Healthcare on the Alentejo Coast has an innovative digital solution for the management of complex chronic patients

The Local Health Unit of Litoral Alentejano, EPE (ULSLA), in partnership with Inetum implemented a pioneering digital transformation project to optimize the monitoring of Complex Chronic Patients. Created in 2012, ULSLA began in 2016 to take the first steps towards implementing a Case Management program that was distinguished this year with the Top Health Award , in the Care Integration category.

ULSLA and Inetum implemented a solution to support the Case Management team with the aim of standardizing the clinical practice of monitoring these users, improving communication between different stakeholders and having centralized program management information.

The new system allows all ULSLA healthcare professionals to refer users to the Case Management program in a simpler and more integrated way. The hospital Case Management team, which coordinates and brings together the community teams, now has online access to information from the different users covered by this program and to monitoring the activity of the different community teams. Case Managers are able, based on the information requested on this platform and associated functionalities, to standardize clinical and case management practice among all users, regardless of the team, as well as improve communication flows, with various associated automations and manage care more coordinated and centralized.

”With the Case Management Program, which began in 2017, we have achieved very interesting results such as, for example, a 57 to 61% reduction in visits to the hospital emergency room and a 52 to 60% reduction in hospitalizations. ” highlights Cátia Albino, medical coordinator of the hospital team. “The implementation of this solution with Inetum allowed the computerization of this process and added significant improvements to the efficiency of this program with the aim of increasing the number of users served. It promoted standardization of clinical practice and case management, minimizing possible asynchronies between teams. The program coordination team now has permanent online access to essential information on each case, allowing real-time monitoring of the activity of community teams, as well as monitoring of referred cases – whether they are admitted to the program or rejected, whether they are complying monitoring indicators, among others”, says Adelaide Belo, Coordinator of the Case Management Program.

The solution also provides a WebApp for the user, or their caregiver, to monitor appointments, scheduled procedures, medication intake plans, individual care plans, among others. This promotes greater user adherence to the care plan and greater guidance in the various appointments with the health system.

“A centralized view of the user among all ULSLA health units is essential for good and efficient Case Management, with a view to closer, coordinated and centralized care. This solution represents a qualitative leap in proactive user monitoring and in the daily lives of Case Management nurses. Now we can more easily access essential information for patient monitoring, with alerts for missing contacts anywhere”, reinforces Vítor Gomes, Case Manager of the Odemira Health Center team.”

Pedro Gomes Santos, CEO of Inetum Portugal, states that: “ Inetum has four strategic alliances at a global level and it was with great enthusiasm that we implemented, using Microsoft solutions, a differentiated project, which contributes with notable benefits for both the Sector Public, by reducing the burden on the Health System, or for the Citizen, through closer and more coordinated monitoring of their health.”