ICT AND INTEGRATED TREATMENT IN AUSTRIA (COPD)
Improving patient treatment by integration
Chronically ill patients need better and more efficient and effective support in their treatment process.
The aim of the Carinthian project is to establish an enduring infrastructure and an integrated treatment process using integrated electronic systems in order to:
- Increase participation and self management of patients in their treatment process
- Increase quality of life
- Improve his course of disease
- Improve communication and cooperation between providers of health and social services
- Reduce emergency visits and transports
According to the defined disease management process a long term treatment process supported by eHealth infrastructure has been implemented and is up and running.
The outpatient areas of three hospitals that treat COPD patients now cooperate directly with the patient or with treating nursing homes and mobile nurses. Changes in the treatment process, timing the schedule of ambulances and sometimes coaching can now be initiated by the patient or by nurses from the patient's home. Family doctors are informed near time by the hospital.
As this Carinthian regional project is part of the EU funded Renewing Health project it also participates in the accompanying cluster study – Cluster 5 - and in the over all study of all regional projects.
Desease management Process
Patients start with a medical examination and after it they measure daily (d) and monthly (m) vital parameters (daily: COPD Assessment Test; monthly: weight). After 30 days or by exceeding parameter intervals a parameter report is sent to the hospital information system. The responsible doctor checks the data and plans further treatment activities. If necessary or at least monthly a medical report is sent to patients and family doctors.
The purpose of this study is to test the effects of these integrated services. Patient's quality of life, clinical parameters, patient's and practitioner's satisfaction as well as organizational framework and cost-effectiveness and cost utility will be tested.
In the study one year of treatment is measured. Up to 300 COPD patients (older than 18 and GOLD Class III and IV) are and will be included in the study. A third is in the control group and two thirds are in the intervention group.
Data are collected at the beginning examination, during the treatment process and at the final examination after one year of treatment.
From a technical point of view existing information systems got functionalities of personal health systems and expanded by functionalities to collect, send and receive CDA standard documents. This standard will be used in the Austrian electronic health record project ELGA too.
With this CDA document standard it is possible to integrate the secure health portal, the call centre and the mobile nursing system.
Documents are transported, encrypted and signed by a dedicated report transportation system.
The main expected outcome is a reduction of the need for patients to access hospitals physically. This outcome includes a reduction of waiting time in day care clinics, reduced admissions and a reduction of the respective costs for the health care system. On the side of the patients an improvement of the quality of life, especially through reduced need for traveling and also because of a feeling of improved safety (through the continuous care) can be achieved.
The numerous participants and their positive experiences in the pilot phase lead us to hope for improved acceptancy for the telemedical system and we expect to see similar approaches for other chronic diseases in the future.
Other cluster of Carinthia: Cluster 1