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(-\E$ OP &OW($W(+ EXECUTIVE SUMMARY................................................................................................................................... 2 ACKNOWLEDGEMENTS.................................................................................................................................. 6 TABLE OF CONTENTS...................................................................................................................................... 7 TABLE OF CONTENTS...................................................................................................................................... 7 INTRODUCTION................................................................................................................................................. 9 - CHAPTER 1 - ................................................................................................................................................... 13 ICT FOR A MORE INTEGRATED SOCIAL CARE AND HEALTHCARE AT REGIONAL LEVEL .. 13 1. Domain and semantics ............................................................................................................................. 14 2. Deployment of ICT and AAL in social care and healthcare..................................................................... 15 3. Market barriers ........................................................................................................................................ 17 4 Possible facilitators on a regional level .................................................................................................... 20 - CHAPTER 2 - ................................................................................................................................................... 25 OVERVIEW EU POLICY INITIATIVES IN THE AREAS OF EHEALTH AND ICT FOR AGEING WELL .................................................................................................................................................................. 25 1. Digital Agenda for Europe: the ICT Flagship of Europe 2020................................................................ 25 2. eHealth Action Plan 2004-2010 ............................................................................................................... 26 3. Data Issues ............................................................................................................................................... 27 4. Telemedicine............................................................................................................................................. 28 5. eHealth Governance................................................................................................................................ 29 6. European Innovation Partnerships: a new approach to innovation, health and independent living of elderly people ............................................................................................................................................... 34 - CHAPTER 3 - ................................................................................................................................................... 36 SWEDEN ............................................................................................................................................................. 36 EAST SWEDEN.................................................................................................................................................. 40 1. Current Situation...................................................................................................................................... 40 3. Drivers and Barriers ................................................................................................................................ 47 REGION HALLAND ......................................................................................................................................... 50 1. Current situation ...................................................................................................................................... 50 2. Drivers of health technology in Halland .................................................................................................. 53 3. Barriers of health technology in Halland................................................................................................. 54 4. Examples of current e-health solutions .................................................................................................... 56 5. On-going Initiatives.................................................................................................................................. 58 - CHAPTER 5 - ................................................................................................................................................... 64 KENT COUNTY COUNCIL ............................................................................................................................. 64 1. Kent demographics and the American model........................................................................................... 65 2. The Kent Telehealth project ..................................................................................................................... 68 3. Kent pilot project: evaluating the results ................................................................................................. 72 - CHAPTER 6 - ................................................................................................................................................... 77 NOORD-BRABANT PROVINCE..................................................................................................................... 77 1. Current Situation...................................................................................................................................... 77 2. Home Telehealth ...................................................................................................................................... 84 3. Reimbursement ......................................................................................................................................... 93 4. Drivers and Barriers ................................................................................................................................ 95 - CHAPTER 7- .................................................................................................................................................... 97

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FLANDERS REGION........................................................................................................................................ 97 1. Policy definition in Flanders’ Care.......................................................................................................... 98 1.1 Mission Statement ................................................................................................................................. 98 The mission statement of Flanders’ Care is to measurably improve the quality of care through innovation and responsible entrepreneurship. ............................................................................................................... 98 1.2.Breakthrough Platform ......................................................................................................................... 98 1.3. Care Renewal Platform ........................................................................................................................ 99 Strategic framework: the care innovation cycle ......................................................................................... 99 1.4. Using the existing instrumentation .................................................................................................... 100 1.5. Impulse office: a general gateway ..................................................................................................... 100 1.6. Demonstration projects ...................................................................................................................... 101 1.7. Flanders’ Care Invest......................................................................................................................... 101 2. Barriers to innovation in the care sector................................................................................................ 102 3. Featured projects: prevention and assistive solutions ........................................................................... 103 4. [Assistive solutions] BlueCall Phone ..................................................................................................... 106 - CHAPTER 8 - ................................................................................................................................................. 108 VENETO REGION........................................................................................................................................... 108 1. Current Situation.................................................................................................................................... 108 2. Home Telehealth .................................................................................................................................... 115 3. Reimbursement...................................................................................................................................... 120 4. Outcomes ............................................................................................................................................... 121 5. Drivers and Barriers............................................................................................................................. 122 - CHAPTER 9 - ................................................................................................................................................. 126 FRIULI VENEZIA GIULIA AUTONOMOUS REGION ............................................................................ 126 1. Current Situation.................................................................................................................................... 126 2. Home Telehealth .................................................................................................................................... 133 3. Smart homes and Ambient Assisted Living............................................................................................. 135 4. Outcomes................................................................................................................................................ 142 5. Drivers and Barriers .............................................................................................................................. 144 - CHAPTER 10- ................................................................................................................................................ 146 CATALONIA REGION ................................................................................................................................... 146 1. Current Situation................................................................................................................................... 146 2. ICT Area and Services............................................................................................................................ 149 3. ICT Projects in Catalonia ..................................................................................................................... 152 4. Budget .................................................................................................................................................... 156 5. Main factors supporting ICT .................................................................................................................. 156 - CHAPTER 11 - ............................................................................................................................................... 160 CONCLUSIONS: REGIONS VITAL FOR EHEALTH ............................................................................... 160 ANNEX I............................................................................................................................................................ 163

