Technical Implementation: 116 117
Non-Emergency Medical On-Call Service in Germany
National Association of Statutory Health Insurance Physicians (KBV) 8th April 2013 . 116 117 . page 2
Agenda „116 117“
1. Germany’s On-Call Service 2. European Call Number 3. Implementation 4. Media Coverage 5. First Results 8th April 2013 . 116 117 . page 3
Agenda „116 117“
1. Germany’s On-Call Service 2. European Call Number 3. Implementation 4. Media Coverage 5. First Results 8th April 2013 . 116 117 . page 4
Statutory Ambulatory Health Care in Germany Unique system approach includes specialist care and medical on-call service
Self-Government Medical On-Call Service
• statutory body under public law • universal ambulatory health care provision
• federal organisation: 17 Associations of • health care provision: Statutory Health Insurance Physicians (ASHIPs) - outside regular consultation hours - weekdays and weekends • 148.000 physicians and psychotherapists in - non-emergency 93.000 practices
• direct participation in sub legal regulation
• legal supervision by Federal Ministry of Health • 3.9 million on-call patients in 2009
• 500.000.000 reimbursement claims • 7.0 – 8.0 million on-call contacts (phone)
• 32 billion Euros reimbursement per year
24/7 provision of medical (on-call) service by ambulatory physicians 8th April 2013 . 116 117 . page 5
First Resolution for European On-Call Number in 2006 National Assembly of SHI-physicians
National Assembly On-Call Phone Number
1. implementation of a nationwide call number for ambulatory medical on-call service
2. access for all patients outside regular consultation hours
3. access for all means of telecommunication
4. free of charge
5. preservation of regional organizational structures for on-call service
6. installation of a call-center structure meeting special needs of patients
7. high quality and reliability of service 8th April 2013 . 116 117 . page 6
Agenda „116 117“
1. Germany’s On-Call Service 2. European Call Number 3. Implementation 4. Media Coverage 5. First Results 8th April 2013 . 116 117 . page 7
Germany‘s Call for a European On-Call Number 3-step approach for implementation
Number Reserved for Harmonised Services of Social Value Assignment of 116 117 to NASHIP
Harmonised Services of Social Value German Federal Network Agency
1 reservation at European level
2 assignment at national level
3 technical implementation
reserved numbers to date • 116 006 helpline for crime victims • 116 111 helpline for children • 116 117 non-emergency medical on-call service • 116 123 emotional support helplines
already implemented numbers • 116 116 Cancelling lost or stolen electronic cards • 116 111 helpline for children
EU regulation facilitates single European phone number for harmonised services of social value
Source: Bundesnetzagentur 8th April 2013 . 116 117 . page 8
Germany‘s Call for a European On-Call Number 3-step approach for implementation
Number Reserved for Harmonised Services of Social Value Assignment of 116 117 to NASHIP
Harmonised Services of Social Value German Federal Network Agency
1 reservation at European level
2 assignment at national level
3 technical implementation
reserved numbers to date • 116 006 helpline for crime victims • 116 111 helpline for children • 116 117 non-emergency medical on-call service • 116 123 emotional support helplines
already implemented numbers • 116 116 Cancelling lost or stolen electronic cards • 116 111 helpline for children
EU regulation facilitates single European phone number for harmonised services of social value
Source: Bundesnetzagentur 8th April 2013 . 116 117 . page 9
Agenda „116 117“
1. Germany’s On-Call Service 2. European Call Number 3. Implementation 4. Media Coverage 5. First Results 8th April 2013 . 116 117 . page 10
No Nationwide On-Call Structure in the Past Heterogeneous on-call service: over 1,000 telephone numbers for on-call service in 2010
ASHIPs Structure
central call centre Regional Organisation of the Medical On-Call Service hybrid forms Schleswig- Holstein • responsibility within each ASHIP direct call MD Mecklenburg- Vorpommern • exemplary forms: Hamburg - central ASHIP-unit Bremen Berlin - district office Lower Saxony - self-administration by physicians • no nationwide phone number Brandenburg Westphalia- Saxony- Anhalt Lippe contacting process North Rhine Saxony • central call-center Thuringia • local call-center Hesse • number at district level F Rheinland-Pfalz • local telephone numbers of physicians
