1. Research Study Management Tool
PB2 will draft a Study named “Data Collection & Evaluation”. The output that will result from the implementation of this deliverable will be a Research Study Management tool. The output will be finalized at the 24rth month of the project implementation period.
This output includes the following actions for its finalization:
Target: 900 total sample analysis
- Data analysis
• Library and/or archival searches for materials relevant to the project, research and literature reviews.
• Advanced word processing documents with draft chapters of research summaries and content for the final publication.
• Summary of project reports, articles and existing research into a comprehensive document.
• Collaboration with project leader in complex data analysis for project use and publication content. - Research Study
• Coordination and scheduling data collection,
• Travel in the eligible regions to collect data,
• Observation of practice,
• Interviewing key stakeholders and conducting focus groups.
• Design of methodology and requirements,
• Design of different types of questionnaires-forms (medical history form, evaluation forms for trainees, evaluation forms for doctors)
• Data collection of questionnaires, forms and medical reports from the doctors examining in the medical unit
• Evaluation of the results – conclusions.
2. Mapping
The output that will result from deliverable 3.1 is the Mapping of needs, infrastructures & resources and will be finalized in the 8th month of the project implementation period.
LB will outsource this activity to an expert company. This company should have the adequate sources and resources to implement this crucial action in the most efficient way. Specifically, the contractor should have experience in the coordination of research teams (multi-national or multi-disciplinary) and experience in HTA for different diseases and settings.
Description
Population and social characteristics, epidemiological and clinical data will be collected, along with data about the resources used. All available public infrastructures (health and social services) will be assessed and described in a way that the decision-makers will be able to take any decision based on available evidence. Given that technology is expected to play a significant role in this project, improving the access of isolated and poor communities to the primary and preventive health care, an appropriate assessment framework should be used, in accordance with international best practices. Needs and provided services by all the available healthcare units will be assessed by a multidisciplinary team experienced in the evaluation of eHealth projects and the assessment of healthcare services both in Greece and in other European settings.
Moreover, the developer of this deliverable, will also be able to perform an economic evaluation from the perspective of EOPYY (lead partner and payer of the healthcare services for more than 95% of the Greek population) and to suggest the indicators which should be monitored to continually assess the needs, the resources used and the performance of the provided services. The performance concerns the impact of the provided health and social services on the target population (which is expected to benefit from them), the decision-makers, health and social care professionals who expect that they will reduce the use of resources and consequently workload and expenditures. If this target will not be achieved, a reallocation of the resources may be necessary to improve the efficiency of the health care system in the cross-border area. All these data/indicators will be collected systematically with the objective to support the development of an easy-to-use, unified database to support the strategical design of health care services in
The main objective of this task is to support decision-making by assessing the healthcare needs of the population living across borders, the available to them infrastructures and the resources they use. Special focus will be given to the most vulnerable groups of this population, such as children and elderly women. This knowledge will allow responsible organizations and decision-makers to plan and organize better the health care system across borders. Moreover, it is necessary to invest public money efficiently and provide cost-effective services, especially to the citizens they need them more, reducing the apparent inequalities. The project partners will use this deliverable to design better preventive health programs, to further enhance the health services needed more and, possibly, to reallocate resources to be used more efficiently.
3. Educational programs(3)
3.1 Educational program for general population, is the first axis of intervention. The First Axis refers to educational programs in the field of preventive medicine for general population, parents and vulnerable groups who live in the regions of implementation.
Greece (LB and PB2)
The first axis will focus in two areas:
a) Education about health issues for women including breast, ovarian and uterine cancer and screening principles and benefits and
b) Common medical emergencies affecting children and elders.
Target group: General Population (300 persons trained during this educational program)
Introduction and purpose of the activity
Detecting cancer early is critically important because, if effective treatment is provided, the burden of both illness and death can be reduced. Improvements in cancer treatment and early detection have resulted in a steady drop in breast cancer mortality rates since the early 1990s, but additional efforts are necessary to ensure that this trend continues. The same applies for the gynecological cancer. Public education about screening methods of breast and gynecological cancer and the need for regular checkups will potentially increase enrollment of women in the screening programs. The obvious benefits will be early detection of female cancer and therefore early treatment and better prognosis. Last but not least, reduction in mortality and morbidity rates.
Public education about common medical emergencies affecting children and elders will help reduction in mortality and morbidity rates and improve the quality of life of children and elderly.
These educational programs will have the form of seminars (8) with a 4-hour duration and will be held in all eligible Regional Units of Regions of Western Macedonia as well as Central Macedonia. More specifically, three seminars will take place in the Regional Unit of Thessaloniki, two seminars in the Regional Unit of Pella, one seminar in the Regional Unit of Florina, one seminar in the Regional Unit of Kilkis and one seminar in the Regional Unit of Serres.
North Macedonia (PB5 and PB6)
PB5 and PB6’s priority is to deliver educational programs in the field of preventive medicine for women, especially education about health issues for women including breast, ovarian and uterine cancer and screening principles and benefits. The morbidity and mortality from non-communicable diseases is constantly raising therefore, early detection of cancer is critically important because, if effective treatment is provided on time, the burden of both illness and death can be reduced. The same applies for the gynecological cancer. Public education about screening methods of breast and gynecological cancer and the need for regular checkups will potentially increase enrollment of women in the screening programs. The benefits will be early detection of female cancer and therefore early treatment and better prognosis, as well as reduction in mortality and morbidity rates.
Trainings will be conducted in the same places as the Info days: Gevgelija, Stojakovo, Bogdanci and Dojran. The target group is the female population, aged between 35 and 60. Approximately 100 persons per place. Each of educational trainings will last approx. 3-4 hours.
3.2 Educational program for local doctors, is the second axis of intervention. Key factor of the fourth package are the Educational programs for doctors resulting in the strengthening of the skills of the local doctors.
The Second Axis refers to educational programs which aim to train the healthcare professionals who work in the regions of implementation. These educational programs will be more advanced in comparison with the educational programs in the first axis, with more specialized subjects in the sphere of breast cancer and gynecological cancer, prevention of diagnosis and treatment. Furthermore, in the context of these seminars, the LB will inform the healthcare professionals who work in the regions of implementation regarding the operation of e-Platform.
Greece (LB and PB2)
These educational programs will have the form of seminars (8) with a 6-hour duration and will be held in all eligible Regional Units of Regions of Western Macedonia as well as Central Macedonia. More specifically, three seminars will take place in the Regional Unit of Thessaloniki, two seminars in the Regional Unit of Pella, one seminar in the Regional Unit of Florina, one seminar in the Regional Unit of Kilkis and one seminar in the Regional Unit of Serres.
Target group: Local doctors (200 local doctors trained during this educational program)
North Macedonia (PB4, PB5 and PB6)
The pilot screening program for early detection of breast cancer and cervical cancer is aimed for women in the regions of Bitola and Gevgelija.
PB4 will engage 4 persons (2 specialists in radiology and 2 radiology technicians with experience in breast cancer screening programs) from University clinic from University clinic for Radiology ,Skopje, General City Hospital 8-th September Skopje and University Clinic Naum Ohridski, Skopje to provide advanced training on best practices related to examination and early detection of breast cancer. Training will be conducted in the above-mentioned health institution.
Target groups for this educational program will be 8 radiotechnologists and 6 radiology specialist that are working on examination of breast cancer in health institution in Gevgelija and Bitola: 2 doctors and 3 technicians from Gevgelija and 4 doctors and 5 technicians from Bitola. They will receive advanced training on the project and on the best practices related to examination and early detection of breast cancer. In order not to jeopardize the normal functioning of the hospitals and not to create obstacles in providing health care services for the patients in both hospitals, they will be divided in 4 groups. Duration of the training will be 5 working days (full working time).
3.3.Practical Training on mannequins, is the third axis of intervention and will be carried out solely by PB2 in the Greek side of the borders.
The third axis will focus in two areas:
a) CPR and choking first aid (infant/child CPR) courses
b) CPR and choking first aid (elder CPR) courses
Target group: parents and caregivers. These two groups of people should be encouraged to take CPR and choking first aid courses in order to be ready to provide help to the infants and children (100 persons trained in CPR and First Aid).
The Third Axis aims to improve the skills of ordinary people in emergency and rescue services.
