Assessing readiness for scaling-up innovations in Active and Healthy Ageing Falls prevention (Profiter). Introducing innovation into Regional ehealth Policy Antonio Addis Research Governance Area Regional Agency for Health and Social Care Agenzia sanitaria e sociale regionale 1
Emilia Romagna Region Population 4.471.104 January 2013 Aged 65+: 1.018.053 (22,8%) Public beds in hospital: 15.359 Total expenditure of Regional Health Service: 8,677 billion Euros Coverage of healthcare online services: ~100 % of GPs and citizens reached by the Sole network + Electronic Health Records
Can Regional Health Authorities ignore innovations?
REGIONAL COORDINATION TEAM Department of Health Policies Department of Productive Activities Regional Agency for Health and Social Care of Emilia-Romagna - ASSR consortium for innovation and technology transfer- ASTER A1 Prescrip.+Adherence Best Practices A2 Fall Prevention Reference Site ASSR A3 Frailty B3 Integrated Care C2 Indipendent Living Policy & Decisional Level Policy&Operational Level Operational Level
PROFITER PRevention Of Falls IniTiative in Emilia Romagna: a regional network for fall Clinical information Fall risk factors Digitalization ICT Regional Fall Registry Retrospective Analysis Activity Monitoring / fall detection instrumented scales Interoperability among different clinical specialties Personalized Fall Risk Model Fall Risk Calculator Personalized Intervention Training of personal carers
Working Group 1 Collection, digitalisation, and retrospective analysis, Electronic Health Dossier (FSE) Regional Fall Registry (RCC) 160 140 120 100 80 60 40 20 0 CADUTE ANNO 2013: DISTRIBUZIONE PER FASCE D'ETA' 37 % 27 NUMERO 12 109 13 4 7 81 35 37 13 20 < 50 AA >= 50 AA <60 >= 60 AA <70 >= 70 AA < 80 >= 80 AA < 90 >= 90 AA AA AA AA AA
Working Group 2 Classification of fall risk factors according to the International Classification of Functioning, Disability and Health (ICF) to allow interoperability among different clinical specialties and, in perspective, across European Regions; Development and validation of a personalised fall risk model, integrating known fall risk factors, clinical balance measures, and parameters extracted from wearable inertial sensors; Personalized intervention on community dwelling elderly (Randomized Controlled Trial)
Personalized intervention (RCT) Efficacy of a multifactorial and personalized intervention aimed at preventing falls in community-dwelling elderly in comparison to the usual care: a randomized controlled trial. PI: Fabio La Porta, MD (Rehabilitation Unit, Modena) Transdisciplinary, multicenter study Approved for funding by the Emilia Romagna Health Authority Approved by the local ethical committee Time frame: August 2014 July 2016
Randomized Clinical Trials: aims Early detection of persons at risk before they fall ICT solutions Community-dwelling elderly at high risk of falling Frailty Parkinson Stroke RCT Treatment group Usual Care Integrated care pathway for fall prevention Trans-disciplinary & personalized multicomponent & multifactorial Fall reduction at 1 year Secondary goal: ICT-based screening tool validation
Fall Risk Calculator Working Group 3 Mapping of the identified fall risk model into an operational programme for the prescription of personalized interventions and/or ICT-based assistive devices for falls prevention and rehabilitation in community dwelling older subjects; Specific training for personal carers of high-risk subjects;
Mapping EU AAs vs Profiter Action Area 1: Implementing an integrated and person-centred service pathway, which is enhanced by ICT and other technologies Action Area 2: Data and evidence to support the implementation of an integrated and person-centred pathway Action Area 3: Awareness, information and education to underpin the implementation of an integrated and person-centred pathway Action Area 4: Governance, innovation, sustainability and scaling up WG1 D2.2 W22 D1.2, D1.3 WG3 D3.1, D3.7
Conclusion Governance Research Reference European Innovation Active Falls ehealth Innovation Prevention Site Healthy Partnership Ageing Aknowledgment: Profiter Coordinator, Lorenzo Chiari (Bologna) WG1: WG2: WG3: Fulvio Lauretani, Giovanna Campaniello (Parma) Fabio La Porta, Franco Valzania (Modena, Baggiovara) Giulio Pioli (ASMN Reggio Emilia), Chiara Mussi (Modena,Baggiovara) aaddis@regione.emilia-romagna.it
Conclusion Governance Reference Site European Innovation Partnership Innovation Aknowledgment: Profiter Coordinator, Lorenzo Chiari (Bologna) Falls Prevention ehealth Active Healthy Ageing Research WG1: WG2: WG3: Fulvio Lauretani, Giovanna Campaniello (Parma) Fabio La Porta, Franco Valzania (Modena, Baggiovara) Giulio Pioli (ASMN Reggio Emilia), Chiara Mussi (Modena,Baggiovara) aaddis@regione.emilia-romagna.it