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3.3. epSOS II W:9856CJ 90> 3=:e>79 D166 20:=96C 5> D1B>;>B 9: 1;764B> hh 8BB191:;86 7:4;9=1>2 8;B B>>3>;>B 9: 9>29 90> A>82151619C :A 1;764B1;? >3+O+ 2>=F17>2 9: :90>= =>6>F8;9 2>=F17>2 61N> 90> >$4=:3>8; ]>8690 );24=8;7> 78=B GA:= =>1<54=2><>;9 :A 78=>HQ 8;B hh! G><>=?>;7CH 2>=F17>2I (0> 3=:?=>22 9089 082 5>>; <8B> 1; 9012 8=>8 1; 2470 8 =>6891F>6C 20:=9 3>=1:BJ 8;B 90> 76>8= D1661;?;>22 :A ,><5>= +989>2 9: >;?8?> 1; 8701>F1;? 1;9>=:3>=856> 2:6491:;2 90=:4?0 >3+O+ 5:B> D>66 A:= 8701>F1;? 90> R-$q2 V>C -791:; h#I #I ($E$,$R)&)W$ (0> 6>?126891F> e:4=;>C 9:D8=B2 D1B>23=>8B B>36:C<>;9 :A 9>6><>B171;> 5>?8; D190 90> &:<<4;17891:; :; 'Telemedicine for the benefit of patients, healthcare systems and society'J D0170 D82 8B:39>B 5C 90> $4=:3>8; &:<<1221:; :; # W:F><5>= !TTcI (0> #LC>8= 1;191891F> A:=>2>>2 8 2>9 :A 8791:;2 9: 5> 4;B>=98N>; 5C 90> &:<<1221:;J ,><5>= +989>2 8;B 90> 9D: 38=91>2 e:1;96CI (0> 8791:;2 81< 89 <>>91;? 90> A:66:D1;? 90=>> :5e>791F>2k 5416B 7:;A1B>;7> 8;B 877>398;7> A:= 9>6><>B171;> 8<:;? 42>=2Q 3=:F1B> !c


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W:==N^31;? GbdIh C>8=2 F>=242 bbI! C>8=2HI P:= D:<>; 1; E1;N^31;? 90> 8F>=8?> 61A> >@3>798;7C D82 85:49 hIS C>8=2 01?0>= 908; 1; W:==N^31;? Gc!Id C>8=2 F>=242 chIS C>8=2HI &:==>23:;B1;? >@3>798;7C 89 51=90 1; 90> D0:6> 7:4;9=C D82 c!I" C>8=2 A:= D:<>; 8;B A:= <>; bbIc C>8=2I .>?8=B1;? 90> B1AA>=>;7> 5>9D>>; E1;N:31;? 8;B W:==N:31;? 1; 61A> >@3>798;7C 12 862: =>A6>79>B 1; B1AA>=>;7>2 1; 90> 7842>2 :A B>890I .12N :A BC1;? :A 1270><17 0>8=9 B12>82> 12 A:= >@8<36> 85:49 "Ti 01?0>= 8<:;? 5:90 <>; 8;B D:<>; 1; W:==N^31;? 7:<38=>B 9: E1;N^31;?I (0> =12N2 :A BC1;? A=:< 64;? 78;7>=J &OYRJ 1;e4=1>2J 3:12:;1;?J 867:0:6L=>689>B B>890 8;B 24171B> 8=> 866 01?0>= 8<:;? 90> 3:346891:; :A W:==N^31;? 7:<38=>B 9: 90> 3:346891:; :A E1;N^31;?I P:= <:29 :A 90>2> 7842>2 :A B>890 90> F864>2 1; W:==N:31;? 8=> 85:F> 90> ;891:;86 8F>=8?>J D016> F864>2 8=> 5>6:D 1; E1;N^31;?I 1.1 Home Telehealth (:B8CJ A:66:D1;? 0:<> 9>6>0>8690 2C29><2 8=> A466C 1<36><>;9>B 1; 90> =>?1:;J 1; A466L 2786>k

