behaior change to develop a consistent appraoch against eating disorder needs a strong...
TRANSCRIPT
Behavior change to develop a consistent approach against eating disorder needs a strong patient’s empowerment
Andrea Migliavacca, Renata Guarneri, Marco Decandia, Luca Piras
December 7th, 2015
Lombardia Informatica’s mission is to innovate services and increase the Regional System’s productivity through Information Technology, in order to improve Citizen’s quality of life and Lombard companies’ competitiveness.
100% owned by Regional Government.
Responsible for the soundness and the effectiveness of the whole Regional Information System.
Cannot compete with Private Companies in Italy, but can be involved in Projects abroad
LISPA
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Since 1999 Lombardy Region developed SISS – eHealth Regional System.SISS first goal was create a Regional infrastructure to connect and guarantee an information exchange between all the health care operators and citizen.
Electronic Health Record – Citizen in the center
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• 9.900.000 Citizens (roughly 99% of total)
• 150.000 Health & Social Care Operators
• 7.800 General Practitioners (98%)
• 2.600 Pharmacies (100%)
• 35 Public Hospitals (100%)
• 15 Local Healthcare Units (100%)
• Private Healthcare Service Suppliers
(98%)
• Nursing home (100%)
• Facilities for people with disabilities
(100%)
Some figures
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• 6 millions active EHR (Electronic Health Records)
• 17,5 millions ECDs• 93 million prescriptions• 4,3 millions online consultations of
medical reports by citizens• 3,5 millions bookings
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Vision
CITIZEN-CENTRIC Information sharing: SISS is an instrument of dialog between medical operators and citizens.
TERRITORIALISATION OF ASSISTANCE (Dehospitalization, associative primary care, clinical pathways, domiciliary assistance, ...) Extended support of care in the Region territory: new organization for chronic disease care
REDUCED RESOURCES Integrated governance for resource optimisation: correlation between clinical/ epidemiological data and administrative data.
How
to a
chiv
e th
at?
Electronic Health Record for citizens
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EHR
The citizen clinical history is shared between all the health care operators and providers in charged to care the citizen
Physician second opinion is available. It is possible an immediate clinical document sharing
In the Personal Page the citizen could exchange clinical documents, relevant biometric measurement with his or her GP
The documents update is in real time.All the clinical documents are immediately available
Electronic Health Record for citizens
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Personal Page
-Personal
documents
Personal Page
-Personal
clinical History
Personal Page
-Data
monitoring
Reports (Labs, Radiology,
Discharge letters,Ambulatory visit and procedures,
first aid) provided and digital signed
by public and private hospitals
Chronic disease patients
documents
ePrescriptioneDispensatio
n
PatientSummary Personal
Page-
Personal documents
EHR
Booking and payment
Administrative services
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SISS ongoing evolution
• Inclusion of vital signs• Calendar management• Privacy management• Hospitalization clinical dossier on line
• Services during Home Visits: Electronic Prescriptions Sick-leave certificates Consultancy/radiology service booking
• DICOM image exchange for fast consultancy and reduction of physical transfers
CITIZEN
PHYSICIAN
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Why is so important an Empowerment strategy?
CITIZEN-CENTRIC Information sharing: SISS is an instrument of dialog between medical operators and citizens.
TERRITORIALISATION OF ASSISTANCE (Dehospitalization, associative primary care, clinical pathways, domiciliary assistance, ...) Extended support of care in the Region territory: new organization for chronic disease care
REDUCED RESOURCES Integrated governance for resource optimisation: correlation between clinical/ epidemiological data and administrative data.
Need a citizen interested and with all tools to have a correct relation with the healthcare providers
Need to involve all the care giver (social and parental resources)
Activation of all the resources present on the field and optimization
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What empowerment is?
Active Citizen
Engagement
Knowledge
CollaborationCommitment
Tolerance of Uncertainty
EducationInformationMotivationCommunication
NotificationInformation sharingSecond opinionTrainingActivities scheduler
Mea
nsFu
nctio
nalit
ies
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What citizen expects?
PALANTE Project resultsGood level of activation
EU citizens/patients: Are already largely
activated (levels 2 & 3) Have no prejudices to
eHealth Expect eHealth being useful
and ease to use
Empowerment
Citizen
Not only access to Electronic Clinical Documents and services.But also• Citizen empowerment platform• Interaction with platforms and
devices through the “Personal Page”
Citizen in the center
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Behaviour change
platforms
Fitness platforms
Life Style analysis
platforms
Wearable data
collectors and data analysis platforms
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Empowerment and Behaviour Change Platform a good synergy
Empowerment
Focus• Citizen actives and
responsible for his health
Tools• Information• Education• …
Limits• Quite mono directional
activity• Create awerness but need
support for day by day life
Behaviour Change Platform
Focus• Real and virtual environment
to activate a behaviour change
Tools• Game• Training• Social• …
Limits• Involve active people• Need motivation
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Integration with a behaviour change platform: the Pegaso project experience
A mobile, social and networked gaming platform to engage young people to stimulate healthier choices to prevent obesity.
1) Individual & Environmental Monitoring, through a high level-monitoring platform including wearable sensors and mobile phone as well as multimedia diaries for the acquisition of physical, behavioral and emotional attitude of adolescent.
2) Feedback System provides feedback in terms of “health status” changes, required actions to undertake etc. This function will also propose personalized healthy modification of the lifestyle thus promoting active involvement in behavior change.
3) Social connectivity and engagement, social network where users can share experiences with a community of peers concerning e.g. physical activity, food consumptions and everyday habits through different gaming strategies.
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Behaviour Change PlatformPegaso Experience
• Develop Awareness
• Affective learning
• Create motivation
• Enable Behaviour Change
The connection between BCP and EHR (Personal page)
Biological data
Physiological data
Physical activity data
Nutritional dataGP
Teen agers
Personal Health Folder
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Actual and future challeges
External platform could be able to identify potential health risk situation
eHealth system are from technical point of view able to transmit data, information, alert to the GP or other specific actor
Constrains:• Ethical and Privacy• Legal • Social acceptance • …
?
Behaviour changer
platforms
Fitness platforms
Life Style analysis
platforms
Wearable data
collectors and data analysis platforms
