PT  - JOURNAL ARTICLE
AU  - Carme Hernandez
AU  - Anders Grimsmo
AU  - Theodore Vontetsianos
AU  - Giannis Vogiatzis
AU  - Albert Alonso
AU  - Anael Barberan-Garcia
AU  - Felip Burgos
AU  - Isaac Cano
AU  - Joan Escarrabill
AU  - Babak Farschian
AU  - Helge Garasen
AU  - Joe Gorman
AU  - Ilias Lamprinos
AU  - J.I. Martinez-Roldan
AU  - Montse Meya
AU  - Alexis Milsis
AU  - Arild Pedersen
AU  - Jordi Rovira
AU  - Stian Saur
AU  - George Vidalis
AU  - Salvatore Virtuoso
AU  - Josep Roca
TI  - Integrated care services supported by information and communication technologies (ICS-ICT) generate efficiencies in healthcare: The NEXES project
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - 214
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/214.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/214.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - We hypotesized that deployment of ICS-ICT aiming at transferring complexity from hospital to community-based services is cornerstone to face the challenge of chronic conditions. Objectives and Method: To assess deployment of 4 patient-centred ICS-ICT in 3 European sites, adressing COPD, cardiac disorders and type II diabetes: i) Wellness and Rehabilitation (W&R, n=421); ii) Enhanced Care for frail patients (EC, n=1,340); iii) Home Hospitalization (HH, n=2,454) and; iv) Remote support for diagnosis in primary care (Support, n=7,000) combining different study designs. Two different ICT approaches: Health Information Exchange (ELIN®) and Health Information Sharing (Linkcare®) were compared. The Model for ASsessment of Telemedicine applications (MAST) was used for evaluation. Results: Efficacy, complementariness and high degree of transferability were proven for all ICS-ICT. Organizational factors appeared as major modulators of NEXES' outcomes. HI-Sharing showed high potential for scalability of ICS-ICT. Ethical and legal barriers were identified. Conclusions: ICS-ICT showed potential to generate efficiencies. Deployment strategies shall adapt to site specificities. Sustainability is strongly dependent on the contextual business plans encompassing all stakeholders. Reimbursment based on bundle payments and shared risks between payers(s) and healthcare providers are suggested. The business model relies on the potential of ICS-ICT to generate efficiencies, thus facilitating innovation with no further increases in total health costs.Supported by NEXES (EU Grant CIP-ICT-PSP-2007-225025) and PITES (FIS-PI09/90634).