Social alarmJ :; B>7121:; :A 245F>;91:; 582>B :; 1;B1F1B486 ;>>B2I (0> 868=< 12 582>B :; 30:;> 7:<<4;17891:; 8;B 7:;;>79>B 9: 90> <4;171386 0:<> 78=> 2433:=9 2>=F17>2 8;B 8 <:;906C 8BB191:;86 A>> A:= 90> 868=<J 1; 90> =8;?> hTL"T $4=:I

Health care adviceJ 8F816856> A=>> :A 708=?> A:= 90> >;91=> 3:346891:; A=>> 30:;> ;4<5>= hhbb 7:;;>79>B 9: 8 =>?1:;86 2433:=9 2>=F17>J 3=:F1B1;? 2>6AL78=> 8BF17> := 8BF17> 9: 7:;9879 8 3=1<8=C 78=> 7>;9=>I +4336><>;98=C 1;A:=<891:; 12 8F816856> :; 90> D>5 219> DDDIhhhhI2>I

O;> :A 90> 3=:A16> 8=>82 :A $829 +D>B>; 12 1;;:F891:;J B>F>6:3<>;9J =>2>8=70 8;B ?=:D90 D190 8 A:742 :; 0:<>L582>B 78=>J 7:L:=B1;89>B 8;B 2433:=9>B 5C 90> =>?1:;86 1;191891F> W>D (::62 A:= ]>8690I )9 12 1;19189>B 5C E1;N^31;? ';1F>=219CJ (0> &:4;9C &:4;716J 90> <8e:= <4;171386191>2 8;B 2:<> bT 7:<38;1>2I )<3:=98;9 582>LA4;B1;? 7:<>2 A=:< *1;;:F8J D0170 12 90> +D>B120 8490:=19C A:= 1;;:F891:; 2C29><2J 7:LA4;B>B 5C 90>

#"


=>?1:;86 879:=2I (0> :=?8;12891:;J D0170 :3>=89>2 82 8; 1;9>=<>B18=C 1;B>3>;B>;9 822:71891:;J 3=:F1B>2 1;;:F891:; 2433:=9J =>2>8=70 A4;B1;?J 9>29 8=>;82 8;B ;>9D:=N1;?I

\>6:D 8=> 2:<> >@8<36>2 :A 833617891:;2 8;B 9>70;:6:?1>2 29166 1; >@3>=1<>;986 298?>2 := 316:9 2786>J D1901; W>D (::62 A:= ]>8690 hT k

Connected medicine dispensers/reminders (0> 7:<51;>B B123>;2>=l=><1;B>= B>61F>=2 90> 3=:3>= 7:<51;891:; 8;B 8<:4;9 :A 31662 89 90> 3=:3>= 91<>2I )9 78662 A:= 899>;91:; F18 2:4;B 8;B 61?09 868=<2I )A 90> 31662 8=> ;:9 98N>; 8; +,+L<>228?> <8C 5> 2>;9 F18 54169L1; X+,I

Remote monitoring of heart diseases ]8;BL0>6B B>F17>2 D190 54169L1; X+, 7:<<4;17891:; B1?19866C =>7:=B 8 58217 $&X 74=F>J <>824=>B 90=:4?0 90> 904<52I (0> 74=F> 12 B1=>796C 9=8;2A>==>B 9: 8 D>5L582>B 2>74=> B898582>J D0>=> 19 12 8;86C2>B 5C 78=> 3=:A>221:;862I

Electronic pen health diary (0> 3>; 1; j4>291:; 12 42>B 82 8; :=B1;8=C 3>; A:= D=191;? 383>= GD190 8; 1;F12156> 3899>=;HJ D016> 90> 1;A:=<891:; 862: D166 5> 8F816856> B1?19866CI ); 9012 782> 19 12 42>B A:= 3>=2:;86 0>8690 B18=1>2 D=199>; 5C 3891>;92 D190 B18?;:2>B 0>8=9 A8164=>I

); 8BB191:;J 8 <469194B> :A :90>= 3=:B4792 8;B 2>=F17>2 8=> 1; B1AA>=>;9 =>2>8=70 8;B B>F>6:3<>;9 298?>2J 549 29166 ;:9 D190 24AA171>;9 3=:9>791:; :A 1;9>66>79486 3=:3>=9C =1?092J 1; :=B>= 9: 5> 3456120>BI hT

##


Social Alarm connected to relatives -F816856> 5:90 82 <:516> 8;B 29891:;8=C 2>74=19C 30:;>2J 9012 7:<<>=7186 2>=F17> B1=>792 2>74=19C 3=1<8=C 9: =>6891F>2 8;B A=1>;B2J 549 D190 8 =><:9> 8=:4;BL90>L76:7N 298AA 2>=F17>I

O; 90> ;891:;86 6>F>6J :; 5>086A :A 90> +D>B120 ?:F>=;<>;9J 90> +D>B120 );291949> :A -221291F> (>70;:6:?C G+)-(H 12 =>23:;2156> A:= 8 3=:?=8< D190 B>F>6:3<>;9 8;B 1;A:=<891:; >AA:=92 A:= 90> 34=3:2> :A 2433:=91;? <4;171386191>2 1; 29=>;?90>;1;? 2>74=19C 1; 3>=2:;86 2:7186 868=<2 1; 7:;;>791:; D190 90> :;?:1;? 1;9=:B4791:; :A B1?1986 9>70;:6:?C D1901; 90> 9>6>30:;C 8=>8I R4=1;? !ThT M !Th"J 9>70;:6:?C 294B1>2 8;B 9>291;? :3>=891:;2 D166 5> 78==1>B :49 1; !h <4;171386191>2I (0> 34=3:2> 12 9: 3=:F1B> 1;A:=<891:; 8;B 5>99>= B:74<>;9891:; 9: <4;171386191>2 9: >;24=> 90> 3>=2:;86 2:7186 868=< 2>=F17>2I (0> 3=:?=8< D166 862: 7:;9=1549> 9: 90> 7=>891:; :A 8; 1;B429=C :=?8;12891:; 8;B 90> A:=<46891:; :A 298;B8=B2 A:= B1?1986 2:7186 868=< 7:<<4;17891:;I (0> 9>29 >;F1=:;<>;92 1; 90> $829 +D>B>; =>?1:; 8=> <8e:= 822>92 :A 90> 1;191891F> W>D (::62 A:= ]>8690J 8;B 8=> 1;7=>821;?6C 42>B 5C 879:=2 1; :90>= =>?1:;2I (0> 7:=> >;F1=:;<>;9 A:= 9>292 1; =>86 61F1;? 7:;B191:;2 12 6:789>B 1; 90> :=B1;8=C 0:421;? 8=>8 Ee4=8 1; W:==N^31;?J D190 2:<> h!TT 838=9<>;92 8;B !TTT 1;085198;92J D190 8 208=> :A >6B>=6C 85:F> 90> ;891:;86 8F>=8?>I

Picture 4. The test environ!ment in an ordinary housing area in the city of Norrkรถping, consisting mainly of 3!4 story buildings, erected in the early 50s, with 1200 apartments and 2000 inhabitants.

#S


1.2. Smart homes and Ambient Assisted Living K0>; 19 7:<>2 9: 2<8=9 0:<>2 8;B 8<51>;9 822129>B 61F1;?J ;: =>86 A466L2786> 1;29866891:;2 08F> 5>>; <8B> 1; 90> =>?1:;I ]:D>F>=J 90> 719C :A W:==N^31;? 082 =>7>;96C 5>>; 2>6>79>B 82 8 ;891:;86 9>29 8;B B><:;29=891:; >;F1=:;<>;9 A:= 833617891:;2 :A 9>70;:6:?C A:= 90> >6B>=6CI (0> 2>6>791:; D82 <8B> 1; 8 7:<3>9191:; D190 :90>= 7191>2 1 :90>= =>?1:;2J 82 8 38=9 :A 90> 3=:?=8< f(>70;:6:?C A:= >6B>=6Cg A:= D0170 +)-(J (0> +D>B120 );291949> :A -221291F> (>70;:6:?CJ 12 =>23:;2156>J :; 5>086A :A 90> +D>B120 X:F>=;<>;9I \>6:D 8=> 2:<> >@8<36>2 :A 8221291F> 2:6491:;2J 29166 1; >@3>=1<>;986 298?> := 316:9 2786> 1; 90> =>?1:;k

