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How to improve performance using efficient
information systems for both Citizens and
Professionals in the Health Social sector
Prague 22nd June 2009 Dott. Alessandro Pigatto
Local Health Unit n.2 Veneto
Region direzione.servizi.sociali_at_ulssfeltre.veneto
.it
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Objectives of the System of Social Health Care
Services
Physical health
Satisfaction of primary, social and relational
needs
Relational health
IMPROVEMENT OF THE QUALITY OF LIFE OF THE
POPULATION
Emotional health
Improvement in living and economic conditions
Social Integration
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The Veneto Social Health Care System
Veneto

• Promotion of an
• Integrated Social Healthcare System
• Local Social Health Care Units (ULSS or LHUs)

Risposte INTEGRATE ai bisogni degli utenti
INTEGRATED responses to the needs of Citizens
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The System of Social Health Care Services in
the Veneto
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Integration takes place

• Through a process of admittance of individual
  cases into the social health care system
• managing a case from the first contact, to
  admittance and release, interpreting the
  complexity of the case, and sharing information
  with various service providers
• Through local programminghandling up-to-date and
  comparable data on users of services and on
  interventions carried out at the local and
  regional level.

THE SOCIAL INFORMATION SYSTEM
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Information needs in local level programming

• These include
• Knowing
• the needs of the population
• The individual characteristics of the Users
• Services and interventions activated by the
  Municipalities and other Players in the System
  (LHUs, Third sector (voluntary, no-profit),
  private institutions)
• Improvingthe use of services ? sharing
  information on individual users from different
  service providers intervening on the same user
• Comparing policies activated at the local level

in a newly evolving context
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Why do we need a Social Information System?

• It is important for the Region
• To direct and manage the system of services on
  the basis of the evolution in demand and of
  changing population needs
• To provide a complete picture of reference for
  defining system priorities
• To provide valid, reliable data which can be
  analyzed in realtime, and compared with data from
  other territories on interventions activated and
  on the users of Health Social Services.

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Regional needs

• Define a common language in the realm of social
  services
• Collect information in a homogenous way from the
  Social Services Department, from LHUs or from the
  Territory
• Optimize data collection and the management of
  information flows on different organizational
  levels
• Provide comprehensive and comparable information
  between different services or territories

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The importance of the Social Information System

• For the Organizations in the territory (LHUs,
  Municipalities, private-public health care
  Institutions) it is vital we
• are able to read and interpret correctly the
  demand by Citizens for social services
• organize and direct local social services to
  cater to population demands and needs
• provide updated and fully integrated data on the
  use of health social services by the
  population
• are able to follow closely the evolution over
  time of individual cases as regards their
  different use of services
• use a common language across different
  environments in the territory, thereby enabling
  comparisons with other territorial institutions
  and service providers.

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Information collected by the Social Information
System a basis for the evaluation of the
Welfare System and for improving communication
between System Actors.
Other Services
Municipality Social Services Head Office
Family Planning
Information Sharing on Users Basic
information Needs Interventions/ services
Services to combat Addictions
Child Neuropsychiatry
Centre for Mental Health
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Objectives of the Regional project

• To define the basis of the Social Information
  System accessible to the territories for
  collecting homogeneous information on
• personal details (of the individual or family
  nucleus)
• context of reference
• needs
• services/ interventions activated

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Key decisions taken in setting up the Social
information system

• The key element on which to collect information
  the USER
• To use the same language to classify
• The basic information on the users (social and
  personal information on the users and the
  context)
• Needs
• Services/ interventions activated
• To include in the main characteristics of users
  NEEDS

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Units of Analysis
Personal details
Context
Needs
Services/ interventions
Family nucleus
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STABLE FAMILY NUCLEUS
Needs of the nucleus
User
Member of Nucleus N
Member of Nucleus A
..
Vital statistics
Context
Personal details
Personal details
Individual needs
Interventions made at the individual or
couple/family level
Caregiver
Other members Extended family
Personal details
Personal details
Individual needs
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Contents of Social Information System
Prague 22 June 2009 Dott.Claudio Beltrame
Local Health Unit n.10 Veneto
Region Direzione.servizisociali_at_assl10.veneto.it
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1- Personal and family details

