On 30th November, RENEWING HEALTH will hold a Midterm Workshop in the prestigious venue of the European Economic and Social Committee (www.renewinghealth.eu/news/events[...]full-programme). It aims to share information about this ambitious Project which is co-funded by the European Union under the CIP ICT PSP (Information and Communication Technologies Policy Support Programme), 9 Regions of 9 Member States, and some NGOs.  It also offers the opportunity for the eHealth community to go beyond the geographical coverage of this project, and listen to other relevant experiences of deploying eHealth services such as that of Kaiser Permanente in the U.S.A.

RENEWING HEALTH is the largest project ever launched in Europe for evaluating the impact of ICT, and in particular of the so called Personal Health Systems, in the management of chronic patients in home settings. It addresses a major societal challenge in the Union, not only because chronic diseases are typical of old age, but also because their incidence and cost for society are rapidly growing in Europe and beyond.

Even if Personal Health Systems have been in use for a number of years, they have been mostly trialled on small numbers of patients, for short periods of time, and with a focus almost totally concentrated on the clinical outcomes of their use. RENEWING HEALTH uses the randomised controlled trials (RCT) methodology, with almost 8.000 patients recruited for the intervention group and 18 pilots running in parallel in 9 European regions, and a total duration just short of 4 years. It has the potential to provide, finally, the hard evidence that decision makers are waiting for to reorient investment towards ICT. (More at www.renewinghealth.eu/health-services).

RENEWING HEALTH has adopted a multidisciplinary evaluation methodology which will take into consideration much more than just the clinical outcome of the trials. The economic and organisational impact of these services will equally be assessed; this is of particular importance these days because in the current gloomy economic scenario, the economics of innovation cannot be ignored. Likewise for the quality of life of chronic patients, and for acceptance by the different categories of users: patients, relatives and other informal carers as well as healthcare professionals. 

The evaluation methodology of choice is MAST, a methodology developed under contract with the European Commission. MAST makes it possible to compare and aggregating data from different projects with similar interventions, and is attracting major interest outside the RENEWING HEALTH Consortium because of the demand so far unsatisfied for a robust methodology which increases the base of evidence in favour of the large-scale uptake of home monitoring for the sustainable management of chronic patients.

The most rigorous RCT design, widely accepted by the scientific community, has been selected for the trials in such a way that the results of the Project will be sound and unchallengeable. This ensures, among other things, that external factors such as changes in chronic disease treatments or in the organisations of the healthcare systems, which might occur during the trials, do not affect the evaluation.

The Midterm Workshop will also represent an opportunity to present some of the pilots which are underway in the context of RENEWING HEALTH. Their characteristics and differences are well representative of the variety of situations that are encountered in the European Union, and of the interest of learn more from one another and exploit the cultural richness that it encompass.

Renewing Health contact point

Dr. Lorenzo Gubian

Coordinator

REGIONE DEL VENETO, ITALY

Tel. +39 04 12 79 34 02

lgubian@gmail.com 

Marc Lange

Workshop organizer

EHTEL

Tel. +32 2 230 15 34

marc.lange@ehtel.eu 

Personal Health Systems and Telemedicine Applications with 

a Patient-centred Approach

RENEWING HeALTH aims to improve health services in Europe for the increasing number of patients suffering from chronic conditions – in particular diabetes, cardiovascular disease and chronic lung problems– by providing better evidence on telehealth services. The project will establish and continuously enhance a comprehensive, multidisciplinary and reusable evaluation methodology to strengthen the evidence-based use of telehealth-based services in Europe and world-wide. 

Nine European regions supported by their national governments have joined forces in a Pilot A project, in collaboration with competence centres and patient and industry associations. Together they implement real-life large-scale trials to validate and evaluate innovative telemedicine services with a patient centred approach, using a common rigorous assessment model. The nine regions already have a high level of maturity and are advanced in their use and implementation of Personal Health Systems (PHS) and telemedicine applications and services. 

Service Solutions and Technology enjoy commitment at the highest level from nine European Regions (endorsed by Member States) to contribute to a large scale implementation and evaluation of solutions based on Personal Health Systems for the management of Chronic Obstructive Pulmonary Disease (COPD), Diabetes and Cardiovascular diseases. The results of the project will provide valuable information for the planning and design of future healthcare delivery in Europe and provide recommendations for large-scale deployment of telemedicine solutions and for their interoperability. The project is one of the largest in this area to date. 

The service solutions in RENEWING HEALTH are based on Personal Health Systems and telemedicine services and technologies. These are designed to give patients a central role in the management of their own diseases, promote compliance to treatment, increase quality of life, and empower patients; they should also help healthcare professionals detect early signs of worsening in the monitored conditions.

The services are scaled up and include a large number of patients. Across the regions, they are grouped in a limited number of clusters that bring together services and technologies with similar features. The services are then trialled and assessed at individual and cluster level.

RENEWING HEALTH also focuses strongly on the integration of the applications with mainstream Health Information Systems to ensure sustainability and consistent working procedures.

The evaluation of the large scale pilots in all the nine participating regions will be carried out using as a basis the MAST model (Model for Assessment of Telemedicine). The evaluation will produce a systematic and multidisciplinary assessment of the impact and outcomes of the integrated telemedicine services that are included in the RENEWING HeALTH pilots. It is expected that a total of 7.900 patients will participate in the trials.

The pilots are all assessed at individual level as well as cluster level, where using a common set of primary indicators for all the pilots in a cluster allows for a cross-institution, cross-technology and cross-border evaluation of the service solution for each chronic condition. 

Evaluation of the pilots is based on a common minimum dataset which provides information on patient data, quality of life, patient perspectives on Personal Health Systems and telemedicine applications across all pilots.