Integrated care is a key factor for the Basque healthcare strategy, where work has been underway for several years. In fact, it was presented as good practice in 2013 and 2016. Since then, the Basque Country has continued to work in this direction playing an active and committed role, and integrated care has continued to develop and make progress with the aim of improving health and quality of life of patients and citizens of the Basque Country, carrying out prevention action, fostering empowerment of patients and creating personalised plans for patients.
This strategy has created an integrated care model focused on people and patients capable of providing continuity of care both at health and social care levels. They have implemented new structures, processes and tools that have allowed us to meet the health needs of patients in the Basque Country, with a high degree of efficacy, efficiency and coordination between healthcare professionals and social workers.
Key components are:
- Integrated Care Organizations.
- Communication systems.
- Risk stratification.
- New nurses´ roles.
- Patient empowerment.
- Integrated pathways, including mental health.
- Health, social and community coordination.
2020 Internationalisation Framework Strategy , Strategic Plan of governance and innovation 2020 and 2020 Digital Agenda promote the digital transformation, including health and care. Digital skills development is another priority. Osakidetza’s digital transformation supports the use of ICTs in the health service, as a key enabler to provide better quality, more accessible and safer service. ICTs facilitate healthcare integration, collaboration between professionals and citizen empowerment.
Main digital tools, 100% deployed are:
- Osarean, e-health call center.
- Osabide Global, unified Electronic Health Record, including an Integral Program Manager (GIP).
- Osanaia, nursing care.
- Presbide, e-Prescription.
- Personal Health Folder, citizen access to their medical information.
- Osabide Integra, access from social-care.
- Risk stratification.
- Osakidetza Apps.
- Jakinsarea, professional training platform.
It is a proactive strategy to make living spaces more Age-friendly. Included in the Basque Active Ageing Strategy 2015-2020 , it enhances participation of citizens and public, private and social sectors. It is based on the World Health Organization initiative (WHO selected Euskadi Lagunkoia as a case study). It promotes the Age-friendly movement in villages, communities and cities around Basque Country. It is deployed at local level by town councils, associations, organizations, and citizens, as well as other Departments of the Basque Government.
The priorities of the program are:
- Consolidation, networking and exchange of good practices
- Evaluation the impact
- Participation among municipalities
- Promotion of Age-Friendliness in the area of health