Prospective analysis of the implementation of healthcare telemedicine between prisons in the area of Catalonia (Spain)

Abstract

Introduction: Consorci Sanitari de Terrassa is a public entity of the Government of Catalonia, which manages the Prison Hospital Unit of Terrassa (UHPT), a reference in Catalonia for the provision of health services to different prisons. Healthcare delivery to the prison population is a goal for improvement of the Health Department. Telemedicine is an alternative to face-to-face service that can help to improve the care process in patients. Objective: To introduce in this environment a new business model that facilitates communication between health professionals who take care of this population to improve the quality of healthcare in prisoners. Methods: Phase I: comprehensive analysis of the environment, starting with a pilot stage of six months (October / 2010 to May / 2011) between UHPT and Can Brians 2 prison, with a population of 1,500 inmates. To evaluate the experience a survey was conducted with the support of AQuAS (Agencia de Qualitat i Avaluació Sanitàries de Catalunya). Phase II: Intensive observation phase applying Shadowing methodology (May / 2015). Phase III: with information from phases I and II, different elements will be identified and a new business model defined, following the design "Business Model Canvas" (Alexander Osterwalder), in order to facilitate the implementation of the Telemedicine project: "Telecare in prison systems". Results: Phase I: The results of the pilot stage show high satisfaction in patients and professionals and an increase number of visits with the new system. Phase II: The observation process identifies: 1) excessive time spent in transportating patient, arrival and departure in prison units use 3.5 hours; 2) excessive administrative procedures; 3) high use of resources to follow security protocols; 4) lack of communication between different healthcare providers. Phase III: The new business model suggests edit value for improving patient-centered communication and optimizing the use of resources. Conclusions: It will be necessary to consider organizational and management changes to accommodate the new care system, promoting and encouraging change management. It is important to identify a government person to lead the project to ensure continuity and sustainability in other prisons in Catalonia. The implementation of this new business model will improve 1) patient-centered communication between care teams 2) optimization of management related to patient transport and 3) create protocols for clinical processes of healthcare activity according to the patient's health problems. [ABSTRACT FROM AUTHOR]Copyright of International Journal of Integrated Care (IJIC) is the property of Ubiquity Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)