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 .