How policies support patients in their own home in the Region of Southern Denmark

Purpose: The Region of Southern Denmark (1.2 million citizens) is experiencing an increase in the number of elderly citizens with chronic conditions. These demographic changes require a new way of providing care for the citizens, empowering and involving them in their own care. The national policies ensure coherence when treating patients with chronic conditions and support them in their daily lives. These policies have influenced the regional strategies and action plans. Context: Whereas the National Strategy for Digitalization of the Health Care Sector 2013-2017 [1] focuses on creating coherence across health and social care sectors and ensures individualized treatment, the Public Strategy for Digital Assisted Living 2013-2020 [2] focuses on creating a better foundation for standardisation of effective digital assisted living solutions assisted by the National Action Plan from 2012 [3] that focuses on the nationwide implementation and evaluation of telemedicine. The Region of Southern Denmark (RSD) has on the basis on these created Regional Health Agreements 2015-2018 [4] that ensures coherent and improved care for the patients in the region. These are implemented in daily workflows between health and social care providers as they focus on cross-sector collaboration and the ICT support of this to empower citizens. Methods: The national and regional guidelines are reflected differently in the health and social care system. When a patient enters the health and social care sector, his/her treatment will be managed according to agreements and care pathways for chronic conditions to ensure coherent care. Furthermore, electronic messages are sent between the relevant care professionals by MedCom messages reflecting the electronic infrastructure connecting care professionals and ensuring that relevant information about the patient is available at a consultation. A new shared medical record will ensure a better overview of the prescribed medication for a patient regardless of which sector he/she is treated in. Several regional projects reflect and support the vision of the policies e.g. use of telemedicine in psychiatry and ulcer treatment, as well as the established CoLab Denmark that tests and implements solutions supported by national and regional policies.