Digital locks - 316:9 1;29866891:; :A !TT >6>79=:;17 B::= 6::N2 8=> 74==>;96C 9>29>BI (0> B::= 6:7N2 1; j4>291:; 8=> :3>;>B 5C 421;? 8 3>=2:;86 <:516> 30:;>J D0170 <>8;2 245298;91866C =>B4791:; :A N>C 08;B61;? 8<:;? 78=> 298AA

Reminder panels R::=21B> 38;>62 89 90> >;9=8;7> D190 1;A:=<891:; 85:49 90> 298942 :A B1AA>=>;9 B>F17>2 8;B D1;B:D2lB::=2I - N>C7081; B>F17> 862: 78==1>2 90> 74==>;9 298942 D0>; :4921B> 0:<>

Recognition of deviating patterns - F>=C 8BF8;7>B 2>;2:= 8;B 78<>=8 2C29>< D190 5>08F1:4= 3899>=; =>7:?;191:; 8;B 6>8=;1;?J >;8561;? >8=6C 868=< 1A 90> 3899>=; B>F189>2 A=:< ;:=<86 7:;B191:;2I )9 12 8 231;L:AA A=:< B>A>;7> =>689>B =>2>8=70 L 29166 1; 8 7:;7> 3082>

2. Reimbursement K1901; 90> 27:3> :A 90> ]>8690 8;B ,>B1786 +>=F17>2 -79J 7:4;9C 7:4;7162 8;B <4;171386191>2 <8C 90><2>6F>2 B>71B> :; =>?46891:;2 A:= 8221291F> B>F17>2J 2470 82 D0170 3=:B4792 8=> 9: 5> =>?8=B>B 82 8221291F> B>F17>2 8;B 5> 8F816856> A:= 3=>27=1391:; 9: 3>:36> D190 B128516191>2I (0>C 862: B>71B> :; 8;C 708=?>2I P:= <:=> 1;A:=<891:; :; 9012J 36>82> 2>> 90> 2>791:; f+D>B>;J ?>;>=86gI

#U


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

D190

<8;C

368C>=2

8;B

1;

8

5:=B>=68;B

5>9D>>;

345617

8490:=191>2l:=?8;12891:;2J 3=1F89> 7:<38;1>2 8;B B><8;B1;? 7:;24<>=2 8;B =>6891F>2I

,8e:= B=1F>=2 A:= 8221291F> 2:6491:;2J :52>=F>B :; 90> =>?1:;86 8=>;8 8=>k Potential of reduced care demand !"#$%&'(")*+ ,-% ./0*(# 1$)&"('&,(1"' &$% &2&$% &01/, ,-% .1,%",(&* 13 $%4/#,(1" 13 3/,/$% #&$% #1','5 Emerging private market 6-% .$(7&,% 8&$9%, 1.%"' '*12*+: ;12 &** 8&<1$ #(,(%' (" ,-% $%)(1" -&7% .$(7&,%*+ 4$(7%" '-1.' 2(,- &''(',(7% .$14/#,'= 0%'(4%' ,-% ./0*(# 4%*(7%$+ '+',%8 31$ '/#.$14/#,'5 Innovation initiative and support (New Tools for Health) 6-% %>(',%"#% 13 ,-% "&,(1"&**+ 0&'%?3/"4%4 (""17&,(1" ("(,(&,(7% ;%2 611*' 31$ @%&*,- (" ,-% $%)(1" -&' '/0',&",(&**+ ("#$%&'%4 ,-% &#,(7(,(%' &"4 ,-% &2&$%"%'' (" ,-% 3(%*4= &' 2%** &' 0%(") ,-% $11, 13 8&"+ "%2 '1*/,(1"'5 Test environments and pilot installations A-+'(#&* ,%',' &"4 .(*1, ("',&**&,(1"' 13 "%2 ,%#-"1*1)+ &$% (8.1$,&", "1, 1"*+ 31$ ,-% %>.%$(%"#%' )&("%4= 0/, &*'1 31$ ,-% ./0*(# #188/"(#&,(1" &"4 &2&$%"%'' 13 "%2 '1*/,(1"' &81") #&$% ',&335 Demonstration environments and activities

#b


D.%#(3(# 4%4(#&,%4 ./0*(# 4%81"',$&,(1" %"7($1"8%",' '-12(") 2-&, (' #/$$%",*+ &7&(*&0*% 133?'-%*3 &$% (8.1$,&", &"4 '-1/*4 "1, 0% 8(>%4 2(,- ,%',(") 13 "%2 "1, +%, 3/**+ 4%7%*1.%4 '1*/,(1"'= 2-(#- 8&+ #&/'% #1"3/'(1":

