lunes, septiembre 17, 2012

Panel sobre Sanidad 2.0 en Euskadi en el Congreso medicine 2.0 de Boston


En #med2 Boston 2012, hemos tenido la ocasión de contar el caso del desarrollo de la Sanidad 2.0 en Euskadi, la única experiencia monográfica sobre un sistema de salud de todo lo presentado en el evento. Un verdadero orgullo poder mostrar lo trabajado en estos últimos años en Harvard Medical School. A continuación el resumen de lo presentado y la composición del panel.

Health Systems Web 2.0 Approaches to Chronic Illness Panel: The Basque Country Case
Gonzalo Bacigalupe*, University of Massachusetts Boston & Ikerbasque Foundation for Science, Boston, United States
Roberto Nuño-Solinís*, Director O+Berri, Instituto Vasco de Innovación Sanitaria, Bilbao, Spain
Javier Bikandi*, O+Berri, Instituto Vasco de Innovación Sanitaria, Bilbao, Spain
Marie-Pierre Gagnon*, Université Laval, Quebec, Canada
The Basque Country is an autonomous community and the wealthiest region in Spain—a GDP a third higher than the rest of Spain and over 40% higher than the European Union average. Osakidetza—the public healthcare system is based on principles of universal care and equity and is one of the most advanced in the EU. The Basque region healthcare system is integrating a wide collection of healthcare information and communication technologies (HIT) to address more effectively the management of chronic illness (http://cronicidad.blog.euskadi.net). Several factors have stimulated the adoption of emerging technologies in the public healthcare system: (1) an aging population in a country with one of the highest life expectancy in the world, (2) maintaining universal healthcare access, and (3) safeguarding quality of care equity including the continuity of care throughout life, (4) while also, ensuring the financial sustainability of the public healthcare system—i.e., preventing unnecessary hospitalizations.
At the present, in Spain, 70% of the healthcare budget is destined to the management of chronic illness. Without a drastic change in how primary care services functions, the healthcare system—of what has been universally perceived as a model healthcare system—will collapse. The solution is not just the allocation of more financial resources—not available and already a large burden on citizens and their state and regional governments. To address this challenge demands the active participation of patients in the management of their care. The demand for an active participation of patients in their care and the availability of emerging social technologies are two important factors that inform the development of HIT initiatives that are already being evaluated and from which lessons about the management of chronic illness at a national level can be drawn.
This panel will report on primary care efforts that rely on Web 2.0 tools: virtual communities of support for patients and virtual communities of practice. Other HIT efforts have been complementary to these initiatives and have included electronic health records and web-portals for patients to make appointments. The electronic health record is an illustrative example of a top-down implementation. The development of virtual community of practices, on the other hand, has relied on primary care professionals’ grassroots efforts. The virtual healthcare professionals community of practice grew from a sophisticated set of threaded discussions to a systematic evaluation of ideas for potential implementation at the local and regional contexts. Similarly, a virtual support network for chronic patients was launched after testing it with the participation of self-help patient organizations. As one colleague suggested:
Virtualizing communities requires an emphasis on organic growth from the grassroots levels, particularly as we further understand the importance of patients using new communications and information technologies to take more responsibility for their care, and as we realize the potential of crowdsourcing to make incremental improvements and larger innovations to the way providers deliver care.
The HIT experiences in the Basque country offer rich lessons of the power that technology could have in public health and healthcare prevention and intervention. Findings from research and evaluation efforts, lessons learned from the implementation, will be examined. One of the panellists will discuss the results of a survey—based on the Technology Acceptance Model—that showed that the perception of facilitators in the organizational context is the most important variable to consider for increasing healthcare professionals’ intention to use a telemonitoring for chronic care patients. The panels will also discuss how the implementation of similar initiatives in the rest of the European Union, and other national and/or local contexts compare with the initiatives in the Basque Country.