Implementing integrated care in Twente to support vitality among chronically ill people

In 2019, healthcare partners in Twente decided to act upon the growing number of lifestyle related chronically ill people in our region. 

Why? Chronic diseases put a high burden on patients’ quality of care and healthcare costs, while many of the lifestyle related diseases can be better managed or even prevented when citizens become more in control over their own health. Also, less health care personnel will become available to treat all these people. This developments force us to come up with new approaches, making it possible to treat and support citizens more efficiently and in a personalized manner. Clearly, a (mind) shift is needed, among our citizens ánd healthcare professionals, from care to prevention, self-management and cure. To support people’s vitality, despite their illnesses, to improve happiness, mobility and overall quality of life. Also, the current covid-19 situation further underlines the need for more flexible and remote possibilities for care.

How? eHealth may help to treat and support more people in less time. At the same time, eHealth can empower patients in self-managing their disease and supporting vitality. In Twente, it is our ambition to improve the availability and use of proven personalized eHealth interventions integrated into treatment of people with, or at risk of, chronic lifestyle related diseases. The project consists of concrete activities:

1. 1. Developing selection criteria for eHealth technologies
2. 2. Choosing eHealth to be implemented in Twente
3. 3. Preparing implementation; describing new care pathways, including new ways of inter-agency cooperation
4. 4. Pilot implementation in a small setting
5. 5. Evaluation and scaling-up

At each activity, we involve patients, professionals and stakeholders on a management level to ensure commitment to plans and its execution in the regions. Throughout the project, we work on dissemination of the project results to stakeholders, patients and the general public. For example, via regional webinars.

Who are involved? Stakeholders in our project are patients with a chronic lifestyle related disease, starting with type 2 diabetes, regional healthcare partners, such as physicians, nurses, general practitioners, lifestyle coaches, dieticians, etc. Together we work on translating our ambition into practice.

The first intervention: Changing Health! In 2020, Changing Health for people at risk of diabetes type 2 was launched in Twente. Changing Health is an online environment which has been proven effective in the United Kingdom. Participants receive personal information about health and lifestyle, they can monitor their progress and interact with their personal coach. Each participant determines his own goals, in consultation with the coach. This program aims to help participants to lose weight to lower the risk of developing type 2 diabetes.