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Technology users/customers Elderly and relatives Municipal home healthcare Municipal housing Technology application suppliers Security alarm applications Security alarm and aid applications Door lock applications Hearing aid applications Medication dispenser applications Technology component suppliers Home alarm components Tracking and sensor components Wireless communication components Technical consultant (medical) Technical consultant (general) University alpha research Others County development University beta research Research institute

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5.3. The Tai Chi Demonstrator

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Forecast of older people in the KCC area 400,000 350,000

65+ 75+ 85+

N u m b er o f p eo p le

300,000 250,000

200,000 150,000 100,000

50,000 0 2006

2011

2016

2021

2026

Source: South East Plan Strategy-based forecasts (Nov 08), Research & Intelligence, Kent County Council

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Benefits Service Centred

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Age 1971 74,3 19,1 11,7 6,2 3,1

0 years 60 years 70 years 80 years 90 years

Women 2004 82,4 24,9 16,3 9 4,1

2025 86,1 27,8 18,7 10,5 4,4

1971 68,8 15,8 9,8 5,5 2,8

Men 2004 76,4 20,2 12,6 6,9 3,4

2025 79,9 22,7 14,3 7,6 3,4

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1.3. Care Renewal Platform A.8.6"&$#+$#!'$J0&+2'"($I((+9"#.+($W"&#('&%!.2$+($5*#.9'$"(/$L'"6#!:$5)'.()M$E6"(/'&%h$ B"&'$0(.#'%$#!'$3':$%#"3'!+6/'&%$.(9+69'/$.($*"&'$.((+9"#.+($.($#!'$4+&8"66:$'%#",6.%!'/$ B"&'$ G'('-"6$ W6"#4+&8$ `BGWa;$ O&.().()$ #+)'#!'&$ #!'$ &'6'9"(#$ 2"&#.'%$ 4&+8$ *"&'$ .(%#.#0#.+(%M$ 3(+-6'/)'$ .(%#.#0#.+(%1$ *+82"(.'%$ "(/$ #+2$ "/8.(.%#&"#+&%$ .($ #!'$ &'*'(#6:$ '%#",6.%!'/$.((+9"#.+($26"#4+&8$%!+06/$*&'"#'$"($'(9.&+(8'(#$4+&$%8++#!$*++2'&"#.+(;$ !'$ 26"#4+&8$ /.&'*#6:$ "/9.%'%$ #!'$ O&'"3#!&+0)!$ W6"#4+&8$ +($ 9.%.+($ /'9'6+28'(#M$ #!'$ %022+&#$ +4$ /'8+(%#&"#.+($ 2&+<'*#%$ "(/$ #!'$ "-"&/$ +4$ #!'$ E6"(/'&%h$ B"&'$ 6",'6;$ 5//.#.+("66:M$.#$%'&9'%$"%$"$%+0(/.()$,+"&/$4+&$#!'$2"&#.'%$.(9+69'/$.($E6"(/'&%h$B"&'$"(/$ 4+&$ ('-$ .(.#."#.9'%;$ !'$ BGW$ -.66$ "6%+$ 26":$ "($ .82+&#"(#$ &+6'$ .($ 8+(.#+&.()M$ '9"60"#.()$ "(/$"/<0%#.()$E6"(/'&%h$B"&'$"%$+9'&"66$2+6.*:$.(.#."#.9';$ Strategic framework: the care innovation cycle

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! Estimated dependent elderly: !" #$%&'" $(!)%" *+',,," &-#&.-/" $.&" &0%12$%&#" %!" 0)33&." 4$.1!)0" #&5.&&0" !3" #10$(1-1%/6" =2!75"%8&0&'"$(!)%"*,9"&:;&.1&7<&"0157131<$7%"-121%$%1!70"17"%8&1."$)%!7!2/6" "

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" 120.000 100.000 80.000 60.000 40.000 20.000 0 2001

2010

2020

2031

2051

"

Caregivers: =" 0)(0%$7%1$-" .&#)<%1!7" 17" $4$1-$(-&" <$.&514&.0" 10" &:;&<%&#" $7#" %810" .$10&0" <!7<&.70" $(!)%" %8&" 0)0%$17$(1-1%/" !3" 173!.2$-" $0010%$7<&" 7&%K!.N0'" 7$2&-/" %8&" 8!)0&8!-#" 2&2(&.06" "

