E-Care provides an example of an initiative operating on a regional basis that aims to connect various actors – public, voluntary and private – to deliver co-ordinated ICT-supported health and social care services to older people. The project integrates activities between the different service providers at regional and municipal levels and will ultimately integrate telecare and telehealth projects that are currently at pilot stage.
E-Care is a mainstreamed service that has been in operation since 2005, with initial funding provided by the ‘Fund for Non-Self-Sufficiency’ of the Emilia-Romagna Region. It is co-ordinated by CUP 2000, a regional semi-state company that specialises in eHealth and which manages the largest call centre in Italy.
The main aim of the E-Care project is to guarantee independent living for older people at home through customised care plans designed according to the needs of each user. The service covers the municipality of Bologna and the surrounding Province, and the municipality of Ferrara has also joined the E-Care network.
E-Care can be described as a pro-active case management service that aims to identify individual needs and then to provide a co-ordinated ICT-supported response. The different services are provided by a range of actors in the Region, including public, professional and voluntary organisations. The target group for the E-Care project is older people aged over 75 living at home who are physically frail or socially isolated. Clients are normally referred to the E-Care service via social services or GPs.
The E-Care network offers a telecare service that provides social care, social connection and social alarm services along with medical care when necessary. Health and social care information is also provided, as well as a facility for booking medical appointments. The call centre also acts as an intermediary between the client and service providers. A specialised call centre operator contacts the client at least once a week to check that he or she is ok. If a problem arises the operator will decide together with the client the most appropriate action to take, either to call a doctor in the case of a physical ailment, or a voluntary organisation for social support. Each client has a unique electronic file stored in the call-centre that contains basic contact information and a medical history. There is also an interoperable software platform in place that allows for information sharing and data transfer between the different services involved. The Telehealth aspect of the E-Care network is based on two other Telehealth pilot projects, E-Care Lode and the OLDES project, both of which will be integrated into the E-Care project in the future.
The E-Care network co-ordinates activities between the province of Bologna, the relevant municipalities, universities, local health units and pharmacy associations (public and private). The E-Care platform has also been used to integrate services such as:
- “Uffa che Afa” – an initiative set up to support vulnerable people during severe heat-waves
- a tele-geriatrics service to support people who need ongoing care after hospital discharge
- a dementia-specific telecare service
- the “Giuseppina” service that provides free home delivery of food and medication as well as transport services to hospitals or social events.
A key facilitator for the mainstreaming of the E-Care initiative was the commitment of public institutions to the programme both through funding and direct involvement in implementation. Nevertheless, full engagement of social services took some time to evolve, in particular as regards the move from a more reactive towards a more preventative model.
Key learning points
- This is an example of a co-ordinated regional approach to delivering health and social care services to older people in their own homes with the support of ICTs.
- A key facilitator for the mainstreaming of the programme was commitment on the part of the local authorities, both through funding and through direct involvement in service delivery.