From Hospital…… ……. to Home « The use of I C T for healthcare in France » Bertrand BAILLEUL European Health Managers Forum.

From Hospital…… ……. to Home

« The use of I C T for healthcare in France »

Bertrand BAILLEUL

European Health Managers Forum

New challenges in the healthcare

The power of the consumers

The technological transition

The epidemiological changes

The problem of the human resources

The difficulty of public funding

Which vision for the new decade ?

The patient is unique

The place of the different caregivers

Bringing an added value

The emerging solution

An integrated service system

- From hospital to home :

a global solution for the patient

- A new organisation of the care provider

The place of the Rehabilitation The rehabilitation :

A real bridge between hospital and home

A more specialised and larger job

A way to decrease the cost of acute care

Towards a New Concept

« The Home-Based Long-Term Specialised Care »

- In addition to the traditional home care, the specialised home care (managed by the hospital)

New ways of specialised clinical treatments with a coordination of specialized services an increased patient and caregiver support a medicalisation of the home a large use of the new technologies, especially ICT

The place of the ICT

Can ICT bring solutions ?

THE TELEMEDECINE A NEW TOOL

Teleexpertise/Telediagnostic

Teleconsultation

Telesurveillance

Teleassistance

Visioconference

Teleinformation, ehealth

THE TELEMEDECINE IN PARIS AREA

- Paris : a large area with 15 Millions people

(20 University Hospitals, more than 100 General Hospitals)

- The telemedecine in Paris area :

a network of 41 Hospitals in Paris area 52 Applications 40 Specialities

The example of TELIF : A tool for the neurosurgery

Some examples

The stroke

The transplantation

The home care

THE STROKE (1)

- 150 000 Brain Strokes in France per year- 20% patients die in the first days- 70% patients have severe handicaps- 3 Hours for dealing a patient with a brain stroke- Difficult transfert in Paris due to large traffic jams- With Telemedecine, it was possible to decrease these

figures from 30% during the last three years (scann and thrombolyse)

THE STROKE (2)

Telemedecine is now used for :

- Telediagnostic

- Teleconsultation

- Visioconference of medical meetings

- Medical files

THE STROKE (3)

Telemedecine is starting to be used in rehabilitation centers in connection with stroke centers for :

- Choice of transferts

- Teleconsultation

- Visioconference of medical meetings

THE STROKE (4)

Telemedecine is planned to be used for home care in connection with stroke centers and rehabilitation centers for :

- telesurveillance

- visioconference with local and home caregivers

- medical files

- telediagnostic

THE TRANSPLANTATION (1)

Liver transplantations need a short stay in the transplantation centers and quick transfers in specialised rehabilitation centers.

Telemedecine is used for :

- Choice of transferts

- Teleconsultation

- Visioconference of medical meetings

THE TRANSPLANTATION (2)

Telemedecine is planned to be used for home care for :

- telesurveillance

- visioconference with local and home caregivers

- medical files

- telediagnostic

- teleeducation (nutrition)

THE HOME CARE (1)

Specialised Home care are now using technicals tools for :

- Heart pressure controle

- Chimiotherapie

- Palliative care

- Life support/ventilator assistance system

THE HOME CARE (2)

Telemedecine is planned to be used for home care for :

- telesurveillance - visioconference with local and home

caregivers - medical files - telediagnostic - teleeducation, ehealth - telesupport

THE PLACE OF ITC

- ITC will allow the development of new ways of care

- but it will raise new challenges partly for the rehabilitation care but mainly for the home care

The specialised home care

a big challenge for the coming years thanks to ICT ……but large unsolved problems remain

Which cooperation with the traditional home care ? Are the home caregivers ready to be so much involved ? How to deal with the risks in a home which become a

mini hospital ? Is it cheaper and more efficient than keeping these

patients in the hospital ?

CONCLUSION

ICT are necessary for facing the new challenges of healthcare

but it will be necessary to deal with new problems

What will be the place of the hospital with which organisation and …………….which architecture ?