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8&"-!<$-"0&.41<&0"?16&6"7).0175"$7#"8!2&O($0&#"<$.&B"&7<!)7%&.0"0)(0%$7%1$-"#1331<)-%/"17" 2&&%175" %8&" $0010%$7<&" 7&&#0" !3" %8&" PQR" $5175" ;!;)-$%1!7" $7#" 2)<8" 10" %.)0%&#" !7" %!" .!)58-/"C,6,,,OC*6,,,";.14$%&"<$.&514&.0"$7#"3!.&157";.14$%&"7).0&06" 8!)58"%8&".&51!7" .&;!.%0" %8&" 8158&0%" 7)2(&." !3" S7%&5.$%&#" T!2&<$.&" <$0&0" 17" %8&" <!)7%./" ?);" %!" C'I*D" <$0&0"!)%"!3"I,,',,,"178$(1%$7%0B6" " Hospitalization: U&01#&7%0"!3"PQR"8!0;1%$-1V&#"17".&51!7$-"$7#"&:%.$.&51!7$-";)(-1<"$7#";.14$%&"8!0;1%$-0" ?&4&./"I,,,"178$(1%$7%0B" " 199,3 200

195,2 192,7

190 187,0 178,4

180

173,8 167,6 170

164,7

163,2 161,3

160

150 1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

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Departament de Salut

Intervention Model and ICT Strategy Catalan healthcare system

6 Main Strategic Objectives and 34 Actions S.O. 4 S.O. 1 Implement ICT as a strategic element in Healthcare

Answer efficiently the requirements of information, management and security in the sector and the Department

S.O. 2

S.O. 5

Support citizens in the access to information and services to promote their health

Endow agents with the proper infrastructures and guarantee interoperability

S.O. 3

S.O. 6

Endow professionals with ICT tools to perform a high-quality care

Boost and project Catalonia as an innovative territory in Healthcare ICT

7

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Departament de Salut Key ICT Projects

â&#x20AC;&#x201C; Governing characteristics Catalan healthcare system

Telemedicine

Medical Image Digitization Plan

NETWORKING MODEL

RESOURCES SHARING

Catalan Shared Medical Record INTEROPERABILITY

Personal Health Folder CO-RESPONSIBILITY

10

Electronic Prescribing COLLABORATION MODEL

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Electronic Prescription (Rec@t)

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Plan to Digitalise Medical Images of Catalonia (PIMed)

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3.5.

Telemedicine and Telecare Plan

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Setting the Foundations for ICTs across Catalonia

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Connecting for Health

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Knowledge for Health

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Innovation & Partnerships

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What normative visions and programmes do these technologies carry/embody, and what social norms are being manifested in the care practices they are involved in? How do the promises of telecare technologies, in policy documents and statements, in their design and investment programmes relate to actual care practices? And how can we build an ethics or ‘ethical framework’ that can guide both the development of AND the evaluation of telecare systems?

How and to what extent, do users and carers negotiate and creatively reshape these technologies/visions as they effectively become integrated in their daily lives?

Empirical research The Spanish study: is based on observations and interviews from Red Cross call centers and installations of pendant alarm systems; interviews with personal home telecare coordinators, users and volunteers; interviews with telecare designers, and group discussions with telecare users/health care professionals. The Dutch study: is based on observational fieldnotes and interviews with users, careers and professionals from two projects involving medical remote care technologies: the ‘health buddy’ project in oncology care and a project in home care where a web camera system is used alongside the health buddy. The UK study: !" #$!%&" '(" '#!%)*$+ '($," - %,&('+%!" $(&" (+%)* %.!" . +/" 0'( +') (1" 2%(+)%" .')3%)!4" (!+$,,%)!" $(&" ',&%)" +%,%2$)%" 5!%)!4" 2',,%2+%&" $!" 6$)+" '-" $" !+5&7" '-" $" +%,%2$)%" !%)* 2%" 86%(&$(+"$,$)04"!%(!'="543.7"7.B2D.3"4;7".;B2=6;@.;:4?"4?4=@3P"2;"6;."D6E;:8"2;"(;A?4;7!" "