Educational programs will have the form of seminars for small groups (8 – 10 people), organized by PB2. These educational programs will have the form of seminars (10) with a 6-hour duration and will be held in all eligible Regional Units of Regions of Western Macedonia as well as Central Macedonia. In particular, two seminars will take place in the Regional Unit of Thessaloniki, two seminars in the Regional Unit of Pella, two seminars in the Regional Unit of Florina, two seminars in the Regional Unit of Kilkis and two seminars in the Regional Unit of Serres.
These seminars will be organized by medical experts with academic (at the postdoctoral level) and teaching experience. Teaching experience must be in the field of first aid in an academic institution (university or technological educational institution).
4. E-Platform
An electronic platform will be created by LB in WP5, which consists of three basic subsystems fully interconnected.
Contribution of PB4, PB5 and PB6:
The Ministry of Health has established a national E- health system called “Moj termin”, which is implemented and used in all health institutions and institutions from all segments of health care. However, the newly created e-Platform should be compatible with the national system Moj termin. Thus, the personnel working in the E-health directorate will meet with the experts engaged in the development of the platform in order to be informed on its architecture, technical and functional characteristics, and all distinct parts of this information system. Additionally, they will provide relevant data needed to the consultants on the national E health system (involvement of PB4, PB5 and PB6).
General description
The platform is the central interface of users with applications and other subsystems and the basic channel for the provision of digital services. The platform completes in a single operating environment the entire subsystems of the information system. The access of a specific user group to the platform is accomplished through an appropriate certification mechanism and each user has access to the applications of his responsibilities and to the services that concern him.
The implementation of this project has advantages, such as:
1. Added value in the existing Health Insurance File by enriching data from other countries (hospital information, medication, diagnostic test results, etc.)
2. Possibility of statistical reports relating to cross-border care
3. The cooperation of Greece with North Macedonia can act as a “pilot” project, which then spreads to other countries
The aim is to create a system that will include three basic subsystems fully interconnected:
1. Register Health Professionals
Health professionals will be registered on the basis of specific criteria:
• Specialty
• Years of experience
• Coverage area
• Payroll
• Hours of home visits
• Supplied equipment (e.g. portable cardiograph, pressure gauge, thermometer, etc.)
2. Application for the observation of patient and the record of visitors
This app is for healthcare professionals and can be installed on a portable device (e.g., tablet, smartphone) to follow the doctor on home visits.
With this application, the doctor will be able to keep track of history and patient history (electronic dossier). It will also be linked to EOPYY’s e-prescription system.
3. Application for the selection of doctors
This application is addressed to users (patients) who wish a visit of doctor in their home, either due to inaccessible hospital access or for any other reason.
The user can choose from predefined search criteria (e.g., experience, range, price range, desired time of visit) and choose a specialty or describe his problem and the application will refer him to the corresponding specialty.
Health professionals who are linked to the application and will accept the patient’s call will be required to go to the patient’s home within a predetermined time (e.g., 3 hours).
5. A fully equipped mobile unit
The Mobile medical unit for children and elderly includes the following independent departments: Audiology, gynecology, breast surgery, general practice and ultrasound.
A) Participants
• Elderly men and women.
• Children. Only children who are accompanied by parents / guardians / educators and signed a relevant consent form are subject to screening.
Target group: 300 persons (women & children) examined in the mobile unit.
Β) Operation
This Mobile Unit will operate in all eligible Regional Units of Regions of Western Macedonia as well as Central Macedonia. More specifically, the Mobile Unit will travel two times in the Regional Unit of Thessaloniki (two different places), two times in the Regional Unit of Pella (two different places), two times in the Regional Unit of Florina (two different places), two times in the Regional Unit of Kilkis (two different places) and two times in the Regional Unit of Serres (two different places).
The Project’s Mobile Unit, which will be acquired by PB3 (in order to ensure the sustainability of project’s outputs), will operate under the auspices of PB2. The work-team for the implementation of this Activity will consist of:
• A Gynecologist specializing in breast cancer (LPM, Dr. Zafrakas)
• A Gynecologist specializing in gynecological cancer
• A MD Radiologist
• A General Doctor
• An Otolaryngologist
These doctors and the auxiliary staff (driver and secretary – contact person) will provide health services to the Project’s target groups ten times in 10 different areas (eligible areas). Each trip will last two days. Therefore, the total operation of the Mobile Unit will be 20 days.