• Basic information of a statistical nature on the
  user, and if necessary on the members of the
  family nucleus
• Clinical record holder
• Date of birth
• Sex
• Municipality/ Country of birth
• Nationality
• Marital status
• Type of user

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Example Personal Details Form
Name, address (road, area code, city, province),
telephone numbers
Date of birth, place of birth, nationality,
country of origin, marital status, type of family
nucleus

• Single person
• Childless couple
• Couple with children
• Single parent with children
• Living together, and related (siblings, cousins
  etc)
• Living together, but not related (eg. Carer)
• Other (specify)

• Single
• Married
• Living together
• Legally separated
• Divorced
• Widowed

Marital status
Type of family nucleus
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1b Foreign citizenship

• More specific information on country of origin
  and length of stay in Italy of the user
• Country of origin
• Date of arrival in Italy
• Reason of stay in Italy
• Information on residence permit

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2 Information on the context

• Information on the various areas of life of the
  user
• Health care information
• Level of education and work conditions
• Economic conditions
• Living conditions
• Composition of the family nucleus
• Composition of the social network
• Legal conditions

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Example Health Care information
Main health care details of the clinical record
holder Local Health Unit, Health district,
Health Insurance Number, surname, name, telephone
number, email address
Health conditions of the clinical record holder
Certified pathologies, confirmation of invalidity
(), Date
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3 - Needs of the individual and of the family
nucleus

• NEEDS OF THE FAMILY NUCLEUS
• Living living conditions, quality of living
• Economic resources economic conditions,
  financial management
• Family relationships, family roles and relations
• NEEDS OF THE CAREGIVER
• Family management of everyday family life
• NEEDS OF THE INDIVIDUAL
• Work Work conditions, work/professional
  training, school education-careers advice
• Care physical care, material care, basic health
  care, specialist health care, family care, care
  in relationship
• Maintenance or development of autonomy autonomy
  carrying out daily chores in and out of the home,
  autonomy in caring for oneself, mental autonomy
• Citizenship/ social belonging social network/
  social relations outside the family, social
  integration, respect for social norms
• Development of personal identity harmony in
  personal development, existential dimension
• Protection and guardianship protection of
  individual rights, protection against
  dangers/risks in potentially problematic
  situations, protection during acutely problematic
  situations of zione
• Accessibility to services ones attitude to
  services provided

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An example of a table of needs
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Innovative strategies

• Adopting a common language among the various
  actors of the social services sector
• Promoting clear dialogue among LHU social service
  providers and between LHUs and Municipalities
  enabling information on users to
  be shared
• Providing an updated database which includes
• Information on users of various social services/
  on interventions
• The changing needs of service providers
• Services/ interventions carried out

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Information Flow diagram
The Information System of all the LHUs collects
electronic information on users
Integration with the Health Care Information
System
Merging with alreadyexisting regional software
(Adonet, MFP)
REGIONALDATAWAREHOUSE
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How the project has evolved

• The aim has been to launch a new information flow
  which does not simply overlap with others
• 
  . but
• moves towards constructing a fully integrated
  information system,
• . and
• adapts to different approaches adopted in the
  territories in line with the development of the
  local information system
• . in order to
• fill information gaps and merge information with
  that of the LHUs, the Region, ISTAT, the Ministry
  of Welfare

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Theoretical knots still left untied

• What information contained in the Regional Social
  Services Information System may be considered to
  be mandatory?
• Must a needs analysis examine a broader profile
  of needs or a prevalent need?
• Is it necessary to envisage a link between needs
  and services/interventions?
• When is patient care within the social health
  system considered to be complete?

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Some afterthoughts

• Individual social health professionals must be
  in a position to access information on their
  users at any given time works in progress
• Information on an individual and on a family
  nucleus must be collected and memorized only on
  one occasion
• It is important to consider the circular nature
  of some information among different services, to
  avoid double financing and to promote the joint
  management of a case ? CARE MUST BE TAKEN TO
  RESPECT PRIVACY LAWS

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Thank you for your
attention !
Alessandro Pigatto- Claudio Beltrame Direzione.ser
vizi.sociali_at_ulssfeltre.veneto.it Direttore.serviz
isociali_at_assl10.veneto.it