Reconcile health care needs in the future:

clinician point of view

Meeting on Hypertension, diabetes and renal diseases.

20 Feb 2009

Different approaches to face the chonic care delivery in the future Clinical improvement need to face resources

scarcity (staff, funds) More presence of Evidence and outcome based

payment (P4P, pay for performance) and Disease Management experiments

Increasing the health care cooperation and integration I s necessary to cope with funding restrictions (OECD report 2007)

Preventive measures to substitute chronic burden (GP-nephrologists interaction, case management)

Different approaches to face the chonic care delivery in the futureMany models, approaches can be applied,

Chronic Care Model, Clinical governance, HTA, EBM.

Clinician have to adopt/adapt the care delivery to match trends.

Complexity drives to team up with payor, patient, thechnology

Chronic Care Model "A framework through which

NHS organizations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish." (Scally and Donaldson, 1998)

This definition is intended to embody three key attributes: recognisably high standards of care, transparent responsibility and accountability for those standards, and a constant dynamic of improvement.

Clinical Governance model "A framework through which

NHS organisations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish." (Scally and Donaldson, 1998)

This definition is intended to embody three key attributes: recognisably high standards of care, transparent responsibility and accountability for those standards, and a constant dynamic of improvement.

‘Clinical Governance’

Research Practice development plans Postgraduate

medical education

Audit Evidence based

medicineDissemination of

guidelines

Personal development

plans

Practice accreditation

Special interest groups

The audit cycle: what we need more ?

The role of the data integration, availability and consumerism

conclusion Every model can be used as framework, but one

have to be implemented Accountability, traceability, clinical data mining,

evidence based and guideline supported care are the key success factors

Multidiscplinary teams (including a more empowered patient) are request to answer complex questions

Operational, clinical , economical compliance have to be aligned in a shared governance model

Need of integrated care (and budgets) models…and integrated providers

Focused Health Communities

Personal Health Records

Personal Health Tools

Personal Health Tools