Isolated but well assisted

A conference organised by DIPLOCAT and the Catalan ministries of Health and Social Rights focuses on the issue of integrated health and social care in sparsely populated areas

DIPLOCAT and the Government of Catalonia´s ministries of Health and Social Rights have organised today a conference in Barcelona entitled Isolated but Assisted. Integrated health and social care in sparsely populated areas: exchange of good practices and innovation processes. The goal of the conference was to incentivise the study and exchange of international best practice models applicable to health and social care in remote or sparsely populated areas of Catalonia, thus contributing to geographical levelling up and the fight against depopulation.

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The first to welcome the attendees was Aina Plaza, Director General of Health Planning and Research at the Catalan Ministry of Health, who said that integrated care is one of the major challenges of her Ministry and that the collaboration with DIPLOCAT allows them to get to know first-hand international experiences of good practices and move forward in the right direction. For her part, the secretary general of DIPLOCAT, Laura Foraster i Lloret, also referred to this collaboration and mentioned the study trip to Sweden that took place in September 2023. This visit allowed to have a close look into a very specific innovative experience in the field of socio-health care and the use of new technologies in a remote and difficult to access area such as the Västerbotten region.

After the institutional welcome words, the presenter of the event, journalist Isaac Romero, gave the floor to Tino Martí, digital health facilitator at EHTEL (European Health Telematics Association), who spoke about the key policy trends and the implementation of digital transformation and integrated care in Europe. According to Martí, one of the major challenges that European countries have been facing for years is to make patients' medical data accessible and shareable, always respecting local current regulations. In this sense, he explained that Catalonia and its digital health application "My Health" (La Meva Salut) are currently a leading model. When it comes to learning from others and analysing international models, Martí insisted on the importance of not replicating them, but transferring and promptly adapting those good practices that are considered appropriate.

Two round-table discussions followed. The first looked at innovative experiences from Sweden, Scotland, Finland and Catalonia, and how they use digital tools in the health and social care sectors to facilitate their work in remote areas. Participants were Monica Walhström, Social Services R&D Strategist in Västerbotten (Sweden); Donna Henderson, Head of International Engagement for the Scottish Government's Health and Social Care Finance, Digital and Governance Directorate; Vesa Jormanainen, Senior Ministerial Advisor at the Ministry of Health and Social Affairs, Government of Finland; Joan Carles Contel, responsible of Integrated Health at the General Directorate of Health Planning and Research of the Catalan Ministry of Health; Rosa Fumàs, responsible for the Digital Transformation Plan for Basic Social Services of the Catalan Minister for Social Rights; and Fernando Leeson, Director of the Digital Transformation Unit at TIC Salut Social Foundation.

One of the recurrent themes of this first round table was the aging of the population, which means that the needs for health and social care increase and extend over time. To respond to these needs, however, there is a general widespread lack of qualified medical, nursing and social assistance staff, and even a lack of unqualified staff, as in the case of northern Sweden. Faced with the increase in needs and the lack of staff to attend them, digitization becomes essential. As the Scottish representative said, "necessity is the mother of invention", and in this case innovation involves finding digital and technological solutions, whether automatic medicine dispensers, robot-chairs to be able to shower without external help or automated mechanisms that help people get out of bed if they are unable to do so autonomously. Finally, the Catalan representatives of the ministries of Health and Social Rights exposed the problems inherent in the fragmentation of data and services, and how they are working together to overcome them.

The second round table examined the specific measures that are being implemented to achieve quality health and social care in rural and sparsely populated areas. The different sectors involved in Catalonia were represented, including social organisations, local authorities, and also the responsibles for the social and health care at the remote Aran Valley. Participants were Carme Ferrer, Mayor of Senan (Conca de Barberà), member of the Tarragona Provincial Council and President of the Small Municipalities Forum in the Catalan Association of Municipalities (ACM); Marta Burgell, representative of the Catalan Mental Health Federation (Third Sector Platform of Catalonia); Maria Àngels Borràs, Director of the Aranese Health and Welfare Service; and Jordi Vilana, Managing Director of Aran Salut.

The interventions of the two representatives from the local and social entities served to put on the table the real problems of everyday life, sometimes ignored in government's strategic plans. The mayoress of Senan, for example, said that digitization can indeed be used to overcome geographical distances, but that it must be borne in mind that in Catalonia there are still areas with connectivity problems, aside from the digital gap that mainly affects older people. For her part, Marta Burgell warned that there are large areas of the country where the demands for social and health assistance are very high and resources are very limited, and that often the needs can only be met thanks to volunteerism. She was in favour of technological solutions, but she asked that they come with human support and a comprehensive look at the problems they want to solve. The two representatives of the Aran Valley explained the idiosyncrasies of their territory, "dispersed and isolated like few", and presented their specific integrated care model.

On the other hand, and as part of its international visitors program, DIPLOCAT has collaborated with the "DICARE Twinning Project" of the Catalan Ministry of Health. Between 8 and 10 May, Donna Henderson and Vesa Jormanainen have carried out a series of visits and meetings with representatives of the Ministry of Health and have been able to share experiences and knowledge about the digital transformation of the respective social care and health services.

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