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Telemedicine during the COVID-19 days: the Catalan Public Healthcare System’s evolution of Primary Healthcare model

Telemedicine during the COVID-19 days: the Catalan Public Healthcare System’s evolution of Primary Healthcare model

The eConsulta (electronic and remote clinical consultarion) it is as an asynchronous teleconsultation integrated into the eCap (clinical workstation), the most widely spread Electronic Helathcare Record across de Primary Healthcare service from the Catalan Public Healthcare System. Its deployment started from 2015 to 2017 when the entire territory was covered and supplied on behalf of Primary Healthcare teamworks [1]: nowadays it enables a combination of Primary Care speciallity doctor’s presential service. The eConsulta it is one of the availiable services gathered into the La Meva Salut (My Heath) personal data healthcare folder. This tool is useful since 2009 to permit the access of citizenship to their own clinical information, ask doubts or questions to their care professionals or digitally manage specific paperwork. This interface, logged in through a safety authentication process, allows to choose which professional to address yout consultations, to attach documents and saving previous interactions with the system. Since the deplyment of both tools, eConsulta and La Meva Salut, users and technology have increased becoming an engine for digital transformation for Primary Care during the last decade.

The eConsulta and the LMS have increased becoming an engine for digital transformation for Primary Care during the last decade.

Just as their European colleagues, the state of alarm has forced to the Catalan Healthcare System to speed up the digital transformation of its centres [3]: the confinement determined by the government beacause of the risk of COVID-19 spread during the regular development presential care services has chabged radically all activities and the Primary Care assistance model eorienting it to a telematic mode (telephone, teleconsultation and videoconference) not only to the COVID-19 affected patients but to the entire citizenship. We present some of the following adapted measures.

Firstly, furthered improvements adjusting the already existent services’ access: the use of eConsulta has been activated for the total amunt of care professionals equalising amount of face-to-face services. La Meva Salut has entered into force increasing the total amount of logged non presential. The rate of citizens has surpassed the half million during the last month. As a result, the number of daily eConsultations during the first confinement month has increased five times the regualr average. Nevertheless, the most significant increase is the telephonic attention.

The number of daily eConsultations during the first confinement month has increased five times the regualr average.

On the other hand, other service’s functionalities have also increased. Medication plans or other administrative tasks have been substituted by a telematic mode. 

Finally, new tools have been deployed. The information systems logins by care professionals or the videoconsultation. This pademia has been the trigger to all these services already existing but shown now as s’han desplegat noves eines com l’accés als sistemes d’informació dels professionals sanitaris de manera remota  i la videoconsulta (servei molt ben rebut tant pels professionals com pels pacients). La crisi sanitària ha estat un catalitzador per tots aquests serveis, que s’estan mostrant indispensable to any modern heathcare system.

Daily presential assistance services before and during the pandemia. 9T: Phone calls; 9C: Presencial service; 9Ec: eConsultations. FONT: SISAP

 

COVID-19 it will have evidenced the resilience of the Catalan public Healthcare System at the readapting itself to a digital healthcare model enabling a fast reaction to strike back the pandemic and softening sanitary emergency. Once the crisis would be over, it will be necessary to analyse every single tool deployed during this stage and attend to the lessons learned and consider the healtcare professionals as the true heroes who made it possible. 

REFERENCES 

 [1] Solans Fernández O, Lopez Seguí F, Vidal-Alaball J, Bonet Simo JM, Hernandez Vian O, Roig Cabo P, Carrasco Hernandez M, Olmos Dominguez C, Alzaga Reig X, Díaz Rodríguez Y, Medina Peralta M, Hermosilla E, Martínez León N, Gimferrer N, Abizanda González M, García Cuyàs F, Pérez Sust P. Primary Care Doctor Characteristics That Determine the Use of Teleconsultations in the Catalan Public Health System: Retrospective Descriptive Cross-Sectional Study. JMIR Med Inform (2020). 

 [2] López Seguí F, Walsh S, Solans O, Adroher Mas C, Ferraro G, García-Altés A, García Cuyàs F, Salvador Carulla L, Vidal-Alaball J. Teleconsultation Between Patients and Healthcare Professionals in the Catalan Primary Care Service: Descriptive Analysis through Message Annotation in a Retrospective Cross-Sectional Study. JMIR Preprints. (2020). 

[3] Mehrotra, Ateev, et al. “Rapidly Converting to “Virtual Practices”: Outpatient Care in the Era of Covid-19.” NEJM Catalyst Innovations in Care Delivery 1.2 (2020). 

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