What innovative care models and technologies could improve outcomes?
Challenges arising from growing demand for LTC and financial pressures are making policy-makers rethink how LTC is organised and delivered. Innovative solutions involving the use of new technologies and the personalisation of care offer a significant potential to improve the cost-effectiveness and sustainability of the system whilst improving the quality of life of users and their carers.
The European Commission has emphasised the role of Information and Communication Technologies (ICT) and more personalised LTC services as a mechanism to stimulate service innovation and improve quality of life for people with LTC needs. A body of evidence is emerging on the cost-effectiveness of technology-based interventions or personalised service models. However, the available evidence on new models of care is complex and sometimes contradictory. There is a lack of systematic information about cost-effectiveness and impact on outcomes as well as around the role and value of different interventions in specific contexts.
Central and local policy makers have significant hopes that technological solutions including telecare, telehealth, telemedicine, telecoaching and self-care applications will help improve the cost-effectiveness of the care system. ICT-based services are still underdeveloped in countries. However, as the cost of new technologies falls, wide scale adoption of technology is becoming increasingly viable and may provide a significant tool for the future sustainability of the health and social care systems. Technologies such as mobile health applications, decision support to access other professionals’ expertise, tools to prioritize and manage clinical workload, predictive analytics/risk stratification, patient-flow tracking systems or e-rostering, to mention few, can provide new resources and clinical management capabilities to improve cost-effectiveness of the health and care sectors.
Increasingly “personalisation” of LTC services is seen as a key mechanism to stimulate service innovation. Better fit between care packages with the needs and preferences of service users and their carers, is argued, leads to improvements in the quality of life of the people receiving the support and to a more cost-effective use of the limited resources available. Personal budget, direct payments and vouchers are seen by many governments as promising mechanisms to provide more personalised and cost-effective care; however there is evidence that their uptake is small and their impact on costs and outcomes in different contexts is still to be explored.