Saarland availability Bavaria • outside regular consultation hours
Baden- • high variability within each on-call area Wuerttemberg Medical on-call service lies within the competence of regional ASHIPs
8th April 2013 . 116 117 . page 11
High Volatility of Service during Peak Seasons 8 million calls for on-call service in Germany each year with peaks at Easter and Christmas
Prognosis (Number of Calls) Volatility
Mio calls/ year 7 Calls/ hour Peak day 6 Saturday Weekday 5
4
3
2
1
0 2011 2012 2013 2014 2015 2016 2017 0h 2h 4h 6h 8h 10h 12h 14h 16h 18h 20h 22h 24h
Estimated total after full proliferation: 8 million calls per year 8th April 2013 . 116 117 . page 12
Needs of Patients & Physicians not Always Technically Feasible Scoping & defining technical requirements
Topic Requirement Specification
availability • technical availability 24/7 • redundancy of technical solution • number activation in all public • two call-centers networks
routing 116 117 & • technical routing to region in charge • establishment of a national database geographical localization • routing also for disabled call number • localization of mobile calls • data protection law
manageability for on-call • possibility of short notice change • technical coordination physicians (phone number) • web-application • personal contact person • 24/7 service-number for physicians
emergency calls (112) • forwarding of errant calls to medical • connection to all rescue coordination emergency line centres in Germany • medical trained call-center personnel
large-scale emergency • technical solutions in case of a • contingency plan (regional) disaster
misuse • prevention of pranks or • selective blocking of phone numbers tests of courage
8th April 2013 . 116 117 . page 13
Linking-up Patients and Physicians First step: localisation of patient and mapping to physician on duty
Call Matching on-call district Matching physician Transmission
• area code • ~1.000 on-call districts • matching location of • transmission to • postal code • 5.200 area codes patient with medical medical on-call • address • 12.300 municipalities on-call service unit service • 29.630 postal codes in charge
on-call location Bezirkdistrict 451 xyz X
technical prerequisites map of on-call allocation table districts (daily) 8th April 2013 . 116 117 . page 14
Call-Centre: Indispensable for Calls without Automatic Routing: Specific technical solution for all three channels of telecommunication
Landline Matching successful: transfer Carrier No match No
Matching not successful: Forwarding to Call Center area code check Mobile call service - Inquiry postal code Inquiry of medical on
Software solution
Table of correspondence
Data import
Non-recurring import
Web portal – Data management of medical on-call services
8th April 2013 . 116 117 . page 15
Digitalized Mapping of On-Call Areas in Germany Transformation of Manual maps
Manual Map (Power Point) Digital Geographical Mapping
Approximately 1000 on-call areas in Germany 8th April 2013 . 116 117 . page 16
Database Development Grouping of municipalities, areas and postal codes with corresponding medical on-call service units
Database Content
BZ BD Bereich BUNDESLANLANDKREIS GEMEINDE OKZ 6 AUR BD Emden Niedersachs Emden Emden 3402000 for each of 1000 on-call areas: 6 AUR BD Großefehn / WiesNiedersachs Aurich Grossefehn 3452006 6 AUR BD Großefehn / WiesNiedersachs Aurich Wiesmoor 3452025 6 AUR BD Großheide Niedersachs Aurich Grossheide 3452007 6 AUR BD Hage Niedersachs Aurich Grossheide 3452007 6 AUR BD Hage Niedersachs Aurich Hage 3452008 6 AUR BD Krummhörn Niedersachs Aurich Krummhörn 3452014 6 AUR BD Landkreis WittmuNiedersachs Wittmund Blomberg 3462001 • federal state 6 AUR BD Landkreis WittmuNiedersachs Wittmund Esens 3462003 6 AUR BD Landkreis WittmuNiedersachs Wittmund Friedeburg 3462005 • municipality 6 AUR BD Landkreis WittmuNiedersachs Wittmund Neuharlingersiel 3462010 6 AUR BD Landkreis WittmuNiedersachs Wittmund Westerholt 3462018 • telephone area code 6 AUR BD Landkreis WittmuNiedersachs Wittmund Wittmund 3462019 6 AUR BD Leer Niedersachs Leer