Care safely at home with digital support. Care pathway: COPD/Corona, Diabetes, IBD, Osteoarthritis and Osteoporosis

The care safely at home project using digital support for the COPD/Covid/Diabetes/IBD/Osteoarthritis and Osteoporosis care pathways is a project that is part of the JZOJP program. The aim is to keep a better track of 2nd line patients through remote monitoring and to be able to intervene earlier if necessary. These interventions should lead to a lower frequency of outpatient clinic visits, a shorter length of stay, a decrease in the number of readmissions, higher patient satisfaction, higher professional job satisfaction and, in the long term, a reduction in healthcare costs. This complies with the Quadruple-Aim principle. A project team has been formed for each care path, consisting of: A medical specialist, a nursing specialist or specialist nurse, a tactical and operational manager from the line, an internal process supervisor from the JZOJP program and an external implementation coach and patient council.