Strengthening capacity building for digital health solutions in Member States and regions

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Strengthening capacity building for digital health solutions in Member States and regions

This session will discuss needs and opportunities for capacity building and knowledge transfer to support the scaling-up of digital health solutions for AHA. Lessons learned from twinning actions and practical experience with implementing digital solutions for integrated care will be highlighted.

Chair: Loukianos Gatzoulis, DG SANTE

Scene-setter: Veli Stroetmann, empirica

Panellists:

Jawad Hajjam, Pays De La Loire (France)

Elisio Costa, Porto4Ageing (Portugal)

Tomasz Kostka, Medical University of Lodz (Poland)

Leo Lewis, International Foundation for Integrated Care

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There exist a multitude of innovative digital health solutions for active and healthy ageing in Europe

Good examples are catalogued within the EIP on AHA following the European scaling-up strategy

The EIP on AHA is focusing on steps 4-5 to spread good practices and scale up solutions

Capacity building and knowledge transfer is key in order to enable all health and care authorities in Europe to mutually benefit from existing solutions

The focus of this session is on learning from the EC’s twinning efforts to support this capacity building, as well other EC initiatives and instruments that support digital solutions, especially in integrated care

Veli Stroetmann, empirica, Germany, ScaleAHA study Strengthening capacity building

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Pilot scheme that supports expenses incurred to facilitate the transfer of innovative practices for implementation in another region

Focus on digitally-enabled innovative ICT solutions for health and care delivery for the ageing population

Visits between two types of organisations: o Organisation adopting the innovative practice (receiving/adopter organisation)

o Organisation transferring the innovative practice (originator organisation),

Focus topics in the pilot: online health portals, ICT-supported integration of health and care services, assessment tools, adherence to care plans, homecare, telemonitoring and mHealth systems, regional/national EHR systems, etc.

The twinning scheme

Twinning as an instrument for capacity building

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Twinning overview

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The 2016 call enjoyed participation from around Europe, with particular success in attracting eight Reference Sites from Eastern Europe.

New regions should be motivated to participate through new calls in the coming years, thus increasing the impact of the EIP on AHA and contributing to the Digital Single Market (DSM) Strategy’s priority for large-scale deployment of digital solutions that can support chronic disease management.

Twinning archetypes

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A mature innovation is being adopted by

adjusting it to local conditions (e.g. translation

into local language)

Elements or aspects of the innovation

(product, service, methodology, strategy) are

being implemented using locally available

infrastructure

The innovation (product, service,

methodology, strategy) is being implemented

in its full scope by using local infrastructure

i.e. the innovation is transferred and managed

fully by the adopter

The innovation is being implemented in its full

scope by using the originator’s infrastructure

(paid for or free of charge), i.e. the originator

still has primary ownership, but a license for

use is granted to and acquired by the adopter

Description Example twinnings

Focus on knowledge (know-how) exchange

and training, a central aspect of the innovation

are the required staff skills

Gastrological approach to

malnutrition: Rotterdam - Campania

SAT Andalusian Telecare Service:

Andalusia – Kraljevo

Risk Stratification: Basque Country–

Scotland

Teleswallowing: NWCE - OBK

ALOHA: Pays de la Loire - Porto

MASK Allergy Diary: MACVIA-

France – 10 adopters:

Campania, Catalonia,

Ageing@Coimbra,

Lodz4Generations, Medical Delta,

Northern Ireland, Regione

Piemonte, Region of Southern

Denmark, GARD Turkey (National

Program on Chronic Airway

Diseases)

ADD protection: Campania –

Asturias

ADD protection: Campania -

Olomouc

STEPSelect: Northern Ireland –

Catalonia

STEPSelect: Northern Ireland –

NWCE

STEPSelect: Northern Ireland –

Olomouc

Risk Stratification: Basque Country

– Nouvelle-Aquitaine

IANUS: Galicia – Zagreb

Diraya: Andalusia – Zagreb

Telerevalidatie: Twente – Campania

Living It Up: Scotland – Basque

Country

Living It Up: Scotland – Andalusia

FrailSurvey app: Lazio – Porto

Qmci under RAPCOG: Ireland –

Porto4Aging, Campania, Catalonia

Risk Stratification: Basque Country

– Liguria

1

8

6

4

1

Number

Adaptation

Partial

adoption

Full

adoption

Acquisition

Type

Knowledge

exchange &

training,

digital skills

Lessons learnt and insights (ScaleAHA) Different twinnings require different budget & financing and timelines

More frequent calls for twinnings, focusing on current EC priorities, are required

Some twinning activities resulted in creation of new pilots and joint work on H2020 proposals - national and EU

Having a clear comprehensive twinning plan with clearly identified staff with the right expertise (e.g. business, technical, clinical depending on the topic) is a must.

Example:

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Creation of a Twinning Implementation Group between the transferring and the adopting organisations

Identificationand involvement interested actors in the adopter and originator region

Study visit: Involving actors, Agenda, Visit, documentation

Create working groups Implement possible improvements

Analysis of and potential adaptation of the innovative practice

Provide further information, organize webinars and training sessions

The Basque Country Twinning Plan

Clear vision and strong political commitment

Previous research and piloting

Addressing current healthcare needs and embedding the new

system into present healthcare policies

Public and private partnerships

New business models and innovations

21

21

28

22

19

Product development in close collaboration with the end-users

16

User experience design, user acceptance

16

Local services, integration of the new solution into

the existing environment

18

20

Faster benefit realisation of the innovative practices19

Marketing and business communication17

Funding, financial incentives and investments20

Networking and collaboration21

Success factors to scaling up innovation in AHA

Training and education of staff

Barriers and success factors

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Organisational structures related barriers

Lack of interdisciplinary communication and cooperation

Lack of interoperability and system integration

Time and effort related barriers

Financial and reimbursement problems

10

9

9

8

8

Resistance to change / Scepticism about effectiveness

8

Lack of awareness among professionals and patients

5

Technical barriers (infrastructure, connectivity)

4

Low digital literacy / Addressing the target group

9

Barriers to scaling up innovation in AHA

Important for capacity building is to document the experience of the twinning partners

The ScaleAHA report (www.scale-aha.eu) provides useful information and guidance by documenting barriers, success factors to scaling up, tools and methodologies used, etc.

