The 20th century was characterised by an enhancement of well-being and better economic conditions bringing modifications in lifestyle. Such improvements also led to new risk-factors that could be controlled but not cured causing an increase in chronic conditions. Health systems mainly focused on acute episodes are now working on the implementation of country-tailored solutions aimed at better responding to the burden of (multiple) chronic conditions. In the recent years Europe faced important demographic changes affecting the age structure.
Increased chronic conditions, multi-morbidity and ageing population of both workforce and patients pushed to the promotion of a new integrated care model both at the European and national levels. This model is highly supported by the development and deployment of innovative ICT tools to improve and facilitate the quality and delivery of care in all health settings.
Policy initiatives at the EU level
Over the years the European Union has created a comprehensive policy framework devoted to improving the use of information and communication technologies in health and promoting as well an active and healthy ageing as part of its broader Digital Single Market strategy, one of the Commission’s ten political priorities.
A number of European initiatives and programmes support the development of ICT and telemedicine with a view to maintain cost efficient and high quality healthcare. This is done by means of direct support to research and innovation – such as in the case of the EU Research and Innovation Programme Horizon 2020 providing funding for several EU research projects – as well as through the launch of initiatives aiming at increasing collaboration among different stakeholders in the field.
The European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) launched in 2011 is an example of this strategy. The partnership brings together all relevant actors at EU, national and regional levels in the field and aims to increase the average healthy lifespan of EU citizens by two years by the year 2020.
Integrated care for chronic diseases plays an important role in the partnership, as it represents one of its six specific priority themes for action. The Action Group in integrated care is committed to reduce unnecessary hospitalisation of older people with chronic conditions, involving a shift from reactive service delivery to preventive, proactive and patient specific care. This would be achieved by delivering toolkits and European guidelines that can be used by EU Member States in their national plans for the management of chronic conditions.
Implementation of integrated care at the national level
At the Member States level most health systems have already moved from a traditional hospital-centric and doctor-centric pattern of care to integrated care in which hospitals work closely with primary care, community care and home-care. Almost all European countries made efforts in modifying their hospital provision patterns: delivering better services, increasing quality, improving efficiency and productivity. Further actions are directed to the creation of multi-professional networks and to the involvement of the patient in the pattern of care.
As stated in the literature, the presence of a strong ICT system connecting either the professionals or the professionals and the patients is a successful factor of transition from hospital-focused health systems to continuum care-focused health systems. Such factor became crucial to ensure quality of care, especially in time of financial constraints.
According to the main findings of the HOPE Exchange Programme 2015 many innovations have been already developed throughout Europe. Their introduction is aiming at providing a higher level of care, either by supporting professionals to use and share medical data or by facilitating the patients’ access to medical care, as listed below:
- Collection or integration of medical data to offer a better diagnosis and treatment with innovations in accessing patients’ health records, primary care on-line system, unique electronic patient record;
- Tools to connect professionals;
- Tools to connect professionals and patients with eConsultations and telemedicine;
- Tools supporting patients in their care.
In the framework defined above, integration of care is at the same time a reality and the way forward to reach more sustainable social and health integrated sectors providing high quality and efficient care.