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Peter Raeymaekers X'')& ($+')"T,$(&%)!?"X$)%" c'( (1"J,#%)+"GGI,$$("b;"#5!"b\" 9\b\"@)5!!%," D0$ ,A"6%+%)<)$%70$%3%)!{*,$$(&%)%(<#%"" =%#! +%A"...<-,$(&%)!I2$)%<#%" " Edwin Mermans ^%6$)+0%(+"'-"N'2 $,"$(&"X5,+5)$," ^%*%,'60%(+" V)'* (2%"U'')&I@)$#$(+" VK"@'F"a\9;9" ;[\\"OX"k!IQ%)+'1%(#'!2/" +/%"U%+/%),$(&!" C%,<A"€"b9"Wb":d9"[b"da" O'# ,%A"€b9":";;":d:";We" DI0$ ,A"%0%)0$(!{#)$#$(+<(," N376%A"0%)0$(!" Sabrina Montante N+$--"" V)'1%++'"O$++'(%"G(+%)($> '($,%"" Z%1 '(%"`%(%+'" J*<"&%"C%)*5)%(":W" 9\e\"@)5F%,,%!" C%,<"b["["WebW\9\" T$F<"b["["WebW\9a" D0$ ,"A"!$#) ($<0'(+$(+%{)%1 '(%<*%(%+'< +"" =%#! +%"A" /++6ALL...<)%1 '(%<*%(%+'< +LY$Z%1 '(%" N%&%& @)5F%,,%!LD(1, !/*%)! '(</+0" " Isabel Poli V)'B%2+"O$($1%)" =%!+"N.%&%("" Z5%"&5"Y5F%0#'5)1"b"""""""" 9\\\"@)5!!%,!"""""""""""""" C%,A""""b["[";\9"\d"e"I"0'#A"b["ede"e[b" :;9" T$FA"""b["[";\9"\d"e[" DI0$ ,A" !$#%,<6', {.%!+!.%&%(<!%"" =%#! +%A"...<.%!+!.%&%(<!%"" "

Luisa Poclan Z%1 '(%"J5+'('0$LJ5+'('0'5!" Z%1 '(LZz1 '("J5+'('0%" TZG]YG"`DUDuGJ"SG]YGJ" ]-- 2 '"& "2',,%1$0%(+'""L", $ !'("'-- 2%" ("L" #5)%$5"&%", $ !'("t"@)5F%,,%!" Z5%"&5"X'00%)2%"ea" 9\\\"I"@)5F%,,%!" C%,A"\\b[I[I;\\dde\" C%,<"\\b["8\R[";\\"dd"eeP"& )%2+", (%" T$FA\\b[I[I;\\ddWa" D0$ ,"A"5--<#)5F%,,%!{)%1 '(%<-*1< +" =%#! +%A",5 !$<6'2,%({)%1 '(%<-*1< +" " " Antoni Dedeu Bardales C'( "^%&%5" ^ )%2+')" K- 2 ($"&%"Z%,$2 '(!"G(+%)($2 '($,!" " X''6%)$2 q"‚K-- 2%"'-"G(+%)($+ '($,"J--$ )!" $(&"Q%$,+"X''6%)$+ '(^%6$)+$0%(+"&%"N$,5+" ‚O ( !+)7"'-"Q%$,+/"'-"X$+$,'( $" C)$*%!!%)$"&%",%!"X')+!4"9b9I9;a"8"V$*%,,q" J*%"O$)o$"R" \d\[d"@$)2%,'($4"N6$ ("" C%,<"be""ab";;:":9":\" T$F"be""ab";;:":b"bd" D0$ ,A"+&%&%5{1%(2$+<2$+" =%#! +%A"/++6ALL...<1%(2$+<2$+L!$,5+" " " Maria Francesca Vencato""" ^%65+7"Q%$&"'-"K-- 2%" G(+%)($+ '($,"J--$ )!"S)'56"" X/ %-"DF%25+ *%k!"^%6$)+0%(+"" c%(+"X'5(+7"X'5(2 ,"" c%(+"@)5!!%,!"K-- 2%"" G(+%)($+ '($,"Q'5!%"" e;"Z5%"&5"X'00%)2%"" @I9\\\"@)5!!%,!"" @%,1 50"" C%,A"b["8\R[";\e"\W;\" C%,<"8& )%2+", (%R"Ab["8\R"[";\e"\W;:" T$FA"b["8\R[";\e"\W[[" DI0$ ,A"mariafrancesca.vencato@kent.gov.uk =%#0$ ,A" /++6ALL...<3%(+<1'*<53L#5! (%!!L'5)j (+% )($+ '($,j.')3<$!6F""

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Healthy Technology in a Regional Environment  

This publication aims to present the experience of European regions in planning and deploying ehealth solutions. It focuses on the identific...

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