The TIC Salut Social Foundation, a public body at the Department of Health of the Government of Catalonia, today presented in Manresa its report on “Remote care in hospital care, public health, mental health and addictions”. The four hospital care centres in the region took part in this study, which was promoted by the Central Catalonia Health Region: Althaia-Manresa University Care Network, Anoia Health Consortium-Igualada Hospital, Vic Hospital Consortium, and Central Catalonia Health - Berga Hospital.
The work has made it possible to “share experiences and knowledge to systematically address common challenges in the implementation of new care channels in hospital care, public health, mental health and addictions,” explained Jesús Berdún, the study’s coordinator and remote care manager at the Social Health ICT Foundation.
The report sets out the degree of remote care in hospitals in the region in 2021, as well as the activity carried out through these channels, which was between 18 and 25 per cent. According to Inma Cervós, the manager of the Central Catalonia Health Region, this volume “shows the effort made by the centres and professionals to adapt the provision of services to the current situation, minimising the impact of the pandemic through remote care”.
The remote care channels integrated into the technological infrastructure of the Catalan public health system, which are accessible by hospitals in the region, are telephone calls, eConsultation and VideoConsultation. In 2021, telephone calls were the most-used channel, with 166,670 calls accounting for 75% of the total remote hospital activity. As the report points out, it is the most-used channel for most specialties because it does not require specific skills and is a traditional tool. The most common use cases are to give patients positive results, medication changes, information prior to surgery, and post-op follow-up.
VideoConsultation increased compared with previous years, with a total of 1,380 consultations. This channel has a higher resolution than the phone, but it requires specific digital skills and proper management of the waiting room for optimal operation. The most frequent uses of this tool were in the specialties of endocrinology, rehabilitation, dermatology and mental health.
Finally, the report also reports a growing but still minor use of eConsultation in the specialties of dermatology, endocrinology, digestive tract and clinical haematology, as this channel is still in the testing phase. However, it is expected that in the future it may have an impact similar to that of primary care, which in Catalonia as a whole conducts an average of 170,000 consultations per week.
The specialties that, all together, used the various remote channels the most were endocrinology, anaesthesiology, traumatology, rehabilitation, mental health and allergen immunotherapy, among others.
The document contains a series of recommendations to lay the foundations for the remote care model in the region. The aim is for these new channels to be an instrument at the service of professionals and patients in the usual care process that allows appropriate clinical and therapeutic decisions to be made. It is certainly not seen as a substitute for face-to-face consultations.
In order to be able to implement it, it is recommended to reserve time for remote care in the schedule; to train professionals to use these tools; and to clarify the protocols so as to be able to standardise and establish action guidelines with quality assurance. It is also proposed to include eConsultation, improve the informed consent process for users to offer this type of care, and combine the schedules for each channel for long-term evaluation of the configuration that produces the best results.
The document also provides recommendations for the public, such as exploring their preferences, assessing their experience, follow-up to improve perceived quality, advising them and sharing training content so that they can learn to use the various tools.
During the lockdown due to the COVID-19 pandemic, remote care became a necessary component of clinical practice to provide safer care to patients. Several studies show an upward trend in including remote care channels in hospitals after the initial months of lockdown. However, their use is not yet well-established or homogeneous among the different centres.
In 2021, the Catalan Health Service established a three-year plan with three specific annual indicators for the implementation of the remote care model (ASI-AE01): defining the centre's remote care model in 2021 and partially incorporating it into the healthcare portfolio; developing protocols, user guides and implementation in 2022; increasing its share of the service portfolio by 10% over the previous year; and, in 2023, reaching 35% remote care through the various channels available. It is in this context that the Central Catalonia Health Region began working with the four centres and the ICT Social Health Foundation to implement a remote care model that guarantees the quality, accessibility and sustainability of public health services.
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