Leer (Ostfriesland 3457013 • postal code 6 AUR BD Norden Niedersachs Aurich Norden 3452019 • holidays (date) 6 AUR BD Papenburg Niedersachs Emsland Dersum 3454007 6 AUR BD Papenburg Niedersachs Emsland Dörpen 3454008 • bridge days (date) 6 AUR BD Papenburg Niedersachs Emsland Heede 3454020 6 AUR BD Papenburg Niedersachs Emsland Kluse 3454025 • opening-hours Monday – Sunday 6 AUR BD Papenburg Niedersachs Emsland Papenburg 3454041 6 AUR BD Papenburg Niedersachs Emsland Rhede (Ems) 3454044 • opening hours holidays 6 AUR BD Rheiderland Niedersachs Leer Jemgum 3457012 6 AUR BD Rheiderland Niedersachs Leer Weener 3457021 • emergency contact numbers (2nd line) 6 AUR BD Sögel Niedersachs Emsland Börger 3454005 6 AUR BD Sö l Ni d h E ld Et 3454011 • MD-contact number for patients
8th April 2013 . 116 117 . page 17 76% of Patients’ Calls Can Be Routed Directly to a Regional On-Call Service Unit
Landline Matching successful: Forwarding Carrier No matching No Matching not successful: Forwarding to Call Center area code check Mobile Successful area code allocation call service - Query code of Query postal medical on
Software solution
Table of correspondence
Data import
Non-recurring import
Web portal – Data management of medical on-call services 8th April 2013 . 116 117 . page 18 91% of Patients’ Calls Can Be Routed Directly to a Regional On-Call Service Unit
Landline Matching successful: Forwarding Carrier No matching No Matching not successful: Forwarding to Call Center area code check Mobile Successful postal code allocation call service - Query code of Query postal medical on
Software solution
Table of correspondence
Data import
Non-recurring import
Web portal – Data management of medical on-call services 8th April 2013 . 116 117 . page 19
8th April 2013 . 116 117 . page 20
Further Tasks during Implementation… …launch of service: 16th April 2012
2010 2011 2012 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12
1 EU inception 116 117 15.06.12: award German allocation Roll-out Number allocation 116117 16th April
2 01.06.12: results 2012 - Pilot Spezi
fication Service requirements
01.06.12: call 25.07.12: award
3 - Call for EU-wide tenders EU tender 4
- 1. System specifications 2. Internal roll-out Imple
mentation 3. Testing
5 Consulting 09.12: revision
Data protection legislation Public affairs
Monitoring Internal communication Public relations 8th April 2013 . 116 117 . page 21
Agenda „116 117“
1. Germany’s On-Call Service 2. European Call Number 3. Implementation 4. Media Coverage 5. First Results 8th April 2013 . 116 117 . page 22
Marketing Campaign and Target Groups
2011 2012
7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12
ASHIPs Roll-out 16th April physicians 2012 social-professional organi- sations (e.g. GMA) politicians on regional and federal level patients' organizations, health insurance funds
media
general public
Intensity 0 100 8th April 2013 . 116 117 . page 23
Wide Marketing Campaign Promoting 116117 Additional marketing efforts by regional ASHIPs
Website: www.116117info.de Stickers, cards and posters 8th April 2013 . 116 117 . page 24
Supply of Flyers and Patient Information in Several Languages Telephone number aims at non-German speaking persons too
Patient information (EN) Flyer (EN) 8th April 2013 . 116 117 . page 25
Agenda „116 117“
1. Germany’s On-Call Service 2. European Call Number 3. Implementation 4. Media Coverage 5. First Results 8th April 2013 . 116 117 . page 26
Over 3 Million Calls Have Been Routed in the First Year of Service 116 117 – a success story
Number of weekly calls
250.000 Mobile networks (21%) 200.000 High Landline 150.000 (79%) Flu activity Moderate Composition 100.000
20,4% 50.000 Low
0 41% 15% KW 16 KW 18 KW 20 KW 22 KW 24 KW 26 KW 28 KW 30 KW 32 KW 34 KW 36 KW 38 KW 40 KW 42 KW 44 KW 46 KW 48 KW 50 KW 52 KW 02 KW 04 KW 06 KW 08 KW 10 KW 12 Apr. May Jun. Jul. Aug. Sep. Oct. Nov. Dec. Jan. Feb. Mar. Landline Mobile networks Usage call center
About 4.0 million calls are expected in 2013 8th April 2013 . 116 117 . page 27
Broad and Positive Media Coverage since Launch of Service
8th April 2013 . 116 117 . page 28
Thank you!
http://www.kbv.de E-Mail: [email protected] http://www.116117info.de 8th April 2013 . 116 117 . page 29
Backup 8th April 2013 . 116 117 . page 30