Home care in Flanders. Tom Vermeire Flemish Agency for Health and Care Head of the Prevention, Primary Care and Home Care Division

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1 Home care in Flanders Tom Vermeire Flemish Agency for Health and Care Head of the Prevention, Primary Care and Home Care Division

2 State structure Competences o Belgian vs. Flemish competences o Context and mission of the Flemish Agency Challenges care / home care Flemish Home Care Policy Integration of innovation and technology o Personal alarm systems o Vesta o Vitalink o Care pilot projects

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4 General Health Care Policy in Belgium Compulsory public health insurance system Independent medical practice Free choice of health care provider by the patient Fee-for-service payment of providers, with reimbursement

5 Competences - Belgium Public health insurance system Organic laws Basic rules concerning planning and financing health care infrastructure Financing regulations concerning operating costs of hospitals and nursing homes.

6 Competences - Flanders Person-related matters come under the competence of the communities: Health promotion Prevention of noncommunicable and communicable diseases Implementation of hospital standards, quality assurance policy in health services Financing health care infrastructure Ambulatory mental health care Coordination of primary care and home care

7 Flemish Agency for Care and Health Policy Council Minister Strategic Advisory Council Management committee Flemish Agency for Care and Health Youth Welfare Care Inspectorate Department of Welfare, Public Health and Family Child and Family Flemish Agency of Disabled Persons PC Geel PC Rekem Flemish Care Fund Fund for Youth Welfare

8 Flemish Agency for Care and Health Our mission is to create the conditions to promote, protect and restore the welfare and health of the current and future population of Flanders, with the aim of securing an optimal level of welfare and health for all citizens.

9 Challenges for Care - Home Care Ageing and dejuvenation Changing family structures and household types (reduced household sizes, dwindling first-line care ratios,...) Shortage of professional care providers Growing dementia problem Growing ethno-cultural diversity Affordability of care

10 Flemish Home Care Policy Giving older people the possibility to continue living at home independently as long as possible

11 Flemish Home Care Policy We recognise and subsidise a whole range of care facilities Figures Budget: 635 million euro Over users Administered hours of care: 21.5 million Over FTE professionals Over volunteers

12 Flemish Home Care Policy We assure professional care for the care needy o 119 facilities for help at home and additional home care o 3 facilities for logistic help We increase the participants ability to do things independently and reinforce their social network o 212 local services centres We give support to the users and their informal caregivers o 60 regional services centres o 32 social work services run by the health insurance funds o 6 associations of users and informal carers o 49 minding services o 6 hosting services

13 Integration of innovation and technology PAS (personal alarm systems) VESTA Vitalink Care pilot projects:

14 PAS - personal alarm systems It is an emitter worn around the neck or wrist and which is connected to an alarm centre. In case of emergency, the user can warn the alarm centre, which is manned 24/7 at the touch of a button. If necessary, the alarm centre will contact the neighbours, relatives or acquaintances who have committed themselves in this system. If none of these persons can be reached, the emergency services are called

15 PAS - personal alarm systems The standard personal alarm has a 30 year history. They are mainly supplied by health insurance funds, the public centres for social welfare and local and regional services centres. The Technology 2005 and 2006 projects carried out research into the technologies and their practical applications which would best support elderly people living at home. Lots of applications were tested (sensorised carpets, antislip solutions, lit navigation to the toilet, kitchen safety adjustments,...) but weren't satisfactory or remained stuck at gadget level. The PAS still passed the tests. Opportunities were discovered in the extension of the PAS with applications enhancing the security feeling: 1/ fall detection, 2/ smoke and fire detection, 3/ CO detection and 4/ movement detection.

