
appointment Smart cards
Waiting
Internet appointment
lists
HealthResponds
Information and Services Centre Information
Telephone
appointment
Electronic
prescription Virtual Office (InterS@S)

14. Chronic diseases: A challenge for eHealth
eHealth in Andalusia: “Salud Andalucía 24h”
Transparency .
Tobeinformed is health HealthResponds
Education Web Telephone enquiries
Information TV/DTV Second medical opinion
entertainement Mobile Iiving wills
Health card
Waiting lists
Telephone appointment
Healthcare information
Health advices
Information on Quality in
Discharge telephone survey
Health Centres
AIDS, Tobacco, bird flu...
Expectations bank
SMS services
Healthcare Information
Health Advices
Collection of Expectations
to promote participation
e-Administration
Living wills
Smart card
24
health andalusia
hr
Individual assessment and
and information information on Health

15. Chronic diseases: A challenge for eHealth
Electronic prescription
70000
62.763
60000
48.753
-22.32%
50000
40000
30000
20000
10000
0
SEP-05 SEP-06
GP consultations before and after electronic prescription

17. Chronic diseases: A challenge for eHealth
Health Wave Plan: Telephone follow-up
Heath Wave Response Plan
Weather
forecast
Daily alert
level
HealthResponds
People at risk: 5,821
Total Calls: 42,964
Emergency Coordination Centre
Hospital Emergency Room Family nurse People at risk

18. Chronic diseases: A challenge for eHealth
Digital Retinography in diabetic patients
Users: 6,720
Total SMS: 112,192
Vaccines Warnings Appointments
Advices

19. Chronic diseases: A challenge for eHealth
Digital Retinography in diabetic patients
People studied: 13,892
With retinopathy: 4,306

21. Chronic diseases: A challenge for eHealth
Improving the management of Chronic diseases
Proactive
Healthcare
System
Effective
Self-management
Support

22. Chronic diseases: A challenge for eHealth
ICT applications in Chronic diseases

23. http://www.opimec.es