Towards hybrid care: the heart failure case – hospital and home


28 May 2021 - 28 May 2021


The workshop was opened by George Dafoulas (EHTEL), who delivered a short overview of hybrid care. He highlighted the role it can play in the health and care revolution – Health 4.0 (which is akin to Industry 4.0, the “fourth industrial revolution”). Presentations focused on hospitalisation@home. Today, hybrid care is seen as bring together “the best of both worlds”, virtual and physical.

Two presenters spoke. They were, first, Julie Vranken (Jessa Hospital) and second, Astrid van der Velde (Isala Heart Centre). Both are intensively involved in the NWE-Chance project where the focus is mostly on cardio-vascular disease and heart failure.

First, Julie Vranken told of how hybrid care is “still in its infancy”. Yet, this hybrid approach enables all sorts of organisational and technological improvements. She examined the testimonial of Hugo, an example patient, a user of a Hospitalisation@Home model that is patient-driven. Hugo has benefitted enormously from the widely-ranging support offered by this new service. Hugo’s nurses really appreciate using it too. The service enables Hugo to stay at home rather than having to make a hospital visit. Hugo enthuses, “I would definitely want to make use of (these) home care services in the future.” Organisationally, an easily-viewable dashboard located on a cloud-based platform portrays information based on many types of data. Technologically, patient’s vital parameters can be brought together while displayed in easy-to-use technologies, like weighing scales and wearables.

Second,  Astrid van der Velde  took the floor. She showed how the three hospitals involved in NWE-Chance are located geographically so close together and yet have very different local contexts. She outlined the challenges of how to select patients for the NWE-Chance initiative and what (digital and organisational) skills are needed by staff members. Hybrid care means that patients, doctors and nurses all have a lot of eHealth help at hand! Astrid assessed the kinds of legal, regulatory, and financial hurdles affecting hybrid care. She was keen to highlight the many lessons learned by the NWE-Chance initiative. It is anticipated that, in the future, the group’s collective experience will enable it to launch an innovation hub, through which they will share their many experiences with others.

The two presenters were joined by the Spotlights Telemedicine conference keynote speaker. A hospital doctor, Stefan Busnatu (Carol Davila University of Medicine and Pharmacy, Romania) is an enthusiast of artificial intelligence (AI). He drew attention to the work of the vCare project. He focused chiefly on what kinds of emerging technologies can support hospital care. Besides AI, other examples referred to included big data, tele-rehabilitation, and avatars/eCoaches.

Moderated by Diane Whitehouse (EHTEL), the discussion explored questions posed by the international audience from Asia and the Middle East. Attendees were interested in the practicalities. Can hybrid care handle the conditions of people with co-morbidities? What clinical protocols are used when an emergency occurs? What are the safety and security challenges?

The panellists outlined the key elements involved in advancing hybrid care in terms of organisation, technology, and finance or budget. Together they explored such issues as communication; education; patient safety; high-quality management; and reduction in the burden of care of healthcare professionals. In respect of technologies, the importance of both big data and “smart thresholds” were mentioned. In financial or budgetary terms, the presenters examined what would make hybrid care economically viable for low- and middle-income countries. To the fore were overcoming challenges related to reimbursement schemes/systems; the high costs of hospital square meterage and personnel costs; travel/transportation; and making infrastructures and networks available.

The session was wrapped up by George Dafoulas (EHTEL) who referred to exciting new developments in hybrid care in countries such as Greece, Norway, and India.


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