16 VESTA ICT Is an electronic data exchange (via web services) between the Flemish Agency for Care and Health and the professional care providers: o facilities for family care and complementary home care o facilities for logistic help It started in 2009 (home care), extended in 2012 (complementary home care/logistic help) It s background: o the ambition to lose a paper consuming subsidisation process o outdated software It s budget: EUR 2.5 million

17 VESTA ICT Our services transfer data on: o users: care dependency, family composition, house calls, users' financial contributions o staff: in and out-of-service dates, legal position, working regime o hours worked: date and time, type (care, training, ), user

18 VESTA ICT Vesta has 2 objectives: o An efficient and prompt payment of subsidies to the services (+ web application for services: possibility to consult the detailed computation of subsidies immediately) o Collecting and analysing policy information (on the basis of the transferred data on personnel and users)

19 VESTA ICT The transferred data open up new opportunities: o automatic entitlement: financial allowance out of the care insurance scheme (from June 2013) o automatic computation of user contributions (planned, but on hold) o maximum invoice in home care (planned, but on hold)

20 Care pilot projects: innovation in care, architecture and space Joint initiative by the Flemish Minister for Welfare, Public Health and Family and the Government of Flanders Architect Incentives to innovation in care Integration of care, architecture and space Context Urgency brought on by the rising number of elderly people + accommodation More elderly people, with different profiles and other accommodation and care needs. Limited space for new infrastructure

21 Care pilot projects: innovation in care, architecture and space Learning process, scientifically monitored and evaluated Implementation of thoughtful infrastructure o o o o o Better care services through better architecture Innovative concepts in the care sector & architectural/spatial concretisation Integration of care in a complex spatial context Space which is 'course of life' proof and integrated care models Inherent care, prominent despite its invisibility.

22 1 Care pilot projects: innovation, care, architecture and space Sint-Truiden RZ Sint-Trudo 2 Dilbeek CV Peka 3 Kortrijk VZW Korenbloem 5 Geel VZW Astor 4 Wuustwezel VZW Coda.

23 Vitalink Digital platform For patients and healthcare and welfare professionals Managed and controlled by the healthcare and welfare sector Flemish administration is facilitating Within the limits of the continuity of care Ultimate goal: better healthcare

24 Vitalink Principles Central position of the patient o Viewer : making the data accessible o Informed consent o Therapeutic link Safety and privacy o Encrypted data, end-to-end o Identity and role of the users is always checked by ehealth platform User friendly o Incorporated in existing software packages of the healthcare professionals o No double input of data!

25 Vitalink Motor for innovation Vitalink is a public service for the health and welfare sector Everyone in the sector can propose and develop projects for Vitalink A project proposal is only accepted when o all partners involved work together o Partners agree on the information that will be shared (contents, structure, standards, access/rights) o Etc. Creates dynamism, cooperation, innovation, professionalism,

26 Vitalink Status Four pilot projects are sharing medication schemes of 600 patients Positive (technical) evaluation of the platform (end of June) End October: platform available everywhere in Flanders and Brussels

27 Vitalink Pilot projects Where? o In region of Aalst, region of Turnhout, S-E Limburg, region around Brussel Who? o Patients, GPs, pharmacists, nurses, home care o Software providers o Knowledge institutions What? o Sharing the medication scheme

28 Vitalink Software packages and users Pharmacists o 81 pharmacies (114 pharmacists) o 4 different software programs GPs o 38 gps o 4 different software programs Independent nurses: o 6 nurses o 2 software packages Nursing and home care organisations: 5 Patients o 2 patient viewers o 700 patients

29 Vitalink What will change end October? New actors: o Dentists, midwives, other physicians New data types o Summarized Electronic Health Records o Vaccinations Later: connected to hospitals and hospital networks

30 Vitalink Sumehr SUMmarized Electronic Health Record Minimal set of data for a physician to understand the medical status of the patient Already built-in in most EHRs Will be stored in Vitalink Only shared between physicians

31 Vitalink Vaccinations Connection with the Flemish vaccination database Vaccination data available for same group of health professionals as the medication scheme Information also available for the patient Read-only,no editing possibilities

32 Want to know more? Flemish health portal: Vitalink: Care pilot projects: