Summary
The Toulouse Gerontopole, a WHO Collaborating Center since 2017, put in place a deployment strategy of the WHO Integrated Care for Older People (ICOPE) program in the Occitanie region of France. The implementation of the program by the Gerontopole benefits from the support of Health Regional Agency of Occitanie and the Ministry of Health (Experiment ICOPE article 51). The objective is to enable as many seniors as possible to join the WHO ICOPE program and benefit from evidence-based care pathways that are integrated across health services and responsive to the needs and preferences of older people. Territorial deployment is based on the ICOPE MONITOR platform made up of digital tools (the ICOPE MONITOR app, the ICOPEBOT MONITOR conversational robot and the ICOPE MONITOR database) to facilitate the implementation of the 5 steps of the program and the ICOPE remote monitoring teams made up of health professionals to support seniors and stakeholders in setting up the program. As of December 31, 2022, 26,559 seniors have joined the ICOPE program through this deployment strategy.
Planning and Implementation
-
What was the challenge you were trying to address?
ICOPE is about preserving older people's independence for as long as possible by supporting the upkeep of their functional ability through health care that responds to their needs and preferences. Such care requires a holistic approach that integrates multiple health care services and disciplines together to form care pathways that place older people's needs at the centre instead of treating one disease or condition at a time. Integrated, person-centred care necessitates a fundamental reimagining of how we provide care for not just older people, but for everyone – and often requires a restructuring of our health care systems to better serve the needs of our populations.
-
Who were you trying to impact?
Older people in general
-
What sectors were you targeting?
Education, Health, Information and Communication, Long-term care
-
Who else was involved?
Government, Civil Society Organization, Older People's Association, Academia, Health Care, Social Care, Private Sector
-
How did older people participate?
Older people were part of the process at multiple or all stages
Lessons learned
-
Please describe how collaboration worked in your initiative.
To implement the ICOPE Care Program, we have developed several partnerships with institutions that work in the field of the older people and a number of targeted actions have started to facilitate the use of Step1 (self-screening test) by these institutions: - A partnership is set up with CEDIP (CEntre D'Information et de Prévention - Agirc-Arrco), which is a complementary pension fund in France, to carry out Step1 for their beneficiaries. To November 2022, 353 seniors have been assessed. - Departmental Council of Haute Garonne is a partner of the Toulouse Gerontopole. Their assessors were trained in June 2020 to carry out Step1 for all independent seniors who request them for a personalized autonomy allowance. - Several other actions were performed. A project was developed with the French Mutual Insurance, which brings together the majority of existing mutual health insurance companies in France, to disseminate information about this program to primary healthcare providers. The Federation of Health Homes of Occitanie (FORMS) was contacted to set up the ICOPE program in Health Homes. We are also collaborating with the Post Office and set up several experiments in different cities in Occitanie in order to carry out Step1 by trained postmen from the Post Office. To November 2022, 1090 seniors have been assessed. - A collaboration is developed with French National old age insurance fund (CNAV) to implement STEP1 within the usual professional practices of home caregivers and create an innovative and specific prevention offer for young precarious retirees (62-70 years old).
-
What was the impact of your initiative on older people, their families, and/or their communities?
Seniors and their families were quite satisfied with the ICOPE Care Program in a satisfaction survey carried out in 2021.
-
What issues did you face, and how did you address them?
3,000 seniors for whom an email address was available in the ICOPE MONITOR database received by email a survey regarding their level of satisfaction with several aspects of the ICOPE Care Program and 1,215 (40.5%) responded to the survey. The mean age was 72.5 years and 56% were female. The survey included questions on the use of digital tools, given the major role they played in the implementation of the ICOPE Care Program. Among the 1,215 responders, 52.5% (n=638) used digital tools in total autonomy, 6.8% (n=82) with the help of a caregiver or a family member and 40.7% (n=495) were assessed by a professional. Among those using digital tools in total autonomy or with the help of a caregiver or a family member (n=720): 49% (n=353) used the ICOPE MONITOR application and 51% (n=367) ICOPEBOT. 78% (n=563) were overall satisfied with the ICOPE Care Program and the digital tools they used.
-
What lessons did you learn from implementing this initiative?
No matter how efficient or effective a country's health care system may be at first glance, every country's health system always has room to improve particularly in adapting their services and practices to better serve older people and address complex health needs.
-
Do you have any other reflections you would like to share?
We have observed in practice that the WHO's ICOPE program is a valuable program that allows different professionals from different sectors to work together to promote the quality of life of older adults.