RENEWING HEALTH, REgioNs of Europe WorkINg toGether for HEALTH, is a European project, partially funded under the ICT Policy Support Programme (ICT PSP) as part of the Competitiveness and Innovation Framework Programme by the European Community.
It aims at implementing large-scale real-life test beds for the validation and subsequent evaluation of innovative telemedicine services using a patient-centred approach and a common rigorous assessment methodology. It involves nine of the most advanced regions in the implementation of health-related ICT services, where service solutions are already operational at local level for the telemonitoring and the treatment of chronic patients suffering from diabetes, chronic obstructive pulmonary or cardiovascular diseases (COPD or CVD).
Although integration of the service solutions at regional level is the highest priority for the Project partners, the use of international standards and the progressive convergence towards common interoperable architectures will be equally sought to prepare and facilitate their subsequent scaling up at national and European levels.
The project is supported by the health authorities of the participating regions which have responsibility for the healthcare budget; they are fully committed to deploy the telemedicine services in their territory, once they have been validated on a large scale and their positive cost/benefit ratio has been demonstrated, and also to co-operate among themselves and with other European initiatives with similar objectives to promote the further uptake of the services at pan-European level.
The consortium includes eight regions officially endorsed by Member States for their participation in the RENEWING HEALTH. This of course paves the way for the countrywide deployment of telemedicine services derived from RENEWING HEALTH in these Member States and even beyond.
Description of the way to implement the initiative
RENEWING HEALTHÂ involves a consortium of nine of the most advanced regions in the implementation of health-related ICT services, belonging to nine different Member States or Associated Countries. In those regions the service solutions are already operational at local level for the telemonitoring and the treatment of chronic patients suffering from diabetes, chronic obstructive pulmonary or cardiovascular diseases. The services are designed to give patients a central role in the management of their own diseases, fine-tuning the choice and dosage of medications, promoting compliance to treatment, and helping healthcare professionals to detect early signs of worsening in the monitored pathologies.
These services will be scaled up, integrated with mainstream health information systems, grouped into a limited number of clusters bringing together services showing similar features, trialled and assessed with a rigorous and common assessment methodology, and using a common set of primary indicators for pilots belonging to a same cluster.
Although integration of the service solutions at regional level is the highest priority for the project partners, the use of international standards and the progressive convergence towards common interoperable architectures will be equally sought to prepare and facilitate their subsequent scaling up at national and European levels. Each cluster of pilots will operate as a multi-centre clinical trial measuring the efficiency and the cost effectiveness of the implemented solutions, giving scientific validity to the results of the trials and so promoting the adoption of remote patient monitoring and treatment on a large scale.
The evaluation of the large scale pilots in all the 9 participating regions will be carried out using as a basis the MAST assessment model (Model for Assessment of Telemedicine). The evaluation will produce a systematic and multidisciplinary assessment of the impact of the personal health systems (PHS) and integrated telemedicine services that are included in the RENEWING HEALTH pilots.
The need to keep an overall co-ordination while catering for autonomous work packages management and decentralised decision power implies a two-level management structure, which addresses the need for both consistency at project level and flexibility in the field. In this scheme, the upper level of management is responsible for the overall supervision of the project, while the lower level has the mandate to carry out the individual work packages and the activities in the countries.
The upper level of management is represented by the project Steering Committee, composed of senior representatives of the partners, by the Project Co-ordinator, by the Administrative and Financial Co-ordinator, and by the Quality Manager.
The Steering Committee gives strategic guidelines to the Project Co-ordinator and the Administrative and Financial Co-ordinator, and steers the project according to the agreed objectives. The Steering Committee will be responsible for the approval of the financial budgets. Decisions on managerial and technical issues will be made following standard procedures of circulation of agenda items, discussion and agreement at meetings. Virtual meetings through videoconferencing, tele-conferencing and e-mail will be held to improve efficiency and reduce travelling costs.
The Steering Committee will also address legal, confidentiality, security and ethical issues emerging during the lifecycle of the project. It will evaluate, and approve when appropriate, the candidature of additional regions applying to become part of the RENEWING HEALTH initiative. It will meet at the start and completion of the project and at six-monthly intervals during the project duration.
The RENEWING HEALTH consortium will also avail itself of two advisory boards representing the voice of two extremely relevant groups of stakeholders: the users and the industry. In addition to these boards, a Technical Committee will also be created with the aim to discuss technical issues which are relevant for the Project as a whole.
Main results, benefits and impacts
RENEWING HEALTH addresses clinical outcome, patient/user, economic and organisational objectives:
- Clinical objectives - RENEWING HEALTH improves the quality of life of chronic patients suffering from diabetes, chronic obstructive pulmonary or cardiovascular diseases. Quality of life of them will be improved by removing anxiety about health conditions and by reducing the need to use emergency services and hospital stays.
- Patient/user perspective objectives - RENEWING HEALTH will provide coherent clinical services through ICT that take into proper consideration patients' and professional users' needs, capabilities, risks and benefits. RENEWING HEALTH intends to implement solutions that support the empowerment of the patients and increase patients' satisfaction.
- Economic objectives - RENEWING HEALTH implements a new healthcare model that is expected to reduce the cost of chronic patients' care to society by progressively reducing the reliance of these patients on the expensive facilities geared to tackle only the acute episodes of the chronic disease they suffer from and to replace them with more affordable homecare.
- Organisational objectives - RENEWING HEALTH intends to create an organisational model for telemedicine services that ensures a safe, clear and efficient pathway for patients in their journey through the healthcare system by creating standard patients programs for each telemedicine service. The programmes will also take into account the active participation of the patients in the organisational model. The organisational model will also be transferable to other patients groups and healthcare systems.
The achievement of the four objectives described above will be monitored and documented through the use of the European evaluation model developed in the MethoTelemed study.
The evaluation of the project will include the following elements:
- A scientific trial protocol for each cluster of projects that includes, among others, a detailed description of objectives, design, methodology, outcomes, statistical considerations
- The selection/elaboration of questionnaires for collecting the opinion of the various categories of stakeholders and/or for measuring impacts which cannot be measured through the automatic analysis of collected data or relevant databases
- Training of local project teams in the use of MAST model
- A multicentre web-based clinical database for collection and analysis of data
- Evaluation of outcomes based on the MAST model and its possible adaptations, taking into account the primary outcomes agreed for each of the clusters and the secondary ones agreed for individual pilots.
The expected result of the evaluation is:
- Validation of piloted PHS and telemedicine services using the MAST model
- Validation of the MAST model itself through real life pilots
This field will be completed by the submitter when the lessons learnt have been identified and understood.Scope: International