Jul 9, 2025

Iolanda Moragues Casabón began by contextualising the role of the Barcelona Provincial Council, a super municipal institution that provides technical, economic and technological support to the 311 municipalities in the province of Barcelona. Nearby municipalities in the provinces of Girona and Lleida have also been added to this network, due to proximity criteria, bringing the total number of municipalities it supports is 315. However, Barcelona is not part of the provincial telecare service, as it has its own management.

The province of Barcelona represents 24% of the Catalan territory, but concentrates 74% of the population of Catalonia, with more than 5.7 million inhabitants. This reality forces us to pay special attention to territorial equity, since a wide variety of municipalities coexist in the province: from 185 municipalities with less than 5,000 inhabitants, to large cities such as Hospitalet de Llobregat, the second most populous in Catalonia.

The Provincial Council decided to take over direct management of the local telecare service to ensure equal access for everyone across the region. They’re now responsible for setting the service model, handling the tendering and contracting process, overseeing quality, and covering between 40% and 47% of the service costs. Meanwhile, the local municipalities still own the service, refer users, manage individual cases, and fund the remaining 53%. The service itself is delivered by a selected provider, which brings in the staff, technology, equipment, and R&D needed, operating under a public-private partnership model.

In Catalonia, telecare is included in the basic portfolio of social services. Although legally municipalities with more than 20,000 inhabitants and county councils should be in charge of its management, the Provincial Council has chosen to provide the service directly to all municipalities, regardless of their size.

"As of May 15, the service supports 117,773 people. Every day, more than 45 people call simply to talk; every five minutes someone calls for help, and every two hours a mobile unit is activated for an emergency. There are mobile first and second response units distributed throughout the territory. In addition, more than 2,200 people receive a daily call, more than 143,000 home visits are made annually, and at least one possible case of abuse or suicide risk is detected daily, thanks to specific detection and action protocols".

The service, launched in 2005, will celebrate its 20^th anniversary in 2025. Since then, it has experienced strong growth: in its first year, it served 3,819 people, while in 2023 the net increase was 9,000 people, and in 2024, there has already been an increase of 8,000. This growth has been accompanied by the incorporation of more preventive profiles, reflecting a more proactive approach.

"Currently, the Provincial Council is immersed in a digitalisation process. In its beginnings, telecare consisted of a remote alarm system; In 2017, the personalisation of the service was reinforced, and in 2021 it opted for proactive telecare. Today, the focus is on moving towards predictive and cognitive models."

The contract in force since 2021, which is about to end, has already made it possible to digitalise 60% of homes. In addition, two pilot projects have been launched that integrate artificial intelligence:

• “Tot en un sensor”: a sensor system installed in the homes of people who live alone. Through motion, temperature, humidity and light sensors, connected to a central platform, daily routines are monitored. When a change is detected that becomes a trend, an alert is generated, and a home visit is triggered. This system allows for early detection of cognitive impairments, mental health problems or situations of isolation.
• Intelligent alert and assessment system: based on Big Data analysis, it does not require physical sensors and can be applied to all users. It allows for improving efficiency in periodic revaluations of the service (every six months). In a pilot test in two regions (one experimental and the other control), it has been shown that this system better detects the necessary changes in the level of care, optimises time and improves the quality of the intervention.

Both projects are still in pilot phases, although “Tot en un sensor” is more advanced. Due to a lack of wifi connectivity in many homes, there were challenges to begin with, but through a dedicated desire to connect citizens with a proactive service, the challenges were overcome.

Iolanda also spoke about the growing efforts to strengthen coordination between telecare and the health system. While regular information-sharing is still evolving, promising steps have been taken in collaboration with the Department of Health of the Generalitat to identify what data would be most valuable for both sectors. Several municipalities have already piloted new protocols that define which health-related risks should be flagged directly by telecare teams, not just to social services, but to healthcare professionals as well. These early initiatives have been well received by health staff and mark an exciting move toward more integrated, person-centred care, with the potential to scale up in the near future.