Tergooi Hospital (Gooi and Vechtstreek), in partnership with health insurer Zilveren Kruis, are set to bring 20 percent of their current hospital care closer to home. Both organisations have signed a declaration of intent for the new proposal. In doing so, they hope to respond to patients’ needs to receive the right care in the right place.
Subsequently, optimal use must be made of innovative technological options, such as telemonitoring for COPD and heart patients. The Zorg Dichterbij program aims to realise this possibility. In addition, Tergooi and Zilveren Kruis are starting projects focused on prevention. The goal is to avoid repeat trips to the hospital for treatment and/or admittance for patients with a specific condition.
Accelerated relocation of care to the home, an appropriate IT infrastructure and the prevention of care are central to the transition plan that Tergooi and Zilveren Kruis have agreed upon. As is now common knowledge, this is desperately needed to combat challenges such as cost increases, an aging society and the associated growth in the number of chronic disorders, but it is also necessary to help alleviate increasing pressures on the shrinking number of healthcare professionals.
Tergooi has a main location in Hilversum and two regional medical centres. By offering safe care at home, the hospital will organise its healthcare in a different way. Acute, intensive and complex care will remain within the hospital. Good cooperation between healthcare institutions and caregivers within the region is also essential to achieve the desired care in the right place.
Compact New Build
The new construction of Tergooi, which will begin at the end of this year, will be smaller. With the use of online consultations, closer cooperation with care partners, and standardised nursing departments and outpatient clinics, the hospital expects to be able to cope with a more compact building.
Hans den Hollander, Chairman of the Tergooi Executive Board, explains: “As we are starting our new building this year, this is the perfect time for us to implement the change to deliver care in the right place. In doing so, we can continue to improve the quality of our care and respond to the needs of patients, whilst keeping hospital care affordable”.
Care Close By
Tergooi and Zilveren Kruis have already begun with the Zorg Dichterbij program. Part of this includes telemonitoring for chronic heart failure and chronic lung diseases (COPD). More and more doctors from the hospital are also providing consultations via video. Furthermore, treatments are being moved towards the home, for example, with kidney dialysis.
The precondition remains that home treatment is only an option if it is medically justified, says Olivier Gerrits, Director of Healthcare Purchasing at Zilveren Kruis: “Our policyholders prefer to have healthcare as near as possible. We attach great importance to stimulating the movement of care to the home, together with caregivers. So that illness has as little impact as possible on the lives of our policyholders. For us, Tergooi is an example of how we can implement that vision in a sustainable and modern way”.
Right Care, Right Place
In September 2018, the health insurance company announced that it would be investing more in applications that could move healthcare from the hospital to the home environment. In October, Zilveren Kruis announced that it would link its healthcare procurement policy and its focus on “the right care in the right place” to the Medical Specialist Care Outline Agreement 2019-2022.
The Outline Agreement for the hospital sector states that the growth in hospital expenditure must be reduced (via digital care applications, amongst others) in order to reach 0 by 2022. Purchasing Director Gerrits stated at the time that relocation of care to the home (the right care in the right place is also a spearhead of the NVZ and a cabinet ambition) will result in the greatest savings. Even more than just moving care from the second to the first line.
At the beginning of August, the health insurer reported that following a successful pilot with Hartwacht at the Dutch Cardiology Centre, they would also make agreements with hospitals across the Netherlands for telemonitoring heart patients. In accordance, Zilveren Kruis offers hospitals three-year contracts.
In February 2019, Zilveren Kruis signed a multi-year agreement with the Isala Hospital in Zwolle, to further improve the content of healthcare and meet the rising demand for care through the use of e-health, such as telemonitoring. Gelre Hospital followed in March. In addition, just like CZ, the insurer encourages the use of online treatments in mental health care to reduce waiting lists.
The role of Luscii in this Ter Gooi hospital project:
Luscii provides hardware, software and patient support in the Ter Gooi monitoring service as a partner of NAAST Medical Center who delivers the remote care directly from their monitoring center. The Luscii platform is embedded as a button inside the EMR of the NAAST Medical Service Center (UMO). Patients can use the Luscii Vitals and Luscii Contact apps on their iPad to send in their measurements and have (video)-communication with the nurses or doctors at the NAAST Medical Service Center, homecare centre or hospital. Using an advanced protocol, NAAST does interventions on a distance using videocommunication or directly refers through to the doctors and nurses in the Ter Gooi hospital. After enrolment, Luscii is responsible for all logistics (sending the measurement devices), service and (installation) support for patients within InSight.