This session started to look forwards in time. Three speakers focused on projects and initiatives in which digital health will act as an enabler of transformative effects when integrating data and services for better prevention, diagnosis, and care. The presentations implicitly drew on the building blocks of a learning system for health and care.
The session was held with the support of Laurel, a project with a focus on integrated long-term care. It was introduced by Rachelle Kaye of K-Tor Consulting Services, Israel. Insights were offered into Laurel’s large scoping research reviews of value-based care implementation, and the Laurel-developed digital assessment tool, FLINT. The Laurel partners are about to explore a series of case studies/good practices. EHTEL contributes to this exploration.
- “Building a sustainable future for health based on prevention” by Janette Hughes, Digital Health and Care Innovation Centre, UK
- “Scaling-up value-based transformation” by Bert Vrijhoef, Panaxea, the Netherlands
- “Transforming social care through data” by Juan Carlos Contel, Department of Health, Catalonian Government, Spain
🗣️ Speakers
► Session introduction
Rachelle Kaye, K-Tor Consulting Services, Israel
► Building a sustainable future for health based on prevention
Janette Hughes, Digital Health and Care Innovation Centre, UK
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Janette Hughes, of the Scottish national Digital Health and Care Innovation (DHI) Centre, presented a paradigm for prevention, case studies and the future. Her emphasis was very deliberately on the importance of scaling up at a country-wide scale in Scotland. Scale is a “missing part of the jigsaw”, especially with regard to integrated care. Starting from the DHI’s 10-year set of strategic objectives, she emphasised how the centre plans to shift the balance towards prevention and detection. Crucial messages related to the importance of leadership, investment and reimbursement, and looking long-term. The aim is to increase Scotland’s readiness levels for this transition. The plan is to improve partners’ readiness through three kinds of innovation – technical, service, and business. The national centre uses a co-design approach and plans to resolve citizens’ common unmet needs: indeed, “We have to take people with us”.
Janette drew attention to four examples of already-trialled practices in Scotland – key areas that the Scottish government has asked the centre to look at. The first was on type 1 diabetes. The second was a project on preventing type 2 diabetes through the use of an educational intervention app prescribed by general practitioners. Third, a rural centre of excellence is helping citizens to avoid obesity, and self-manage pre-diabetes and diabetes. Fourth, community support helps with connections between health and other services e.g., the third (voluntary) sector. The readiness levels associated with the four initiatives showed that the personal apps in areas of Scotland are already at high levels, e.g., stages 8 or 9 of technical, service, and business readiness. Meanwhile, the living lab explorations are nearer to stages 5 and 6.
Towards its end, the presentation looked forwards towards 2030. There Janette explored the contributions that health and social care together make as drivers of people’s and society’s health and well-being. As she reinforced, “We believe the future lies in the social determinants of health”, supported by artificial intelligence (AI).
► Scaling-up value-based transformation
Bert Vrijhoef, Panaxea, the Netherlands
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Scaling-up value-based transformation was the topic of the presentation made by Bert Vrijhoef of Panaxea, the Netherlands, on behalf of the Laurel project. The project is undertaking a cross-system comparison across Europe. Bert’s presentation drew on four pieces of applied research that have already taken place over the 15-year time-horizon of 2006-2024. He looked at scoping reviews from a diversity of sources and locations, including Australia. He especially explored implementation from three perspectives: hospitals, systems, and at “an extra large-scale”. Bert described how volume-driven healthcare is now being transformed into value-driven healthcare. Value-based healthcare has six interdependent components (“building blocks or cornerstones”) that are mutually reinforcing. All have to be implemented. Bert reflected, however, that implementation strategies are described rarely and evaluated even less often. Four systems enablers help to scale up value-based healthcare: one is the emergence of the very critical enabler of a learning culture. Overall, conceptualisation, description, and evaluation of value-based implementation strategies are needed: the Laurel project certainly goes in this direction. This element of Laurel’s work will help clarify the answers to such basic questions as: “Is value-based care still work-in-progress?”, “Is it too complex?” “Where are the concrete applied examples taking place?”
► Transforming social care through data
Juan Carles Contel, Department of Health, Catalonian Government, Spain
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Juan Carles Contel of the Department of Health, Catalonian Government, Spain, made his presentation in conjunction with support from TicSalutSocial, Catalunya. Together, “We are trying to work on health and social care services.” He showed how Catalunya has implemented integrated care: this he called the Catalonian experience of navigating the rough seas. Juan described the main features of the Catalunyan region’s 8 million inhabitants and their access to social care services. He outlined the start of the Catalunyan integrated care journey, and why this integration is needed. Progressing over a 40-year time-period since 1986, the autonomous region now has its focus on a Health and Social Integrated Care Agency. Among the events, signposts, and challenges faced have been stop-starts, many iterations, and general complexity. On its journey, Catalunya has, however, developed many tools, among them algorithms and ‘graphic assessments’, which have many benefits. Key are the available data, transformation, interoperability, and what Juan calls “viewers” (screens, dashboards, and score-cards). Technically, of importance to the joint single care plan intended are standardisation, tools, datasets, data repositories, platforms, and coding systems. Of importance is the ”double agenda” of the work of both health and social care, working in tandem with the Catalunyan Department of Social Affairs. Five top priorities remain for a “better digital health and care future”.
These three presentations, with their many direct examples of concrete experiences of implementation, help build a bridge to the reflections shared in the next session of the Symposium, on the European Health Data Space (EHDS) and its infrastructure. Certainly, in the space, some of the primary and secondary data to be shared include data related to social care.
