Competitive Health Services Project

The Competitive Health Services project aims to find ways to enhance the provision and accessibility of health services in the sparsely populated regions of Europe by developing and implementing innovative eHealth solutions and promoting transfer of the best eHealth practises across the Northern Periphery.

Competitive Health Services project aims to find ways to enhance the provision and accessibility of health services in the sparsely populated regions of Europe by developing and implementing innovative eHealth solutions and promoting transfer of the best eHealth practises across the Northern Periphery. 

 

Aim & Objectives:

• Mapping and identification European best practices and innovative eHealth solutions which can be transferred, further developed and integrated into a health care system elsewhere in the partner regions Assessing the likelihood of adoption of eHealth innovations using a whole system approach Piloting new eHealth services in the Northern Periphery.
• Mapping and identification European best practices and innovative eHealth solutions which can be transferred, further developed and integrated into a healthcare system elsewhere in the partner regions
• Assessing the likelihood of adoption of eHealth innovations using a whole system approach
• Piloting new eHealth services in the Northern Periphery
• Focus on new eHealth service concepts and solutions for primary health care, chronic conditions and remote specialist services
• Utilization of an implementation model which can replicated elsewhere in the Northern Periphery and other peripheral areas of Europe

Policy Context

The project is funded by the Northern Periphery Programme 2007-2013. This programme aims to help peripheral and remote communities on the northern margins of Europe to develop their economic, social and environmental potential. The success of the programme will be built on joint projects creating innovative products and services for the benefit of the programme partner countries and Europe as a whole.

The diverse regions of the Northern Periphery Programme area share common features such as harsh climate conditions, sparseness of population and remoteness. Transnational cooperation provides excellent opportunities for finding new ways to address shared challenges and explore new opportunities.

The Northern Periphery Programme 2007-2013 (NPP) is part of the European Commission's Territorial Cooperation Objective.

Description of target users and groups

Target group includes users of health services in the partner countries (Finland, Sweden, Norway and Scotland).

Scotland

Target users of Teledialysis are:

• (a) Renal healthcare staff within NHS Highland (consultants, nurses, dieticians, pharmacists, physiotherapists). Most of these are based at the main hospital renal unit in Inverness; the satellite dialysis unit in Wick is staffed by nurses.
• (b) Renal patients - around 16 receiving haemodialysis at Wick renal unit, and outpatients attending the monthly renal clinic at Wick.

Target users of remote speech therapy are:

• (a) Speech therapists and therapy assistants working in North Highland area - Caithness and Sutherland.
• (b) Adults and children requiring speech therapy throughout this large and sparsely populated region.

 

Sweden

Target users of EyeMo are:

• (a) Ophthalmology nurses at Lycksele hospital in the County Council of Västerbotten.
• (b) Diabetics. Around 150 patients have been screened for diabetic retinopathy at the mobile eye unit -EyeMo

Description of the way to implement the initiative

The project consists of 4 Work Packages:

 

Work Package 1 - Management, co-ordination & communication

 

Work Package 2 - Mapping of eHealth Services

Timescale: January 2008 - September 2008

Expected Outcomes:

• Through interviews and questionnaires a comprehensive web-based database of eHealth applications, opportunities, policies and the main results and outcomes of former eHealth projects in the partner countries will be created.
• SWOT analysis will be used to assess the transferability of the existing eHealth applications.
• Publish a report entitled "A Portfolio of eHealth Applications in European Sparsely Populated Areas".

Work Package 2 is now complete and "The Portfolio of eHealth Applications in European Sparsely Populated Areas" can be found in our Downloads section.

 

Work Package 3 - Assessing the adoption of eHealth Services

Timescale: August 2008 - February 2009

Expected Outcomes:

• Develop qualitative and quantitative methods to operationalise a whole system approach to eHealth introduction (the Normalisation Process Model).
• Finalise a list of potential pilot sites
• Produce a detailed description of the methodological approach used to assess readiness.
• Produce a comparative paper to examine regional differences in readiness

 

Work Package 4 - Transnational Development & Exchange of eHealth Innovation

Timescale: January 2009 - December 2010

Expected Outcomes:

• Hold an International Seminar where regional pilot site candidates, eHealth innovations and best practices will be presented.
• Establish Triple-Helix partnerships for piloting the eHealth services
• 'Match' identified best transferable eHealth practice or service concept with a potential pilot site
• Prepare action plans for pilots and obtain approval from the steering group
• Launch 4 Pilot Sites
• Undertake a comparative evaluation of the pilot sites
• Produce a road map to transnational exchange of eHealth Innovation "Innovation System for eHealth Services in European Sparsely Populated Areas"
• Instigate measure to ensure viability and sustainability of piloted eHealth services
• Establish "A European Network of Rural eHealth Care"

Main results, benefits and impacts

Publications

• The project has published the mapping results from Work Package 2 as a report"Portfolio of eHealth applications". The report describes the context and development of eHealth innovations in the northern parts of Finland, Scotland, Sweden and Norway. The report aims at identifying some of the mostimportant aspects of the healthcare sector infrastructure that influence the introduction of eHealth innovations. It also describes the most prominent eHealth services and initiatives which are currently being used in these countries.
• The project has published eNewsletters and brochures which describe project progress. These can be downloaded from the project website.
• The project has been featured in the European Commission's book on regional policy entitled "Investing in our regions, investing in the future".
• The project has been featured in the Inforegio-Panorama magazine

 

Developing new eHealth services

Based on the mapping exercise, the new eHealth services which will be piloted in Finland, Scotland, Sweden and Norway have been selected:

• In Finland, a portable bag which allows remote monitoring of biosignals for 1) cardiac arrhythmia, and 2) weight reductions at home has been piloted and completed. Videoconferencing consultations for wound treatment, and remote speech therapy have been piloted and completed at remote sites
• In Norway, piloting of the portable bag for remote monitoring of biosignals has been completed
• In Scotland, piloting of tele-dialysis has been completed and is now part of normal service. Speech therapy pilot is ongoing.
• In Sweden, the mobile eye screening unit has been piloted.

Track record of sharing

Our conclusions will offer experiences guidelines for providing comparable services in primary health care at other sparsely populated remote sites. Along with the main report, the results of the subprojects will be published in international scientific papers.

 

In Finland, the remote wound clinic and remote speech therapy pilots were seen as services that could be replicated and utilised in a wider context. This necessitates interoperable systems and a regional, unified solution for utilisation of videoconferencing has now been agreed upon. The development of regional services will continue in a project funded by the Ministry of Health and Social Services.

 

In Scotland, there is potential for teledialysis to be replicated in two other satellite renal units served from Inverness by NHS Highland, including one in the Western Isles. The latter will involve cooperation with a separate health board. A renal unit in the Northern Isles also hopes to improve its telemedicine link with the mainland, based on this example.

The Teledialysis project will be presented to the Scottish Renal Association at its biannual meeting in Inverness in March 2011.

 

Remote speech therapy has been demonstrated on the east coast of the Highland region, with potential to spread further as IT infrastructure improves and more health centres are equipped for videoconferencing. Interest in remote patient consultations has been generated among other healthcare teams, largely due to personal advocacy by the pilot's lead therapist.

 

The eHealth departments of NHS Highland and the Scottish Government are kept informed of progress on both project pilots, as are politicians, Highlands & Islands Enterprise, academics, and healthcare staff.

 

In Sweden, the mobile eye unit has been piloted by Lycksele hospital in the geographical area of Southern Lapland. It is possible to expand the service to cover the entire County Council of Västerbotten and reach over 1500 patients living in the remote areas of Northern Sweden, who are in need of screening for diabetic retinopathy and glaucoma follow-ups.

Another possibility to increase the efficiency is to include other services in the same trailer. The County Council of Västerbotten is conducting a health economic analysis of the trailer usage where some suggestions are also made to increase the benefits of using the trailer.

Lessons learnt

It is important to work with telemedicine champions who can inspire other staff to get involved. Offering staff an opportunity to see telemedicine services "in action" prior to transfer of technology is also important as it seems to inspire and motivate staff.

Develop good relationships with eHealth and clinical staff and keep them informed.

Careful preparation and attention to practical, staffing, human and organisational as well as technical factors is important - time on these aspects is well spent, even if progress may seem slow.

Be prepared to adapt the original model to your own health organisation's circumstances - the basic concept can work even if details have to be amended.