An integrated approach to health- and social-care services

Across Europe, providing health- and social-care services is becoming increasingly complex and costly. An ageing population, a multitude of public and private stakeholders, together with a myriad of e-health systems and technologies create numerous hurdles to the provision of efficient and cost-effective care. A team of EU-funded researchers and practitioners are helping to get these services off the ground.

In broad terms, ‘Integrated eCare’ consists of getting actors from health-care and social-care services to collaborate on multiple levels — from private doctors to public hospitals and from home carers to emergency centres for the elderly. They require efficient structuring, awareness of their specific roles in the value chain

and, most significantly, must be able to share informationeffectively.

‘Health-care and social-care services are often delivered independently today. This leads to inefficiencies, duplication of resources, and potentially to reduced quality of care,’ explains Ingo Meyer, a research consultant at Empirica in Germany.

‘Older people are particularly affected by this situation, since they often need both types of services, such as support with daily activities and chronic disease management.’

Empirica coordinated a consortium of 11 partner organisations from five European countries in the    COMMONWELL1 project, a three-year-plus initiative to develop and deploy integrated care models and supporting technology.

The project, co-funded with EUR 2.68 million from the European Commission, proved so successful that the systems and services it developed are still being used at COMMONWELL’s four pilot sites, and plans

are under way to extend the integrated care model to other areas.

‘The idea of integration between health-care and social-care goes back a couple of decades, but it is really gaining momentum now, in part because people are demanding more services and providers are realising that so much time and effort is being wasted because tasks are being performed in parallel by different providers — so the same things get done twice or other things get lost in translation, so to speak,’ Meyer says.

He points to the example of someone being discharged from hospital but the hospital failing to inform their home-care provider that their bandages need to be changed the next day or medication given at a certain time — oversights that can affect the patient’s health and waste health and care providers’ time, money

and resources.

At the heart of COMMONWELL’s solution are systems and technologies to greatly improve and manage information exchange between organisations. The model encompasses everything fromestablishing a protocol for email exchanges between hospitals and home-care providers to sharing the output of home-monitoring systems and linking it with patients’ medical and social-care data.

To address the technological challenges of getting different ICT systems to communicate, the consortium developed a modular software architecture that provides standard open integration points for collaborating systems to access and share information.

Taking advantage of service oriented approaches to systems design, the COMMONWELL architecture

manages real-time and batched event and health data acquired from widely available modules — such as telemonitoring platforms in people’s homes.

The information is then made accessible to different actors over a series of COMMONWELL web

services.

The COMMONWELL system continues to be used at all four pilot sites, while a parallel project called INDEPENDENT2 has sought to extend the integration model toinclude not only public and private health- and social-care providers but also volunteer organisations and informal carers. Empirica is also in the process of publishing a book, ‘Achieving Effective Integrated E-Care Beyond the Silos’, on the organisation’s experiences in both projects and elsewhere in Europe that will address the challenges of establishing

integrated eCare services and offer potential solutions.

In addition, a follow-up initiative, SMARTCARE, will involve several of the COMMONWELL partners

and dozens of municipalities across Europe which are keen to adopt models of integrated care.

‘Integrated care has been talked about for years, but it seems that with initiatives such as these, people are realising that it is time to take action and do it,’ Meyer concludes.

The project was coordinated by Empirica in Germany.

research*eu results magazine — N° 28 — December 2013 / January 2014