Mapping scaling up tools and methodologies

ScaleAHA study recommendations

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Jawad Hajjam, Pays De La Loire (France) RS Pays De La Loire’s experience

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RS Pays De La Loire’s experience

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RS Pays De La Loire’s experience

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RS Pays De La Loire’s experience

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RS Pays De La Loire’s experience

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RS Pays De La Loire’s experience

Elísio Costa, University of Porto and Porto4ageing RS, Portugal

Transfer of innovation on allergic rhinitis and asthma multimorbidity in the elderly (MACVIA-ARIA)

Originator

France

MACVIA-France

Adopters Spain

Andalucia

Catalonia

Portugal

Coimbra Porto4ageing

Poland

Lodz The Netherlands

Medical Delta

Ireland

Northern Ireland

Czech Republic

Olomouc

France

Region Pays de Loire

Italy

Regione Piemonte

Regione Campania Denmark

Region of Southern Denmark

Turkey

Global Alliance Chronic Respiratory

Diseases Regional Network

Allergy Diary

Patient-centred that allows the assessment of rhinitis control by patients

themselves and includes a clinical decision support system.

Medications is recorded daily. Mobile phone messaging facilitates the

management of allergic rinites, providing prompts to assess disease

control, take medication, and visit a health care provider, if appropriate.

Adaptation of a successful French good practice to the Metropolitan Region of Porto and nationwide: the ALOHA initiative

The first European platform dedicated to the prevention of infection diseases in Senior citizens: ALOHA - Acting for LOngevity and Healthy Ageing

www.academia-bem-envelhecer.up.pt

This is a web portal to inform, educate and engage seniors and healthcare professionals on prevention (vaccination, nutrition, physical activity, controlled use of antibiotics) providing tools for personal and tailored recommendations, in order to empower users and enable them to make correct and good preventive choices.

www.aloha-academy.eu

www.academie-bienvieillir.fr

A community-based program to prevent or manage frailty in community-dwelling Older Adults, available on PCs and on mobile devices

FRAILSURVEY mobile phone application for self assessment of frailty

DEP - Lazio Regional Health Service (originator) has a web-based ICT tool for screening of frailty associated with a community intervention. However, as in our region we don’t have yet conditions to do a full implementation of the ICT tool and the community intervention, we decide develop a tool, using the experience of DEP - Lazio Regional Health Service Reference Site: a mobile phone app for self-assessment of frailty.

Validation of FRAILSURVEY App

FrailSurvey includes : - Sociodemographic Data - Social Resources - Self Perception - Time Occupation - Groningen Frailty Indicator

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Good Practices and Lodz4Generations Reference Site Prof. Tomasz Kostka, Medical University of Lodz, Poland

• The population of Lodz is 693 797

• 27,8 % of the Lodz’s population is over 60 (192 877 Lodz citizens aged 60+ in 2017)

• Lodz has the highest percentage of elderly citizens compared to other cities in Poland

• This will rise to 33% by 2020

• In 2035, senior citizens will form the majority of the city’s population.

Successes and challenges

Diagnosis of the situation - Demographic background

HARC FP7 Regpot (2013-2016)

SUNFRAIL, SCOPE

Lodz Region EIP AHA Reference Site 2016

EIT Health & Innostars

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Achievements

EIP AHA RS Twinning: MACVIA – ARIA

CoActive Project: 5 District Centres of Active Seniors - classes in 4 areas: lectures, physical activity, computer, culture

Reverse teaching

Managed Senior Care - new 3-year studies at the Medical University of Lodz from 2017

Social inclusion – creating inclusion areas for seniors in the revitalised Lodz

Jobs for the seniors

Senior Citizens Council – 15 members

Website with information for seniors

From vision to implementation

Courtesy of Aneta Andrzejczyk and Aleksandra Olejnik

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Beyond organisational and workforce capacity building Leo Lewis, International Foundation for Integrated Care

Social connection/discussion is 14 times more effective than the written word / best practice databases / toolkits etc.

Source of data: Nick Milton http://www.nickmilton.com/2014/10/why-knowledge-transfer-through.html

What is the best way to spread new knowledge?

Capacity building and relationships

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Patients who experience a good relationship with their health care professionals are

more likely to engage in positive behaviour

change.

Capacity building and relationships and self-management

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Real patient-centred care

provides holistic care that builds

capacity and empowerment for

self-management through patient

and caregiver engagement that

takes into account the context of

their culture, unique needs,

preferences, and values.

Capacity building, relationships, self-management and empowerment

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Collective empowerment is “a process through which individuals and communities

are able to express their needs, present their concerns, devise strategies for involvement

in decision-making, and take political, social, and cultural action to meet those needs”.

Empowerment is “a multidimensional process that helps people gain control

over their own lives and increases their capacity to act on issues that

they themselves define as important.”

Thank you!

If you would like to share your insights, please contact ScaleAHA@empirica.com

www.eiponaha.eu

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