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The project EFFICHRONIC will be presented on the 16th of September in the workshop “Capacity Building in Integrated Care” of the International Congress on Integrated Care, ICIC20. The speakers will be Marta Pisano, coordinator of the project, and the technicians Raquel Vázquez and Delia Peñacoba, from the Ministry of Health of Asturias, Arturo Álvarez Rosete, high-level expert on Integrated Care, and Inés Rey, from FICYT.

EFFICHRONIC

Health and Social Care systems reaching out vulnerable populations with chronic conditions: Implementation results of the EU-project EFFICHRONIC.

Abstract

Health and Social Care systems reaching out vulnerable populations with chronic conditions: Implementation results of the EU-project EFFICHRONIC.

The quest for integrated care has often been depicted as “crossing the boundaries” (Timmins and Ham 2013), going “beyond silos” (Meyer, Müller and Kubitschke 2014) or “cutting across” (Kodner D L and Spreeuwenberg 2002) multiple systems, services, providers and settings. Indeed, the integrated care agenda encourages systems and services to go proactively beyond themselves and reach out to the most vulnerable people.

At ICIC19, we presented the EFFICHRONIC project, attracting a great deal of interest from the integrated care research community. Funded under the European Union´s Health Programme (2014-2020) (Ref: 738127), the project EFFICHRONIC aims to empower vulnerable hard-to-reach patients and caregivers to self-manage their chronic conditions.

EFFICHRONIC implemented the Chronic Disease Self-Management Programme (CDSMP) in different regions of 5 European countries (France, Italy, The Netherlands, Spain and UK), in those groups of society that are most exposed to the negative effect of the social determinants of health. EFFICHRONIC uses the term vulnerable to refer to situations where the individual is not fully socially integrated and risks falling into social exclusion, either due to socio-economic hardship or because of stress for physical or psychological reasons (chronic conditions, being ill or disabled, the frail elderly or people suffering from mental health problems).

Intersectoral alliances with local and/or regional authorities, the healthcare system, social care organizations and civil society groups were generated at all EFFICHRONIC sites and joined strategies to recruit vulnerable people for the programme were developed. In each territory however, the specifics were determined by the geographical, institutional and administrative characteristics of each region. We are keen to share this rich project experience with integrated care colleagues at ICIC20.

Workshop Outline
• EFFICHRONIC overall project approach and general framework
Marta Pisano González and An L D Boone – 10 minutes
• Project dissemination and communication
Choni Doñate – 10 minutes
• Results of the implementation and Intersectoral recruitment strategies and participant profiles
Marta Pisano González and An L D Boone- 15 minutes
• Internal project Quality Control, SWOT analysis of the used strategies and lessons learnt
Choni Doñate – 10 minutes
• Main elements of Integrated Care in EFFICHRONIC
Marta Pisano González and An L D Boone. 5 minutes
• Questions and Debate
10 minutes

Dra. Marta Pisano

Dr Marta Pisano Gonzalez Heatlh Patient Scholl Coordinator Health Department

EFFICHRONIC overall project approach and general framework

Biography

Marta Pisano González is the Principal Investigator of EU-funded project EFFICHRONIC and works at the General Directorate of Care, Humanization and Social Healthcare Services of the regional Ministry of Health of the Principality of Asturias – Spain. She is the regional coordinator of the Patients´ School of Asturias. Marta holds a PhD in Psychology and is a nurse by training.

Ms Delia Peñacoba Maestre

Ms Delia Peñacoba Maestre Technician Ficyt. Cif: G-33053604. Ministry Of Health Of Asturias.

Results of the implementation and Intersectoral recruitment strategies and participants profiles

Biography

University Degree in nursing. MSc in Communication and Health. Experience as a primary care nurse for 20 years. Nursing director of the Health Area I of the Health Service of the Principality of Asturias from 2012 to 2016. T-Trainer in Chronic Diseases Self-Management and Diabetes Self-Management Programmes by the Stanford School of Medicine. She has worked throughout the EFFICHRONIC project as the program implementation coordinator in Asturias.

Ms Raquel Vázquez

Ms Raquel Vázquez Nurse FICYT. CIF: G-33053604. Ministry of Health of Asturias.

Results of the implementation and Intersectoral recruitment strategies and participants profiles

Biography

BSc in nursing. MSc in research in primary care; master in direction and nursing management. Experience as a primary care nurse for more than 25 years. She has worked throughout the EFFICHRONIC project as the program implementation coordinator in Asturias.

Mrs Inés Rey

Mrs Inés Rey Manager of the European Health Projects Unit of FICYT FICYT – Foundation for the Promotion of Applied Scientific Research and Technology in Asturias

Project dissemination and communication

Biography

BSc degree in Biology. Financial and Administrative coordinator of the project EFFICHRONIC and reviewer of the Communication and Dissemination Plan. She is a Project Manager with extensive experience in EU Research and Innovation projects and policy (FP7/Horizon 2020, CIP, Structural Funds, etc). She has been managing European projects as coordinator or as partner for more than 11 years. Examples of these projects are: EFFICHRONIC and FRAILCLINIC (EU´s Health Programme), ERANET TRANSCAN-2 and LEEP-SME (H2020), Galactea-Plus (COSME), Galactea-PlusKAM (COSME). She is the manager of the European Health Projects Unit of FICYT for the Public Health System of Asturias.

Ms Ascensión Doñate-Martínez

Researcher Polibienestar Research Institute – University of Valencia

Internal project Quality Control, SWOT analysis of the used strategies and lessons learnt

Biography

Ascensión Doñate is PhD in Social Sciences and has a Degree in Psychology. She is a researcher at Polibienestar Research Institute since 2010 where she has participated in more than 15 regional, national and European projects focused mainly on ageing, chronic conditions, palliative care, social and health care pathways and public health policy. She has experience analyzing the impact of health services among their users in terms of quality of life, satisfaction, consumption of services or usefulness, as well as collecting, analyzing and interpreting data.

Dr Arturo Alvarez Rosete

Researcher, Consultant Freelance

Main elements of Integrated Care in EFFICHRONIC

Arturo is a free-lance health policy consultant and researcher, and the external expert of the EU-funded project EFFICHRONIC. He also teaches at the distance learning programme of the London School of Hygiene and Tropical Medicine on integrated care, health systems and health policy process and power.

He has been the Director of the Spanish Observatory on Integrated Care of the New Health Foundation (the Spanish acronym is OMIS). Prior to that, he has been senior policy consultant delivering work for the World Bank and WHO (2008-2014) and policy researcher for the London-based foundation, the King’s Fund. He completed his PhD in Politics at the University of Nottingham (UK). He is currently based in Salamanca (Spain).