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Joan Escarrabill MD Evaluation Area CAHIAQ Master Plan for Respiratory Diseases (PDMAR )

Teleictus Network and the Programme for Prevention and Care of Chronic Patients (PPACP) in Catalonia . Joan Escarrabill MD Evaluation Area CAHIAQ Master Plan for Respiratory Diseases (PDMAR ) jescarrabill@gencat.cat Lulea , 20 th June 2012. Catalonia. 279 km. 155 km.

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Joan Escarrabill MD Evaluation Area CAHIAQ Master Plan for Respiratory Diseases (PDMAR )

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  1. Teleictus Network and theProgrammeforPrevention and Care of ChronicPatients (PPACP) in Catalonia. Joan Escarrabill MD EvaluationArea CAHIAQ Master Plan forRespiratoryDiseases (PDMAR) jescarrabill@gencat.cat Lulea , 20th June 2012

  2. Catalonia 279 km 155 km Area: 32.107 km2 Population (2011): 7.539.000 Lifeexpectancy (2011): 80,55 years Birthrate (2010): 1,47 GrossMortalityrate (2010): 7,92 Infantmortality (2010): 2,63 GDP/Capita (2009): 28.046€ Healthsystem: Universal coveragefinancedthroughtaxes 180 km 65% inhab Allhigh- tech centers 217 km • High urbanconcentration (2009): 232,8 hab/km2 Agència d’Informació, Avaluació i Qualitat en Salut (AIAQS)

  3. “Ciencia y Caridad” Pablo Picasso (1897)

  4. Fromacutetolong-termcare Acutecare Transitionalcare Long-termcare Discharge Hospice Agència d’Informació, Avaluació i Qualitat en Salut (AIAQS)

  5. Fromacutetolong-termcare Acutecare Transitionalcare Long-termcare Tele-stroke Fewpatients High tech High impact Agència d’Informació, Avaluació i Qualitat en Salut (AIAQS)

  6. TeleStroke Network: Context A rapid loss of brain functions due to disturbance in the blood supply to the brain. It can be ischemic or hemorrhagic Stroke = • 15.070 people were diagnosed with Ictus (7% more than the previous year). • 1st cause of death in women and 3rd in men • 1st cause of disability in adults. • 76% older than 65 years

  7. TeleStroke Network: Problems Context 1 2 3 Urgent attention of neurologists is needed in the early hours to avoid the side effects of the disease (the maximum time to administer a thrombotic therapy is 3 hours) Not all the Catalan hospitals have neurology services available 24/7. This centers must send patients to referral hospitals to receive appropriate treatment. The average time required to send and take care of the patient between two hospitals is 1,5 hours. In many cases the delay is too large to implement an effective treatment for the patient and the consequences are irreversible.

  8. TeleStroke Network • The technical solution is designed and adapted according to the neurologists requirements. It is based on a high-quality videoconferencing system installed in an emergency box of the regional hospital and a remote consultation system of digital images (PACS DICOM) to view the TAC that the patient from the regional hospital.

  9. TeleStroke Network: A successfull case • During 2009, 49 patients were treated through the TeleStroke system (7,7% of patients). • Thanks to the development of the TeleStroke Network, during the last year, 250 patients could benefit from this type of telemedicine. • Nowadays, the 22% of stroke patients in Catalunyamay benefit from the TeleStroke Network. Evolution of hospitals with TeleStroke in Catalonia 4 Referral Hospitals 9 Regional Hospitals 2008 2009 2010 Regional Hospital Referral Hospital

  10. Fromacutetolong-termcare Acutecare Transitionalcare Long-termcare Discharge Telemonitoring High intensity A lot of candidates Impactonresources Agència d’Informació, Avaluació i Qualitat en Salut (AIAQS)

  11. EurRespir J 2006; 28: 123–130 Readmissionrisk Integrated care

  12. RenewingHealth Innovative telemedicine services using a patient-centred approach Transitionalcare Dischargeplanning Reduce readmissions

  13. Fromacutetolong-termcare Acutecare Transitionalcare Long-termcare Discharge Hospice Telemonitoring High intensity A lot of candidates Impactonresources Lowintensity A lot of candidates Impactonquality of life Agència d’Informació, Avaluació i Qualitat en Salut (AIAQS)

  14. Long-termfollow up byspecialists in LTOT Chest2001; 119:364–369 Positive inpact of nurse/respiratorytherapist + telephone + home visit Agència d’Informació, Avaluació i Qualitat en Salut (AIAQS)

  15. Eur J CardiovascNurs. 2011 Mar 12. [Epub ahead of print]

  16. Eur J CardiovascNurs. 2011 Mar 12. [Epub ahead of print]

  17. RevEspCardiol. 2011;64:277-85 Admissions Days in hospital

  18. Results 32% 65% Eur J Cardiovasc Nurs. 2011 Mar 12.

  19. Telemonitoring: Lights and shadows Agència d’Informació, Avaluació i Qualitat en Salut (AIAQS)

  20. Evaluation TheOutcomeMeasuresHierarchy Porter EM. NEJM 2010;363:2477-81

  21. TheOutcomeMeasuresHierarchy Imagine thattheexempleis COPD 1 Porter EM. NEJM 2010;363:2477-81

  22. TheOutcomeMeasuresHierarchy 2 Porter EM. NEJM 2010;363:2477-81

  23. TheOutcomeMeasuresHierarchy 3 Porter EM. NEJM 2010;363:2477-81

  24. www.heartcycle.org

  25. ERS Buyer’s Guide (in press)

  26. Journal of Telemedicine and Telecare 2012; 18: 211–220

  27. BMJ 2011;342:d1687 Appropriate package of care for individual patients at a local level

  28. Thankyouverymuchforyourattention!!! Casa Batlló. (Antoni Gaudí, 1906) Agència d’Informació, Avaluació i Qualitat en Salut (AIAQS)

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